Use of restrictive interventions in a child and adolescent inpatient unit - predictors of use and effect on patient outcomes
Use of restrictive interventions in a child and adolescent inpatient unit - predictors of use and effect on patient outcomes
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DOI：
10.1177/1039856214532298
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发表时间：
2014-08-01
影响因子：
1.8
通讯作者：
Dean, Angela J.
中科院分区：
文献类型：
--
作者：
Duke, Suzanne G.;Scott, James;Dean, Angela J.
目标：限制性干预措施(隔离、身体约束和急性/预防性使用)。镇静)可能对患者有负面影响。确定使用限制性干预措施的相关因素，并检查其对住院结果的影响，对于优化住院精神病护理非常重要。方法：本研究记录了15个月来儿童和青少年精神科住院病房使用限制性干预措施的情况。两个模型检验了限制性干预使用的预测因素：(I)事件特征；(Ii)患者特征。结果：在本研究期间收治的134名患者中(61.9%为女性，平均年龄为13.8+/-2.9岁)，26.9%的患者至少接受过一次限制性干预。与限制性干预相关的事件因素有：身体攻击、早期入院和发生在私人空间。预测使用限制性干预措施的患者因素是发育障碍和年龄较小。限制性干预的使用与住院时间的延长或全球症状评分的改善不相关。结论：需要进一步的研究来确定接受限制性干预的高危儿童的最佳做法。
Objectives: Restrictive interventions (seclusion, physical restraint, and use of acute/p.r.n. sedation) may have negative effects on patients. Identifying factors associated with use of restrictive interventions and examining their effect on admission outcomes is important for optimising inpatient psychiatric care.Methods: This study documented use of restrictive interventions within a child and adolescent psychiatric inpatient unit for 15 months. Two models examined predictors of use of restrictive interventions: (i) incident characteristics; and (ii) patient characteristics. The relationship between use of restrictive interventions and global clinical outcomes was also examined.Results: Of 134 patients admitted during the study period (61.9% female, mean age=13.8 +/- 2.9 years), 26.9% received at least one restrictive intervention. Incident factors associated with restrictive interventions were: physical aggression, early admission stage, and occurrence in private space. Patient factors that predicted use of restrictive interventions were developmental disorder and younger age. Use of restrictive interventions was not associated with increased length of stay or diminished improvement in global symptom ratings.Conclusions: Further research is needed to identify best practice in children at high risk for receiving restrictive interventions.