title: [Between control and therapy: an evolutionary concept analysis of special observation in acute psychiatric wards].
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).
  
  
  CONCLUSIONS
  Society and discipline have influenced the concept over time and a distinction between the custodial and controlling pattern versus a therapeutic approach is recommended.
authors.affiliation: Fachbereich Gesundheit, Fachhochschule Bern, Schweiz.
authors.forename: Ursina
authors.initials: U
authors.lastname: Zehnder
authors.affiliation: Abteilung Entwicklung & Forschung Pflege, Universitäre Psychiatrische Kliniken Basel, Schweiz.
authors.forename: Franziska
authors.initials: F
authors.lastname: Rabenschlag
authors.affiliation: Fachbereich Gesundheit, Fachhochschule Bern, Schweiz.
authors.forename: Eva-Maria
authors.initials: EM
authors.lastname: Panfil
mesh_terms: D000208:Acute Disease; D002985:Clinical Protocols; D003134:Commitment of Persons with Psychiatric Disorders; D003299:Cooperative Behavior; D003422:Critical Care / Q000458:organization & administration*; D003617:Dangerous Behavior; D004637:Emergency Services, Psychiatric / Q000458:organization & administration*; D005858:Germany; D019983:Guideline Adherence; D006801:Humans; D033183:Interdisciplinary Communication; D001523:Mental Disorders / Q000628:therapy*; D011567:Psychiatric Department, Hospital / Q000458:organization & administration*; D011785:Quality Assurance, Health Care / Q000458:organization & administration; D016896:Treatment Outcome