[Case Study: Development of Symbolical Alternatives to Physical Restraint in Jeopardizing Situations - PART IV: "Simulation and Reduction of Coercive Measures in Psychiatry"]

Psychiatr Prax. 2019 Mar;46(S 01):S38-S49. doi: 10.1055/a-0785-6617. Epub 2019 Feb 11.
[Article in German]


In all 38 female and male nurses have developed an alternative to physical coercive measures in jeopardizing situations, so-called "Auxiliary-Ego Strategy" (AES). In arrangement with the managers of clinical health services the nurses prepared AES for practice in psychiatric wards. There are feasible support and empirical interpretation by means of observed communication profiles in the phases of a simple heuristic dynamic model. In this case study communication behaviour in coercive measure (physical restraint) show different patterns in comparison with alternatives (AES) in the course of time. Accordingly to AES the ethno theory of nurses is characterized by the following features: different forms of AES, effective factors, conditions of inpatients, situations and teams. Subjects of focus groups were: description of standard coercion measure; 2. development of a simple time-phase model; 3. development of an alternative strategy; 4. psychodramatic simulation of the developed strategy; 5. estimation of plausibility accordingly to the effective factors and conditions.

Insgesamt 38 Krankenpflegerinnen und Krankenpfleger haben mithilfe von Videoaufzeichnungen von psychiatrischen Gefährdungssituationen eine Zwang vermeidende Alternative, die sogenannte „Hilfs-Ich-Strategie“ (HIS) entwickelt. In dieser Fallstudie zeigen sich im empirischen Vergleich zwischen Zwangsanwendung (Fixierung) und Alternativstrategie (HIS) signifikante Differenzen in den Kommunikationsprofilen. Die zugehörige Ethnotheorie der Krankenpflegenden zu HIS enthält folgende Merkmale: Formen des HIS, Wirkfaktoren, Patienten-, Situations- und Teamvoraussetzungen.

Publication types

  • Case Reports

MeSH terms

  • Coercion*
  • Female
  • Germany
  • Hospitals, Psychiatric
  • Humans
  • Male
  • Mental Disorders*
  • Psychiatric Nursing*
  • Psychiatry
  • Restraint, Physical