The Impact of Coercive Measures on the Therapeutic Relationship Between Patients and Nurses in the Acute Psychiatric Care. An Integrative Review.

All included studies were qualitative, so the review describes experiences rather than measuring how often the relationship improves or worsens. Some studies used the term restraint without specifying seclusion, physical, mechanical or chemical restraint, so it is hard to link effects to a particular measure. The review did not include grey literature or non-English and non-German publications, so other accounts may be missing. Patients were not involved in designing or appraising the evidence, and the review did not use participatory methods. The therapeutic relationship was assessed subjectively, so interpretations may vary across studies.

Do not conclude that coercive measures are therapeutic because some nurses reported strengthened relationships. Those reports came only from nurses, and patients described fear, withdrawal and distrust.