AN ATTRIBUTIONAL STUDY OF SECLUSION AND RESTRAINT OF PSYCHIATRIC PATIENTS.

Description

This study used a descriptive correlational design to examine attributions given by psychiatric patients and nurses about the restraint of the patient. A purposive sample of 84 patients and 84 nurses was used. Psychiatric patients who were restrained and the registered nurses who initiated the restraint, or who were in charge of the unit when the restraint occurred, were interviewed. Attribution theory, the study of the reasons people give for why events happen, was the theoretical framework used in this study. An Attribution Interview Schedule, as well as patient, nurse, and situational demographic sheets, were used to collect the data. The data were analyzed using frequency distributions, chi square, and correlations. The results of the data analyses indicated that all nurses and most patients did think about why the patients were restrained although they did not agree about the causes for the restraint. This finding supported the attributional tenets proposed by Jones and Nisbett (1972) who described systematic differences in the causal attributions made by observers and actors. According to them, actors tend to attribute their behavior to situational factors while observers tend to make more dispositional attributions. Nurses stated unanimously that the causes for the patients' restraint were internal to the patient. They also tended to give responses that indicated that they thought the causes were controllable and unstable. The patients gave more varied responses. Nurse, patient, and situational variables were not related significantly to the causes given for the patients' restraint. However, there was a relationship between patients' previous admissions to a psychiatric hospital and the controllability dimension. There was a significant finding between the nurse's past experience of being verbally or physically assaulted by a patient and the controllability dimension. This finding indicated that the more often the nurse had been assaulted, the more the nurse stated that the cause of the assault was due to uncontrollable factors in the patient.

Subjects