Zwischen Kontrolle und Therapie: Eine evolutionäre Konzeptanalyse von Intensivbetreuung in der stationären Akutpsychiatrie

Zusammenfassung

Einleitung: Aufgrund des schwerwiegenden Eingriffs in die Privatsphäre und einer hohen Ressourcen- und Kostenintensität ist eine wissenschaftliche Konzeptualisierung von Intensivbetreuung gefordert für Forschung und Praxis.

Methode: Evolutionäre Konzeptanalyse.

Ergebnisse: Die Vorbedingungen, Eigenschaften und Konsequenzen des Konzepts der Intensivbetreuung lassen sich in insgesamt 8 Kategorien einteilen. Sie bewegen sich in einem Spannungsfeld von Kontrolle und Therapie sowie Sicherheit der Betroffenen und Absicherung der Professionellen.

Schlussfolgerung: Die Ergebnisse erlauben Intensivbetreuung von anderen Überwachungsmaßnahmen zu unterscheiden, gezielt zu erforschen und weiterzuentwickeln.

Abstract

Objective: Special observation is a seriously invasive and resource intensive intervention. It is necessary to scientifically conceptualise this measure for further investigations and practice.

Methods: Evolutionary concept analysis.

Results: The identified antecedents, attributes and consequences of special observation range between control and therapy as well as the safety of patients and the coverage of the professionals. Antecedents comprise of legitimisation (indication, assessment, prescription), resources (internal guidelines, architectural structures, information) as well as context factors (security needs, personal attitudes). The identified attitudes are organisation (qualification, shifting carers, length, place), intervention (relationship, re-assessment, transparency) as well as the field of tension between control and therapy. The consequences consist of side effects (patients, nurses, resources) and conflicts (ethical dilemmas, role conflicts).

Conclusion: Society and discipline have influenced the concept over time and a distinction between the custodial and controlling pattern versus a therapeutic approach is recommended.

Schlüsselwörter

Intensivbetreuung - Akutpsychiatrie - stationär - Konzeptanalyse

Keywords

special observation - acute psychiatry - inpatient - concept analysis

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