Associations of Restraint and Seclusion With Race and Ethnicity on an Adolescent Inpatient Psychiatry Service.
Associations of Restraint and Seclusion With Race and Ethnicity on an Adolescent Inpatient Psychiatry Service.
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青少年住院精神病学服务中的约束和隔离与种族和民族的关联。
DOI：
10.1016/j.jaac.2022.11.012
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发表时间：
2023
影响因子：
13.3
通讯作者：
Brannan,ElizabethH
中科院分区：
文献类型：
--
作者：
Daniels,TeresaE;Victor,Colleen;Smith,EricM;Belgrave,Christa;Robinson,Erica;Wolff,JenniferC;Hunt,Jeffrey;Brannan,ElizabethH
方法EMR查询提供了2018年6月至2021年6月青少年单位所有入院的回顾性人口统计学和R/S数据。人口统计学和入院特征见表1。涉及任何限制或隔离事件的入院被分解为单个变量;表2定义了本研究中归类为R/S的干预措施。在1,865例住院患者中，459例涉及281例患者的R/S。结果经χ 2分析，R/S与种族有显著相关性（χ 2 2= 16. 81，p<0. 05）。001），但不是种族（p=。746）。在校正了年龄、性别和LOS的回归模型中，与白色患者相比，黑人或非裔美国人患者的R/S风险显著更高（比值比= 1.66，p=. 036）。白色患者与其他患者的R/S风险无显著差异（p=. 226）。年龄较小（p=. 004)这些发现突出了一个关键的卫生保健差距与种族有关的住院青少年精神病学服务。与其他结构性差异类似，个人因素和系统因素可能共同导致在使用R/S方面的歧视性做法。R/S风险与年龄和LOS的相关性可能继发于临床表现;然而，即使在调整这些因素后，与种族的相关性仍然显著。这里报告的调查结果是
MethodA query of the EMR provided retrospective demographic and R/S data for all admissions from an adolescent unit from June 2018 to June 2021. Demographic and admission characteristics are presented in Table 1. Admissions involving any occurrence of either a restraint or a seclusion were collapsed into a single variable; Table 2 defines the interventions classified as R/S in this study. Among 1,865 admissions, 459 involved R/S of 281 individual patients. Demographic information was recorded in theResultsThe χ 2 analysis revealed an overall significant association of R/S and race (χ 2 2= 16.81, p<. 001), but not ethnicity (p=. 746). In the regression model adjusted for age, gender, and LOS, patients identified as Black or African American were at significantly higher risk of R/S compared with patients identified as White (odds ratio= 1.66, p=. 036). There was no significant difference in risk of R/S between patients identified as White vs other (p=. 226). Younger age (p=. 004) and longerDiscussionThese findings highlight a critical health care disparity related to race on an inpatient adolescent psychiatry service. Similar to other structural disparities, there is likely a combination of individual and systemic factors leading to discriminatory practices in the use of R/S. The association of R/S risk with age and LOS may be secondary to clinical presentation; however, the association with race remained significant even after adjustment for these factors. The findings reported here are
DOI：
10.1007/s11126-021-09887-x
发表时间：
2022-03
期刊：
The Psychiatric quarterly
影响因子：
--
作者：
Perers C;Bäckström B;Johansson BA;Rask O
通讯作者：
Rask O
心理健康住院治疗中心青少年身体束缚的探索
影响因子：
3.3
作者：
Michael T. Braun;Nicole B. Adams;Courtney E. O’Grady;Deserai Miller;Jonathan B Bystrynski
通讯作者：
Jonathan B Bystrynski