The significance of ethics reflection groups in mental health care: A focus group study among health care professionals

Marit Helene Hem, Bert Molewijk, Elisabeth Gjerberg, Lillian Lillemoen, Reidar Pedersen

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

Background: Professionals within the mental health services face many ethical dilemmas and challenging situations regarding the use of coercion. The purpose of this study was to evaluate the significance of participating in systematic ethics reflection groups focusing on ethical challenges related to coercion. Methods: In 2013 and 2014, 20 focus group interviews with 127 participants were conducted. The interviews were tape recorded and transcribed verbatim. The analysis is inspired by the concept of 'bricolage' which means our approach was inductive. Results: Most participants report positive experiences with participating in ethics reflection groups: A systematic and well-structured approach to discuss ethical challenges, increased consciousness of formal and informal coercion, a possibility to challenge problematic concepts, attitudes and practices, improved professional competence and confidence, greater trust within the team, more constructive disagreement and room for internal critique, less judgmental reactions and more reasoned approaches, and identification of potential for improvement and alternative courses of action. On several wards, the participation of psychiatrists and psychologists in the reflection groups was missing. The impact of the perceived lack of safety in reflection groups should not be underestimated. Sometimes the method for ethics reflection was utilised in a rigid way. Direct involvement of patients and family was missing. Conclusion: This focus group study indicates the potential of ethics reflection groups to create a moral space in the workplace that promotes critical, reflective and collaborative moral deliberations. Future research, with other designs and methodologies, is needed to further investigate the impact of ethics reflection groups on improving health care practices.
Original languageEnglish
Article number54
JournalBMC Medical Ethics
Volume19
Issue number1
DOIs
Publication statusPublished - 2018

Cite this

Hem, Marit Helene ; Molewijk, Bert ; Gjerberg, Elisabeth ; Lillemoen, Lillian ; Pedersen, Reidar. / The significance of ethics reflection groups in mental health care: A focus group study among health care professionals. In: BMC Medical Ethics. 2018 ; Vol. 19, No. 1.
@article{98692e49df46490ebf4c558f36a6111b,
title = "The significance of ethics reflection groups in mental health care: A focus group study among health care professionals",
abstract = "Background: Professionals within the mental health services face many ethical dilemmas and challenging situations regarding the use of coercion. The purpose of this study was to evaluate the significance of participating in systematic ethics reflection groups focusing on ethical challenges related to coercion. Methods: In 2013 and 2014, 20 focus group interviews with 127 participants were conducted. The interviews were tape recorded and transcribed verbatim. The analysis is inspired by the concept of 'bricolage' which means our approach was inductive. Results: Most participants report positive experiences with participating in ethics reflection groups: A systematic and well-structured approach to discuss ethical challenges, increased consciousness of formal and informal coercion, a possibility to challenge problematic concepts, attitudes and practices, improved professional competence and confidence, greater trust within the team, more constructive disagreement and room for internal critique, less judgmental reactions and more reasoned approaches, and identification of potential for improvement and alternative courses of action. On several wards, the participation of psychiatrists and psychologists in the reflection groups was missing. The impact of the perceived lack of safety in reflection groups should not be underestimated. Sometimes the method for ethics reflection was utilised in a rigid way. Direct involvement of patients and family was missing. Conclusion: This focus group study indicates the potential of ethics reflection groups to create a moral space in the workplace that promotes critical, reflective and collaborative moral deliberations. Future research, with other designs and methodologies, is needed to further investigate the impact of ethics reflection groups on improving health care practices.",
author = "Hem, {Marit Helene} and Bert Molewijk and Elisabeth Gjerberg and Lillian Lillemoen and Reidar Pedersen",
year = "2018",
doi = "10.1186/s12910-018-0297-y",
language = "English",
volume = "19",
journal = "BMC Medical Ethics",
issn = "1472-6939",
publisher = "BioMed Central",
number = "1",

}

The significance of ethics reflection groups in mental health care: A focus group study among health care professionals. / Hem, Marit Helene; Molewijk, Bert; Gjerberg, Elisabeth; Lillemoen, Lillian; Pedersen, Reidar.

In: BMC Medical Ethics, Vol. 19, No. 1, 54, 2018.

Research output: Contribution to journalArticleAcademicpeer-review

TY - JOUR

T1 - The significance of ethics reflection groups in mental health care: A focus group study among health care professionals

AU - Hem, Marit Helene

AU - Molewijk, Bert

AU - Gjerberg, Elisabeth

AU - Lillemoen, Lillian

AU - Pedersen, Reidar

PY - 2018

Y1 - 2018

N2 - Background: Professionals within the mental health services face many ethical dilemmas and challenging situations regarding the use of coercion. The purpose of this study was to evaluate the significance of participating in systematic ethics reflection groups focusing on ethical challenges related to coercion. Methods: In 2013 and 2014, 20 focus group interviews with 127 participants were conducted. The interviews were tape recorded and transcribed verbatim. The analysis is inspired by the concept of 'bricolage' which means our approach was inductive. Results: Most participants report positive experiences with participating in ethics reflection groups: A systematic and well-structured approach to discuss ethical challenges, increased consciousness of formal and informal coercion, a possibility to challenge problematic concepts, attitudes and practices, improved professional competence and confidence, greater trust within the team, more constructive disagreement and room for internal critique, less judgmental reactions and more reasoned approaches, and identification of potential for improvement and alternative courses of action. On several wards, the participation of psychiatrists and psychologists in the reflection groups was missing. The impact of the perceived lack of safety in reflection groups should not be underestimated. Sometimes the method for ethics reflection was utilised in a rigid way. Direct involvement of patients and family was missing. Conclusion: This focus group study indicates the potential of ethics reflection groups to create a moral space in the workplace that promotes critical, reflective and collaborative moral deliberations. Future research, with other designs and methodologies, is needed to further investigate the impact of ethics reflection groups on improving health care practices.

AB - Background: Professionals within the mental health services face many ethical dilemmas and challenging situations regarding the use of coercion. The purpose of this study was to evaluate the significance of participating in systematic ethics reflection groups focusing on ethical challenges related to coercion. Methods: In 2013 and 2014, 20 focus group interviews with 127 participants were conducted. The interviews were tape recorded and transcribed verbatim. The analysis is inspired by the concept of 'bricolage' which means our approach was inductive. Results: Most participants report positive experiences with participating in ethics reflection groups: A systematic and well-structured approach to discuss ethical challenges, increased consciousness of formal and informal coercion, a possibility to challenge problematic concepts, attitudes and practices, improved professional competence and confidence, greater trust within the team, more constructive disagreement and room for internal critique, less judgmental reactions and more reasoned approaches, and identification of potential for improvement and alternative courses of action. On several wards, the participation of psychiatrists and psychologists in the reflection groups was missing. The impact of the perceived lack of safety in reflection groups should not be underestimated. Sometimes the method for ethics reflection was utilised in a rigid way. Direct involvement of patients and family was missing. Conclusion: This focus group study indicates the potential of ethics reflection groups to create a moral space in the workplace that promotes critical, reflective and collaborative moral deliberations. Future research, with other designs and methodologies, is needed to further investigate the impact of ethics reflection groups on improving health care practices.

UR - https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85048079755&origin=inward

UR - https://www.ncbi.nlm.nih.gov/pubmed/29871682

U2 - 10.1186/s12910-018-0297-y

DO - 10.1186/s12910-018-0297-y

M3 - Article

VL - 19

JO - BMC Medical Ethics

JF - BMC Medical Ethics

SN - 1472-6939

IS - 1

M1 - 54

ER -