Nurses' attitudes to the use of seclusion: A review of the literature

International Journal of Mental Health Nursing

Volumn 19, Issue 3, 2010, Pages 162-168

  Happell, Brenda ^a   Harrow, Alison ^b  

^a Institute for Health and Social Science Research   (Australia)

^b CENTRAL QUEENSLAND UNIVERSITY   (Australia)

Author keywords

Attitudes; Coercion; Nurses; Seclusion; Workplace culture

Indexed keywords

ARTICLE; CONFLICT; ETHICS; EXERCISE; HEALTH PERSONNEL ATTITUDE; HUMAN; MENTAL DISEASE; NURSE PATIENT RELATIONSHIP; NURSING; NURSING METHODOLOGY RESEARCH; ORGANIZATION; ORGANIZATION AND MANAGEMENT; PATIENT CARE; PATIENT SELECTION; PERSONNEL MANAGEMENT; PSYCHIATRIC NURSING; PSYCHOLOGICAL ASPECT; VIOLENCE; WORKPLACE; PREVENTION AND CONTROL; PSYCHOLOGY;

ATTITUDE OF HEALTH PERSONNEL; CONFLICT (PSYCHOLOGY); HUMANS; MENTAL DISORDERS; NURSE-PATIENT RELATIONS; NURSING METHODOLOGY RESEARCH; ORGANIZATIONAL CULTURE; PATIENT ISOLATION; PATIENT SELECTION; PERSONNEL STAFFING AND SCHEDULING; PSYCHIATRIC NURSING; RESTRAINT, PHYSICAL; VIOLENCE; WORKPLACE;

EID: 77953748787     PISSN: 14458330     EISSN: 14470349     Source Type: Journal    
DOI: 10.1111/j.1447-0349.2010.00669.x     Document Type: Article

References (51)

1. Abma T A, Widdershoven G A M. Moral deliberation in psychiatric nursing practice. Nursing Ethics 2006, 13(5):546-557.
2. Alty A. Nurses' learning experience and expressed opinions regarding seclusion practice within one NHS trust. Journal of Advanced Nursing 1997, 25(4):786-793.
3. Amos P A. New considerations in the prevention of aversives, restraint, and seclusion: Incorporating the role of relationships into an ecological perspective. Research and Practice for Persons with Severe Disabilities 2004, 29(4):263-272.
4. Nursing and midwifery labour force 2005. Canberra: AIHW. 2008, http://www.aihw.gov.au/publications/hwl/nmlf05/nmlf05.pdf, Australian Institute of Health and Welfare (AIHW), Cited 24 Dec 2009]. Available from: URL:
5. Bigwood S, Crowe M. 'It's part of the job, but it spoils the job': A phenomenolgical study of physical restraint. International Journal of Mental Health Nursing 2008, 17:215-222.
6. Bonner G, Lowe T, Rawcliffe D, Wellman N. Trauma for all: A pilot study of the subjective experience of physical restraint for mental health inpatients and staff in the UK. Journal of Psychiatric and Mental Health Nursing 2002, 9(4):465-473.
7. Bowers L, Brennan G, Flood C, Lipang M, Oladapo P. Preliminary outcomes of a trial to reduce conflict and containment on acute psychiatric wards: City nurses. Journal of Psychiatric & Mental Health Nursing 2006, 13:165-172.
8. Bowers L, Alexander J, Simpson A, Ryan C, Carr-Walker P. Student psychiatric nurses' approval of containment measures: Relationship to perception of aggression and attitudes to personality disorder. International Journal of Nursing Studies 2007, 44:349-356.
9. Champagne T, Stromberg N. Sensory approaches in inpatient psychiatric settings: Innovative alternatives to seclusion & restraint. Journal of Psychosocial Nursing and Mental Health Services 2004, 42(9):34-44.
10. Chandler D, Nelson T, Hughes C I. Performance improvement through monitoring seclusion and restraint practices. Administration and Policy in Mental Health 1998, 25(5):525-539.
11. National safety priorities in mental health - A national plan for reducing harm. 2005, http://www.health.gov.au/internet/main/Publishing.nsf/Content/mental-pubs-n-safety, Commonwealth of Australia, Cited 24 Dec 2009]. Available from: URL:
12. Donat D C. Impact of improved staffing on seclusion/restraint reliance in public psychiatric hospital. Psychiatric Rehabilitation Journal 2002, 24(4):413-416.
13. Donat D C. Encouraging alternatives to seclusion, restraint, and reliance on PRN drugs in a public psychiatric hospital. Psychiatric Services 2005, 56(9):1105-1108.
14. van Doeselaar M, Sleegers P, Hutschemaekers G. Professionals' attitudes towards reducing restraint: The case of seclusion in the Netherlands. Psychiatric Quarterly 2008, 79:97-109.
15. Duxbury J. An evaluation of staff and patient views of and strategies employed to manage inpatient aggression and violence on one mental health unit: A pluralistic design. Journal of Psychiatric and Mental Health Nursing 2002, 9(3):325-337.
16. El-Badri S M, Mellsop G. A study of the use of seclusion in an acute psychiatric service. Australian and New Zealand Journal of Psychiatry 2002, 36(3):399-403.
17. El-Badri S M, Mellsop G. Patient and staff perspectives on the use of seclusion. Australasian Psychiatry 2008, 16(4):248-252.
18. Fisher W A. Restraint and seclusion: A review of the literature. American Journal of Psychiatry 1994, 151(11):1584-1591.
19. Forster P L, Cavness C, Phelps M A. Staff training decreases use of seclusion and restraint in an acute psychiatric hospital. Archives of Psychiatric Nursing 1999, 13:269-271.
20. Freuh B C, Knapp R G, Cusack K J. Patients' reports of traumatic or harmful experiences within the psychiatric setting. Psychiatric Services 2005, 56(9):1123-1133.
21. Gaskin C J, Elsom S J, Happell B. Intervention for reducing the use of seclusion in psychiatric facilities. British Journal of Psychiatry 2007, 191:298-303.
22. Hoekstra T, Lendemeijer H H G M, Jansen M G M J. Seclusion: The inside story. Journal of Psychiatric and Mental Health Nursing 2004, 11(3):276-283.
23. Holzworth R J, Wills C E. Nurses' judgments regarding seclusion and restraint of psychiatric patients: A social judgment analysis. Research in Nursing and Health 1999, 22(3):189-201.
24. Janssen W, Noorthoorn E, van Linge R, Lendemeijer B. The influence of staffing levels on the use of seclusion. International Journal of Law and Psychiatry 2007, 30:118-126.
25. Kaltiala-Heino R, Tuohimaki C, Korkeila J, Lehtinen V. Reasons for using seclusion and restraint in psychiatric inpatient care. International Journal of Law and Psychiatry 2003, 26(2):139-149.
26. Lee S, Gray R, Gournay K, Wright S, Parr A M, Sayer J. Views of nursing staff on the use of physical restraint. Journal of Psychiatric and Mental Health Nursing 2003, 10(4):425-430.
27. Lind M, Kaltiala-Heino R, Suominen T, Leino-Kilpi H, Valimaki M. Nurses' ethical perceptions about coercion. Journal of Psychiatric and Mental Health Nursing 2004, 11(4):379-385.
28. Mason T. An ethnomethodological analysis of the use of seclusion. Journal of Advanced Nursing 1997, 26:780-789.
29. Meehan T, Bergen H, Fjeldsoe K. Staff and patient perceptions of seclusion: Has anything changed? Journal of Advanced Nursing 2004, 47:33-38.
30. Morral P, Muir-Cochrane E. Naked social control: Seclusion and psychiatric nursing in post-liberal society. Australian E-Journal for the Advancement of Mental Health 2002, 1(2). http://auseinet.flinders.edu.au/journal/, Cited 24 Dec 2009]. Available from: URL:
31. Morrison P, Lehane M. Staffing levels and seclusion use. Journal of Advanced Nursing 1995, 22:1193-1202.
32. Morrison P, Lehane M. A study of the official records of seclusion. International Journal of Nursing Studies 1996, 33(2):223-235.
33. Muir-Cochrane E. An exploration of ethical issues associated with the use of seclusion in psychiatric patients. Collegian 1995, 2(3):14-20.
34. Muir-Cochrane E. An investigation into nurses' perceptions of secluding patients on closed psychiatric wards. Journal of Advanced Nursing 1996, 23(3):555-563.
35. Muir-Cochrane E, Bowers L, Jeffery D. Comparison in attitudes between nursing and other students in relation to containment measures for disturbed psychiatric patients. Nurse Education Today 2009, 29:83-90.
36. Muir-Cochrane E, Holmes C A. Legal and ethical aspects of seclusion: An Australian perspective. Journal of Psychiatric and Mental Health Nursing 2001, 8(6):501-506.
37. Nelstrop L, Chandler-Oatts J, Bletman T. A systematic review of the safety and effectiveness of restraint and seclusion as interventions for the short-term management of violence in adult psychiatric inpatient settings and emergency departments. Worldviews on Evidence-Based Nursing 2006, 3(1):8-18.
38. Oberleitner L L. Aversiveness of traditional psychiatric patient restriction. Archives of Psychiatric Nursing 2000, 14(2):93-97.
39. Pollard R A, Yanasak E V, Rogers S A, Tapp A. Organizational and unit factors contributing to reduction in the use of seclusion and restraint procedures on an acute psychiatric inpatient unit. Psychiatric Quarterly 2007, 78:73-81.
40. Mental Health Act 2000. 2000, http://www.legislation.qld.gov.au/LEGISLTN/CURRENT/M/MentalHealA00.pdf, Queensland Government, Cited 24 Dec 2009]. Available from: URL:
41. The Reduction and Where Possible Elimination of Restraint and Seclusion 2007, Queensland Mental Health Services, Brisbane, Queensland Government Printing Service
42. Sailas E, Fenton M. Seclusion and restraint for people with serious mental illness. 2000, Publication no. 10.1002/14651858
43. Sequeira H, Halstead S. Restraint and seclusion: Service user views. Journal of Adult Protection 2002, 4(1):15-24.
44. Sequeira H, Halstead S. The psychological effects on nursing staff of administering physical restraint in a secure psychiatric hospital: 'When I go home, it's then that I think about it. British Journal of Forensic Practice 2004, 6(1):3-15.
45. Smith G M, Davis R H, Bixler E O. Pennsylvania State Hospital system's seclusion and restraint reduction program. Psychiatric Services 2005, 56:1115-1122.
46. Sullivan A M, Bezmen J, Barron C T, Rivera J, Curley-Casey L, Marino D. Reducing restraints: Alternatives to restraints on an inpatient psychiatric service - Utilizing safe and effective methods to evaluate and treat the violent patient. Psychiatric Quarterly 2005, 76:51-65.
47. Terpstra T L, Pettee E J, Hunter M. Nursing staff's attitudes toward seclusion and restraint. Journal of Psychosocial Nursing and Mental Health Services 2001, 39(5):20-28.
48. Tunde-Ayinmode M, Little J. Use of seclusion in a psychiatric acute inpatient unit. Australasian Psychiatry 2004, 12(4):347-351.
49. Wright S. Physical restraint in the management of violence and aggression in in-patient settings: A review of issues. Journal of Mental Health 1999, 8(5):459-472.
50. Wynaden D, Orb A, McGowan S. The use of seclusion in the year 2000: What has changed? Collegian 2001, 8(3):19-25.
51. Wynaden D, Chapman R, McGowan S, Holmes C, Ash P, Boschman A. Through the eye of the beholder: To seclude or not to seclude. International Journal of Mental Health Nursing 2002, 11(4):260-268.