Open Access
Who are the restrained and secluded patients: a 15-year nationwide study
Alice Keski-Valkama,Eila Sailas,Markku Eronen,Anna-Maija Koivisto,Jouko Lönnqvist,Jouko Lönnqvist,Riittakerttu Kaltiala-Heino +6 more
TLDR
In this paper, a structured postal survey concerning the demographic and clinical information of restrained/secluded patients was completed in all Finnish psychiatric hospitals during a predetermined week in 1990, 1991, 1994, 1998, and 2004.Abstract:
To find interventions for reducing the use of restraint and seclusion, it is necessary to identify who the restrained and secluded patients are. The aim of the present study was to determine which demographic and clinical groups of psychiatric inpatients are at risk of being restrained/secluded, and whether there have been changes in the restrained/secluded patients’ profiles over a 15-year period in Finland. A structured postal survey concerning the demographic and clinical information of restrained/secluded patients was completed in all Finnish psychiatric hospitals during a predetermined week in 1990, 1991, 1994, 1998, and 2004. The National Hospital Discharge Register was used to gather information on all psychiatric inpatients during the study weeks. Out of the variables studied (age, gender, main diagnosis, phase of hospital stay), only the main diagnosis and the phase of hospital stay were independent risk factors for restraint/seclusion, and remained constant over time. The age profile of the restrained/secluded patients was unstable over time and the risk of being restrained/secluded was not associated with gender. Restraint and seclusion is used mainly among the acute and the most disturbed patients. Therefore, in order to reduce the use of restraint and seclusion, resources should be targeted especially to these groups.read more
Citations
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Journal ArticleDOI
Seclusion and Restraint in Psychiatry: Patients' Experiences and Practical Suggestions on How to Improve Practices and Use Alternatives
Raija Kontio,Grigori Joffe,Hanna Putkonen,Lauri Kuosmanen,Kimmo Hane,Matti Holi,Maritta Välimäki +6 more
TL;DR: This study explored psychiatric inpatients' experiences of, and their suggestions for, improvement of seclusion/restraint, and alternatives to their use in Finland.
Journal ArticleDOI
A cross-sectional prospective study of seclusion, restraint and involuntary medication in acute psychiatric wards: patient, staff and ward characteristics
Tonje Lossius Husum,Johan Håkon Bjørngaard,Johan Håkon Bjørngaard,Arnstein Finset,Torleif Ruud,Torleif Ruud +5 more
TL;DR: The substantial between-ward variance, even when adjusting for patients' individual psychopathology, indicates that ward factors influence the use of seclusion, restraint and involuntary medication and that some wards have the potential for quality improvement.
Journal ArticleDOI
Do patient and ward-related characteristics influence the use of coercive measures? Results from the EUNOMIA international study
Lucie Kališová,Jiri Raboch,Alexander Nawka,Gaia Sampogna,L. Cihal,Thomas W. Kallert,Georgi Onchev,Anastasia Karastergiou,Valeria Del Vecchio,Andrzej Kiejna,Tomasz Adamowski,Francisco Torres-Gonzales,Jorge A. Cervilla,Stephan Priebe,Domenico Giacco,Lars Kjellin,Algirdas Dembinskas,Andrea Fiorillo +17 more
TL;DR: Clinical factors, such as high levels of psychotic symptoms and high level of perceived coercion at admission were associated with the use of coercive measures, when controlling for countries’ effect.
Journal ArticleDOI
Prevalence and risk factors for the use of restraint in psychiatry: a systematic review.
TL;DR: Coercive measures are still widely used in many countries despite attempts to introduce alternatives and should really be tested in large-scale multicenter studies in order to verify their efficacy.
Journal ArticleDOI
Does Gender Influence Outcome in Schizophrenia
TL;DR: It is hoped that studying gender differences will uncover critical elements of good outcome that lead to interventions that will benefit both women and men in schizophrenia.
References
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Journal ArticleDOI
Incidence of seclusion and restraint in psychiatric hospitals: a literature review and survey of international trends
Tilman Steinert,Peter Lepping,Renate Bernhardsgrütter,Andreas Conca,Trond Hatling,W.A. Janssen,Alice Keski-Valkama,Fermín Mayoral,Richard Whittington +8 more
TL;DR: Databases on the use of seclusion and restraint should be established using comparable key indicators because of huge differences in the percentage of patients subject to and the duration of coercive interventions between countries.
Journal ArticleDOI
A comparison of clinical and research DSM-III-R diagnoses of schizophrenia in a Finnish national birth cohort. Clinical and research diagnoses of schizophrenia.
Matti Isohanni,Taru Mäkikyrö,Juha Moring,Pirkko Räsänen,Helinä Hakko,U. Partanen,M. Koiranen,Peter B. Jones +7 more
TL;DR: Despite the official use of DSM-III-R nomenclature, it appears that the clinical concept of schizophrenia in Finland, manifest within the register, remains very restrictive.
Journal ArticleDOI
Interventions for reducing the use of seclusion in psychiatric facilities : Review of the literature
TL;DR: Reducing seclusion rates is challenging and generally requires staff to implement several interventions, including state-level support, state policy and regulation changes, leadership, examinations of the practice contexts, staff integration, treatment plan improvement and more.
Journal ArticleDOI
Structured risk assessment and violence in acute psychiatric wards: randomised controlled trial
Christoph Abderhalden,Ian Needham,Theo Dassen,Ruud J.G. Halfens,Hans-Joachim Haug,Joachim E. Fischer +5 more
TL;DR: Structured risk assessment during the first days of treatment may contribute to reduced violence and coercion in acute psychiatric wards.
Journal ArticleDOI
Pennsylvania State Hospital system's seclusion and restraint reduction program.
Gregory M. Smith,Robert H. Davis,Edward O. Bixler,Hung Mo Lin,Aidan Altenor,Roberta J. Altenor,Bonnie D. Hardentstine,George A. Kopchick +7 more
TL;DR: The rate and duration of seclusion and mechanical restraint decreased dramatically during this period and many factors contributed to the success of this effort, including advocacy efforts, state policy change, improved patient-staff ratios, response teams, and second-generation antipsychotics.