Condition category
Not Applicable
Date applied
Date assigned
Last edited
Retrospectively registered
Overall trial status
Recruitment status
No longer recruiting

Plain English Summary

Not provided at time of registration

Trial website

Contact information



Primary contact

Prof Maritta Välimäki


Contact details

Department of Nursing Science
+358 (0)2 333 8495

Additional identifiers

EudraCT number number

Protocol/serial number


Study information

Scientific title

The impact of eLearning course on nurses’ professional competence in psychiatric nursing: a multicentre, randomised controlled open label study



Study hypothesis

The primary hypothesis of the study is that nurses working in those wards who participate in eLearning course (ePsychNurse.Net) would have better knowledge on coercion-related legislation, physical restraint and seclusion comparing to nurses working in wards who would not participate in the course.

The secondary hypothesis is that nurses working in those wards who participate in eLearning course would have less favourable attitudes towards physical restraint and seclusion and improved job satisfaction compared to nurses working in those wards who would not participate in the course.

We will also hypothesise that ePsychNurse.Net would decrease the seclusion and restraint incidents and length on the wards comparing to those wards who not participate in the course. Further, the costs of eLearning course will be lower than by traditional methods (e.g., education sessions alone).

Ethics approval

Ethics Committee of Helsinki and Uusimaa Hospital District,13/03/2007, 73/E7/2007 HUS

Study design

Multicentre randomised controlled open label study

Primary study design


Secondary study design

Randomised controlled trial

Trial setting


Trial type

Quality of life

Patient information sheet


Nurses' continuing vocational training


Intervention group:
Nurses participated in eLearning course. Nurses receive needs-based education. eLearning course was built up using the Moodle platform and includes following six main themes related to the taking care of this patient group:
1. Legal implications
2. Ethical issues
3. Internal and external factors effecting to the care of distressed and disturbed patients
4. Self-awareness and interpersonal relationships
5. Teamwork
6. Integration of knowledge and practice

eLearning course takes 120 hours during three months. The eLearning course has to be accomplished on a module-by-module basis in a pre-defined order. Each module requires individual working tasks in the form of reflective journal, assignment, discussion forum, self-awareness exercise, and reading material. Virtual patient scenario and self-awareness exercise was included depending on the module. The tutors (experiences nurses with MNS and/or PhD degree) coordinated the course, supervised the students and gave feedback on each module’s tasks accomplished by the students. To ensure appropriate technological resources, the computers were checked for adequate programs needed for running the course. Information on how to use the portal and the aims of the course to the nurses was organized. Nurses were able to study at their work time.

Control group:
The control group had continuing vocational education as usual, essentially fragmentary and irregular. Nurses in Comparison group did not get eLearning Course and they get as usual continuing vocational education.

Duration of intervention was three month after baseline measurement. Total duration of follow-up is 9 months.

Intervention type



Not Applicable

Drug names

Primary outcome measure

Nurses' knowledge related to patients’ rights and seclusion and restraint practices, measured at baseline (BL), 3 and 9 months.

Secondary outcome measures

1. Nurses' attitudes related to seclusion and restraint practices (Attitudes Scale), measured at BL, 3 and 6 months
2. Nurses' attitudes related to mental illness (CAMI 2007), measured at BL, 3 and 6 months.
3. Nurses' general efficacy (General Self-Efficacy Scale) and job satisfaction (Job Diagnostic Survey, job satisfaction), measured at BL, 3 and 6 months
4. Seclusion and restraint incidents and length (Hospital Data Base) on the ward, measured at BL, 3, 6 and 12 months
5. Costs of the continuing vocational education (eLearning course and traditional method/education sessions; time, travel and deputy staff costs)

Overall trial start date


Overall trial end date


Reason abandoned (if study stopped)


Participant inclusion criteria

Ward eligibility criteria:
1. Closed acute psychiatric inpatient wards
2. Practicing seclusion and restraint
3. Not involved in on-going or planned seclusion/restraint research or development projects

Participant eligibility criteria:
1. On the wards registered nurse (permanent position psychiatric nurses/mental health nurses, long term substitute psychiatric nurses/mental health nurses, practical nurses, head nurses and deputy head nurses)
2. Aged over 18 years, either sex
3. Fluent understanding of Finnish language

Participant type


Age group




Target number of participants

Wards: 12, Staff: 229

Participant exclusion criteria

Unable to use the Finnish language

Recruitment start date


Recruitment end date



Countries of recruitment


Trial participating centre

Department of Nursing Science

Sponsor information


European Commission (Belgium)

Sponsor details

Leonardo da Vinci Programme
Centre for International Mobility CIMO
P.O. Box 343

Sponsor type




Funder type


Funder name

European Commission (Belgium) - Funded project from the Leonardo da Vinci Programme (ref: FI-06-B-F-PP-160701)

Alternative name(s)

Funding Body Type

Funding Body Subtype


Funder name

Hospital District of Helsinki and Uusimaa (Finland)

Alternative name(s)

Funding Body Type

Funding Body Subtype


Funder name

The Pirkanmaa Hospital District (Finland)

Alternative name(s)

Funding Body Type

Funding Body Subtype


Results and Publications

Publication and dissemination plan

Not provided at time of registration

Intention to publish date

Participant level data

Not provided at time of registration

Basic results (scientific)

Publication list

2009 results in
2010 results in
2013 results in

Publication citations

  1. Results

    Kontio R, Välimäki M, Putkonen H, Cocoman A, Turpeinen S, Kuosmanen L, Joffe G, Nurses' and physicians' educational needs in seclusion and restraint practices., Perspect Psychiatr Care, 2009, 45, 3, 198-207, doi: 10.1111/j.1744-6163.2009.00222.x.

  2. Results

    Kontio R, Välimäki M, Putkonen H, Kuosmanen L, Scott A, Joffe G, Patient restrictions: are there ethical alternatives to seclusion and restraint?, Nurs Ethics, 2010, 17, 1, 65-76, doi: 10.1177/0969733009350140.

  3. Results

    Kontio R, Hätönen H, Joffe G, Pitkänen A, Lahti M, Välimäki M, Impact of eLearning course on nurses' professional competence in seclusion and restraint practices: 9-month follow-up results of a randomized controlled study (ISRCTN32869544)., J Psychiatr Ment Health Nurs, 2013, 20, 5, 411-418, doi: 10.1111/j.1365-2850.2012.01933.x.

Additional files

Editorial Notes