title: Detached concern of forensic mental health nurses in therapeutic relationships with patients the application of the early recognition method related to detached concern.
abstract: OBJECTIVE
  Improvement of the interaction between forensic mental health nurses and patients may lead to a reduction of inpatient violence. The concept under study is detached concern, which refers to nurses' skills to neutralize the emotional appeal of patients by a balanced attitude between objectivity and emotional involvement. The Patient Contact Questionnaire (PCQ) aims at measuring the degree of concern of nurses for their patients.
  
  
  METHODS
  The PCQ was applied in a pretest-posttest design, evaluating the effects of the Early Recognition Method (ERM). This method aims at the prevention of inpatient violence in forensic psychiatry. Subjects were 116 forensic mental heath nurses working on 16 wards of a large Dutch forensic hospital. First, the baseline scores were compared to scores reported in an earlier study conducted in general psychiatry. Second, pretest-posttest comparisons were carried out for all nurses, and for subgroups of nurses with regard to gender, educational level, years of working experience, and patient population. Third, pretest-posttest comparisons were made on the PCQ item level.
  
  
  RESULTS
  The baseline scores of male nurses indicated significantly higher levels of concern than those of female nurses. In addition, more experienced nurses scored significantly higher with regard to concern than less experienced nurses. When comparing the scores before and after applying ERM, no significant differences were found. However, the sores of female nurses showed a tendency toward more concern after implementation of ERM.
  
  
  CONCLUSIONS
  Detached concern may be a meaningful concept in forensic mental health nursing in measuring nurses' concern for their patients. Levels of detached concern did not change significantly after application of ERM. However, the application of the PCQ could contribute to a better understanding of the interaction between nurses and their patients.
authors.affiliation: Department of Nursing Science, Utrecht University, The Netherlands. faj.fluttert@gmail.com
authors.forename: Frans
authors.initials: F
authors.lastname: Fluttert
authors.forename: Berno
authors.initials: B
authors.lastname: van Meijel
authors.forename: Henk
authors.initials: H
authors.lastname: Nijman
authors.forename: Stål
authors.initials: S
authors.lastname: Bjørkly
authors.forename: Mieke
authors.initials: M
authors.lastname: Grypdonck
mesh_terms: D004645:Empathy; D005260:Female; D005555:Forensic Psychiatry; D006778:Hospitals, Psychiatric; D006801:Humans; D007297:Inpatients / Q000523:psychology; D008297:Male; D001523:Mental Disorders / Q000451:nursing / Q000523:psychology; D009723:Nurse-Patient Relations; D011568:Psychiatric Nursing; D012737:Sex Factors; D011795:Surveys and Questionnaires; D014754:Violence / Q000523:psychology