Self-Reported Perceptions of Patients and Staff on Participation and Verbal and Social Interactions in High-Security Forensic Psychiatric Care in Sweden.
Andreas Söderberg, Märta Wallinius, Christian Munthe and 2 others
PMID 39277822WHAT IT FOUND
Patients and staff rated participation similarly, but patients said staff verbal and social interactions happened less often than staff said.
Patients' sense of participation was linked to staff showing interest in their feelings and behaviour.
Key findings
01Patients and staff did not differ significantly in perceived patient participation, but patients rated the frequency of staff verbal and social interactions significantly lower than staff did.
02For patients, participation was most strongly linked to staff showing interest in feelings, experiences and behaviour, and was not linked to how important they rated those interactions.
03In the analysis of patients' scores, showing interest predicted higher participation, while helping patients establish structure and routines predicted lower participation; background variables did not predict participation.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The survey was done at one clinic, so findings may not apply to other forensic settings. Only 42 of 74 eligible patients and 66 of 100 staff responded, so the views of nonresponders are not represented. Patients who could not complete Swedish questionnaires and those assessed as ineligible were excluded, so more acute or language-limited patients are not represented. The regression was described as exploratory because of sample size, so its negative finding for structure and routines should be treated cautiously. No power analysis was performed, and some preregistration steps were not followed. The clinic had an overrepresentation of patients from security level 1 compared with other Swedish forensic clinics. No questionnaires were excluded even if patients may have given the same answer to every item.
Declared interests
The authors declared no conflicts of interest. The study was funded by the Swedish Research Council for Health, Working Life and Welfare.
The easy way to misread this
Do not conclude that staff should stop helping patients with routines because the patient model showed a negative association. The regression was exploratory and the study measured self-reported perceptions, so it does not show that routine support caused lower participation.