Behavioral management leads to reduction in aggression in a child and adolescent psychiatric inpatient unit
Behavioral management leads to reduction in aggression in a child and adolescent psychiatric inpatient unit
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DOI：
10.1097/chi.0b013e3180465a1a
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发表时间：
2007-06-01
影响因子：
13.3
通讯作者：
Scott, James
中科院分区：
文献类型：
--
作者：
Dean, Angela J.;Duke, Suzanne G.;Scott, James
目的：攻击性在精神科住院的儿童和青少年中很常见。减少攻击性行为的干预措施很少。这项研究旨在评估基于环境的行为管理计划对儿童和青少年心理健康住院病房攻击行为频率的影响。方法：行为管理计划包括个体化的患者管理计划、早期发现和预防、工作人员培训、加强适当的行为以及使用限制最少的选项进行干预。在项目实施前和实施后的6个月内对结果进行评估，包括攻击性行为、伤害、使用身体束缚、与世隔绝、p.r.n的事件。镇静、安全服务的使用和人员配置因素。结果：行为管理的实施显著减少了攻击性行为(p<；.05)和其他不良后果的发生，包括伤害(p<；.05)、身体约束的使用(p<；.001)和隔离时间(p<；.001)。这些结果是在没有减少入院人数、改变入院患者类型、增加人员成本或增加P.r.n使用的情况下实现的。药物。结论：通过实施广泛的行为管理计划，可以减少儿童和青少年精神科住院病房中的攻击行为。这些发现突显了组织方法对行为和风险管理的重要性。
Objective: Aggression is common in children and adolescents admitted to psychiatric inpatient units. Few interventions for reducing aggressive behaviors have been identified. This study aimed to evaluate the impact of a milieu-based behavioral management program on the frequency of aggressive behaviors in a child and adolescent mental health inpatient unit. Method: The behavioral management program incorporated individualized patient management plans, early detection and prevention, staff training, reinforcement of appropriate behaviors, and intervention using the least restrictive option. Outcomes were assessed for 6 months before and after program introduction, and included episodes of aggressive behavior, injuries, use of physical restraint, seclusion, p.r.n. sedation, use of security services, and staffing factors. Results: Implementation of behavioral management led to a significant reduction in the episodes of aggressive behavior (p < .05) and other unwanted outcomes including injuries (p < .05), use of physical restraint (p < .001), and duration of seclusion (p < .001). These outcomes were achieved without reducing the number of admissions, changing the types of patients admitted, increasing staff costs, or increasing the use of p.r.n. medications. Conclusions: Aggressive behaviors in child and adolescent psychiatric inpatient units can be reduced by implementing a broad-based behavioral management program. These findings highlight the importance of organizational approaches to behavior and risk management.