Qualitative exploration of health care professionals' experiences caring for young people with acute severe behavioral disturbance in the acute care setting.

Abstract

Objectives To describe the experience of health care professionals involved in the care of young people with acute severe behavioral disturbance across the acute care setting. Methods We used purposive and snowball sampling to recruit paramedics, nurses, doctors, and mental health clinicians caring for young people with acute severe behavioral disturbance in the prehospital and/or emergency department environments. We conducted one-to-one telephone-based semistructured qualitative interviews with each staff member. The audio recordings were transcribed verbatim, and participant pseudonyms were assigned. We iteratively developed a thematic coding structure. Data collection continued until thematic saturation was reached. Results We interviewed 31 health care professionals—12 doctors, 5 nurses, 7 mental health clinicians, and 7 paramedics. Participants outlined factors they felt contributed to the young person’s behavioral disturbance. They detailed the management strategies used. Participants spoke about their exposure to physical violence while managing these young people and the challenges of balancing patient and staff safety. There was a significant personal impact on participants through providing care to this cohort. Participants acknowledged the workflow, staff resource, and bystander impacts of these presentations. Conclusion Based on participant’s experiences, health care staff aim to provide high-quality care to young people with behavioral disturbance in circumstances that present risks to their safety. There is variability in the way staff are currently managing these young people likely because of the limited high-quality evidence currently available, highlighting key areas for future research.