2012). The death of a patient during a physical intervention in a health care environment adds an element of irony that makes the phenomenon all the more difficult to understand by people. It serves to say that a reduction in the number of restraint incidents would undoubtedly lead to a decrease in the exposure to the risk of patient death and staff injury (Duxbury 2014). An examination of patient deaths during restraint between 1979 and 2000 concluded that downwards pressure on the chest to hold a patient in likely position should be avoided (Bowers et al. 2012). It is perhaps expected that both staff and patients tend to view restraint negatively. staffs view restraint as a necessary part of their job, but one they would like to reduce …show more content…
Contrary to this background, efforts have been made to increase the active use of de-escalation interventions and to reduce forced measures in managing of patients’ aggression and violence (Kaunomäki et al. 2017). The specific strategy or strategies adopted by staff to resolve any particular incident will depend on a range of factors. One factor influencing choice of approach is the attitudes and beliefs of staff about the causes of aggression, and the most suitable ways of responding to aggressive incidents, and the Expert view globally is that the use of controlling strategies should be reduced in favour of greater employment of interpersonal approaches in the first occurrence (Pulsford et al. 2013). Staff attitudes and beliefs have been identified as one influence defining the response of mental health staff to aggressive and violent incidents, and whether staff use interpersonal or controlling methods when responding to specific incidents. (Pulsford et al. …show more content…
For patients, manual restraint can lead to feelings of anger, fear and panic, and a sense that their concerns had been overlooked prior to the incident or that their behaviour had not necessitated the use of restraint (Bowers et al. 2012). Qualitative study by Hinsby & Baker (2004) with patients and staff in a medium secure unit showed that the patients put more emphasis on external and situational causative factors for aggression than staff (Pulsford et al. 2013). studies have sought to establish the views of patients in a high secure setting regarding patient aggression (Meehan et al. 2006). Patients who took part in a focus groups believed that the reason of aggression could be found in the physical environment of the ward, boredom and the lack of meaningful activities, superior and controlling attitudes and interactions by staff, and the controlling use of medication. They also proposed that patients’ illnesses could be a factor in their responding aggressively to situations, but believed that they tried hard to control their behaviour. When considering ways of handling aggression, respondents had mixed views, recognizing that controlling strategies were appropriate in some cases where patients were attacking other patients, but also stressing the value