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Using participatory action research to develop a work model that enhances psychiatric nurses' professionalism: the architecture of stability
University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science. (KAOS)ORCID iD: 0000-0002-2610-8998
2017 (English)In: Administration and Policy in Mental Health, ISSN 0894-587X, E-ISSN 1573-3289, Vol. 44, no 6, 888-903 p.Article in journal (Refereed) Published
Abstract [en]

Ward rules in psychiatric care aim to promote safety for both patients and staff. Simultaneously, ward rules are associated with increased patient violence, leading to neither a safe work environment nor a safe caring environment. Although ward rules are routinely used, few studies have explicitly accounted for their impact. To describe the process of a team development project considering ward rule issues, and to develop a working model to empower staff in their daily in-patient psychiatric nursing practices. The design of this study is explorative and descriptive. Participatory action research methodology was applied to understand ward rules. Data consists of audiorecorded group discussions, observations and field notes, together creating a data set of 556 text pages. More than 100 specific ward rules were identified. In this process, the word rules was relinquished in favor of adopting the term principles, since rules are inconsistent with a caring ideology. A linguistic transition led to the development of a framework embracing the (1) Principle of Safety, (2) Principle of Structure and (3) Principle of Interplay. The principles were linked to normative guidelines and applied ethical theories: deontology, consequentialism and ethics of care. The work model reminded staff about the principles, empowered their professional decision-making, decreased collegial conflicts because of increased acceptance for individual decisions, and, in general, improved well-being at work. Furthermore, the work model also empowered staff to find support for their decisions based on principles that are grounded in the ethics of totality.

Place, publisher, year, edition, pages
2017. Vol. 44, no 6, 888-903 p.
Keyword [en]
Action research, Ethics, Nursing, Mental health nursing, Psychiatric ward, Ward rules
National Category
Nursing
Identifiers
URN: urn:nbn:se:hig:diva-24100DOI: 10.1007/s10488-017-0806-1PubMedID: 28523437Scopus ID: 2-s2.0-85019608957OAI: oai:DiVA.org:hig-24100DiVA: diva2:1107199
Available from: 2017-06-09 Created: 2017-06-09 Last updated: 2017-10-18Bibliographically approved

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CiteExportLink to record
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