Perspectives and Experiences of People Receiving Care on a De-escalation Intervention to Reduce Restrictive Practices in Acute Mental Health Units.
Esario Iv Daguman, Dane Owen, Jacqui Yoxall and 2 others
PMID 42370744WHAT IT FOUND
Standardised measures of empowerment, dehumanisation and staff actions showed no significant change after implementing a nurse-led de-escalation framework.
Patients described how clear communication, gentle care and meaningful activities supported safety, while coercion and system strain harmed recovery.
Key findings
01There were no statistically significant differences across time points for Empowerment, Dehumanization, or the Staff Action sub-scales.
02Participants consistently depicted how uncertainty or inconsistent information regarding medications and unit procedures heightened their sense of fear, resistance, and emotional distress.
03Participants specifically narrated how some nurses, cleaners, and health security assistants, who treated them as individuals, helped restore their dignity, eased their loneliness, and created micro-moments of healing.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
Survey and interview sample sizes were smaller than planned, with interviews representing only two of the three sites. The study lacked randomisation and a control group, limiting causal inference. The standardised measures used may not have been sensitive enough to detect changes in the specific context of the intervention. The qualitative findings are based on a small number of interviews, though supported by survey commentaries.
Declared interests
The research was supported by Southern Cross University and the Translational Research Grant Scheme from the NSW Office for Health and Medical Research. The authors declared no other conflicts of interest.
The easy way to misread this
Do not conclude that the Safe Steps intervention failed to improve care based solely on the null quantitative results. The authors suggest the measures may not have been sensitive to the specific changes, and qualitative data indicated patients valued the relational aspects of care that the intervention aimed to support.