Nursing Staff Factors Contributing to Seclusion in Acute Mental Health Care - An Explorative Cohort Study
Nursing Staff Factors Contributing to Seclusion in Acute Mental Health Care - An Explorative Cohort Study
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DOI：
10.1080/01612840.2017.1297513
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发表时间：
2017-01-01
影响因子：
2.1
通讯作者：
de Haan, Lieuwe
中科院分区：
文献类型：
--
作者：
Doedens, Paul;Maaskant, Jolanda M.;de Haan, Lieuwe
背景：隔离是一种有争议的干预措施。对于攻击性行为的功效尚未得到证实，隔离只是为了防止安全隐患。先前的研究表明，护理人员因素可能是隔离的预测因素，尽管方法问题可能导致了模棱两可的结果。目的：进行一项前瞻性队列研究，以确定护理人员的特征是否与封闭精神科病房的成年住院患者的隔离有关。方法：我们研究了护士的人口统计数据与每个班次的隔离发生率之间的关联。数据收集于2013年五个月内。使用多元逻辑回归进行分析。结果：在单变量分析中，我们发现隔离与女性性别之间不存在显着相关性，比值比 (OR) = 5.27 (0.98-28.49)，而隔离与护士身材高大之间存在显着相关性，OR = 0.21 (0.06-0.72)。我们发现身体身高是最重要的因素，尽管并不显着：OR 调整 = 0.27 (0.07-1.04)。结论：护士的性别可能是隔离的预测因素，但它似乎是由身体身高的影响介导的。我们采用严格的、基于人口普查的前瞻性设计来收集非常详细的数据，发现护士的身材对隔离有很大影响。我们发现护士的身材是隔离的最重要预测因素。这些因素和其他因素需要在更大样本量的进一步研究中进行探索。
Background: Seclusion is a controversial intervention. Efficacy with regard to aggressive behaviour has not been demonstrated, and seclusion is only justified for preventing safety hazards. Previous studies indicate that nursing staff factors may be predictors for seclusion, although methodological issues may have led to equivocal results. Objective: To perform a prospective cohort study to determine whether nursing staff characteristics are associated with seclusion of adult inpatients admitted to a closed psychiatric ward. Method: We studied the association between nurses' demographics and incidence of seclusion during every shift. Data were collected during five months in 2013. Multiple logistic regression was used for analysis. Results: In univariable analysis, we found a non-significant association between seclusion and female gender, odds ratio (OR) = 5.27 (0.98-28.49) and a significant association between seclusion and nurses' large physical stature, OR = 0.21 (0.06-0.72). We found that physical stature is the most substantial factor, although not significant: ORadjusted = 0.27 (0.07-1.04). Conclusion: Nurses' gender may be a predictor for seclusion, but it seems to be mediated by the effect of physical stature. We used a rigorous, census-based, prospective design to collect data on a highly detailed level and found a large effect of physical stature of nurses on seclusion. We found nurses' physical stature to be the most substantial predictor for seclusion. These and other factors need to be explored in further research with larger sample size.