Detached Concern of Forensic Mental Health Nurses in Therapeutic Relationships With Patients: The Application of the Early Recognition Method Related to Detached Concern
published online 13 November 2009.
Objective
Improvement of the interaction between forensic mental health nurses and patients may lead to a reduction of inpatient violence. The concept under study is detached concern, which refers to nurses' skills to neutralize the emotional appeal of patients by a balanced attitude between objectivity and emotional involvement. The Patient Contact Questionnaire (PCQ) aims at measuring the degree of concern of nurses for their patients.
Methods
The PCQ was applied in a pretest–posttest design, evaluating the effects of the Early Recognition Method (ERM). This method aims at the prevention of inpatient violence in forensic psychiatry. Subjects were 116 forensic mental heath nurses working on 16 wards of a large Dutch forensic hospital. First, the baseline scores were compared to scores reported in an earlier study conducted in general psychiatry. Second, pretest–posttest comparisons were carried out for all nurses, and for subgroups of nurses with regard to gender, educational level, years of working experience, and patient population. Third, pretest–posttest comparisons were made on the PCQ item level.
Results
The baseline scores of male nurses indicated significantly higher levels of concern than those of female nurses. In addition, more experienced nurses scored significantly higher with regard to concern than less experienced nurses. When comparing the scores before and after applying ERM, no significant differences were found. However, the sores of female nurses showed a tendency toward more concern after implementation of ERM.
Conclusions
Detached concern may be a meaningful concept in forensic mental health nursing in measuring nurses' concern for their patients. Levels of detached concern did not change significantly after application of ERM. However, the application of the PCQ could contribute to a better understanding of the interaction between nurses and their patients.
Department of Nursing Science, Utrecht University, Utrecht, The Netherlands
FPC Dr. S. Van Mesdag/Forint, Groningen, The Netherlands
Applied Sciences Department: Research Group Mental Health Nursing, InHolland University, Alkmaar, The Netherlands
Academic Centre for Social Science, Radboud University, Nijmegen, The Netherlands
Division of Ortho- and Forensic Psychiatry, Altrecht, Mental Health Institute, Den Dolder, The Netherlands
Molde University College, Molde, Norway
Centre for Research and Education in Forensic Psychiatry, Ullevål University Hospital, Oslo, Norway
Ghent University, Ghent, Belgium.
Corresponding Author: Frans Fluttert, MSc, Rn, Department of Nursing Science, Utrecht University, Utrecht, The Netherlands.
ABSTRACT