Sjuksköterskors erfarenheter av att utföra tvångsåtgärder : En kvalitativ litteraturöversikt

Sammanfattning

Background: Coercive measures in psychiatric inpatient care are legally regulated and aim to protect patients and others, but simultaneously limit patient autonomy. Nurses face ethical dilemmas when balancing respectful care with the implementation of coercive measures, which can cause emotional burden. Patients’ experiences may be negative or, in some cases, perceived as protective, depending on communication and relationships with nurses. There is a need to synthesize nurses’ experiences of coercive measures to deepen understanding of their perspectives when performing these interventions. Aim: The study aimed to describe nurses experiences of implementing coercive measures. Method: Descriptive design with a qualitative literature review. Systematic searches were conducted in PubMed and CINAHL, focusing on qualitative studies of nurses experiences with coercive measures. Included articles were quality-assessed and analysed inductively through meaning units, codes, and categories. Results: Findings are presented in the categories: ethical dilemmas and moral distress, emotional and psychological impact, patient involvement and the importance of the nurse-patient relationship in coercive measures, and the importance of support. Nurses experienced conflicts between safety and respect for autonomy, emotional burden when performing coercion, and to justify their actions. Relationship, communication, and participation were central to reducing trauma and preserving patient dignity. Peer support, reflection, and organizational structures facilitated handling ethical challenges. Conclusion: Nurses experiences of coercive measures are shaped by complex ethical, emotional, and professional challenges. Care needs to be planned and delivered with a focus on relationships, respect, communication, and patient involvement to preserve dignity, reduce suffering, and support patients and nurses in these situations.