The meanings of place and space in forensic psychiatric care - A qualitative study reflecting patients' point of view

Int J Ment Health Nurs. 2019 Apr;28(2):516-526. doi: 10.1111/inm.12557. Epub 2018 Dec 7.

Abstract

The outcome of care for patients sentenced to forensic psychiatric care is of importance not only for the patient but also for society, in preventing new crimes. In recent years, a person-centered perspective is influencing the care, recognizing the design of the physical environment as a therapeutic resource. To capture the complexity of patients' experience of the physical environment, a qualitative approach is needed. The aim of this study was to investigate the meanings of the patient room as a place and space in forensic psychiatric in-patient care from the patients' perspective. An explorative qualitative design was chosen, data were collected by photovoice; a combination of photographs, taken by the patients, followed by interviews. Eleven (N = 11) patients were interviewed. The interviews were analysed by a thematic analysis method. Four themes emerged from the data revealing the meanings of the patient room as a place and space: (i) striving towards normality; (ii) being anchored and protected; (iii) being at-home and homeness; and (iv) being in communion and meaningfulness. The findings show that the physical environment has a say in patients' basic needs and a role in maintaining normality. Substandard reveals a lack of respect and dignity towards this patient group. Involving patients in the design process of new facilities can be a way to make progress.

Keywords: forensic psychiatric nursing; health facility; patient room; photovoice; physical environment; qualitative study.

MeSH terms

  • Adolescent
  • Adult
  • Built Environment
  • Crime
  • Female
  • Forensic Psychiatry / methods*
  • Hospitals, Psychiatric*
  • Humans
  • Interviews as Topic
  • Male
  • Mental Disorders / psychology
  • Mental Disorders / therapy*
  • Middle Aged
  • Qualitative Research
  • Young Adult