Methods and Strategies for Reducing Seclusion and Restraint in Child and Adolescent Psychiatric Inpatient Care.

Methods and Strategies for Reducing Seclusion and Restraint in Child and Adolescent Psychiatric Inpatient Care.
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DOI:
10.1007/s11126-021-09887-x
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发表时间:
2022-03
期刊:
The Psychiatric quarterly
影响因子:
--
通讯作者:
Rask O
Rask O
中科院分区:
其他
文献类型:
--
作者:
Perers C;Bäckström B;Johansson BA;Rask O

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限制和隔离是精神科住院病房在患者或其他人面临迫在眉睫的伤害风险时使用的限制性干预措施。强制措施是有争议的,可能会导致负面后果,包括负面情绪、再创伤、伤害或死亡。文章总结了过去10多年来关于减少儿童和青少年精神科住院病房中的隔离和约束所使用的方法和战略的文献,并报告了其结果。通过在PubMed和QicINFO上搜索2010年5月至2020年5月发表的英文文章,对相关文献进行综述。发现有18篇文章描述了旨在减少儿童和青少年精神科住院病房中限制或隐居使用的方法或战略。评估了以下干预措施:创伤知情护理(TIC)、六项核心战略、以儿童和家庭为中心的护理(CFCC)、协作和主动解决方案(CPS)、基于力量的护理、改良的积极行为干预和支持(M-PBIS)、行为矫正计划(BMP)、自闭症谱系障碍护理路径(ASD-CP)、辩证行为疗法(DBT)、感觉室、员工的正念减压培训(MBSR)和环境护士-客户轮班任务。大多数干预措施减少了对隐居和/或束缚的使用。两项以儿童为中心和了解创伤情况的倡议消除了机械束缚的使用。这项审查表明,可以减少强制措施的使用,应将其列为优先事项。成功的实施需要组织各级的持续承诺和学习意愿。为了便于比较,未来的模型应该评估不同的标准化参数。
Restraints and seclusions are restrictive interventions used in psychiatric inpatient units when there is an imminent risk of harm to the patient or others. Coercive measures are controversial and can lead to negative consequences, including negative emotions, re-traumatization, injuries, or death. The article summarizes the last 10 years of literature regarding methods and strategies used for reducing seclusions and restraints in child and adolescent psychiatric inpatient units, and reports on their outcomes. The literature was reviewed by searching PubMed and PsycInfo for English-language articles published between May 2010 and May 2020. Eighteen articles were found that described methods or strategies aimed at reducing restraint or seclusion utilization in child and adolescent psychiatric inpatient units. The following interventions were evaluated: Trauma-Informed Care (TIC), Six Core Strategies, Child and Family Centered Care (CFCC), Collaborative & Proactive Solutions (CPS), Strength-Based Care, Modified Positive Behavioral Interventions and Supports (M-PBIS), Behavioral Modification Program (BMP), Autism Spectrum Disorder Care Pathway (ASD-CP), Dialectical Behavior Therapy (DBT), sensory rooms, Mindfulness-Based Stress Reduction Training (MBSR) of staff, and Milieu Nurse-Client Shift Assignments. Most of the interventions reduced the use of seclusions and/or restraints. Two child-centered and trauma-informed initiatives eliminated the use of mechanical restraints. This review shows that the use of coercive measures can be reduced and should be prioritized. Successful implementation requires ongoing commitment on all levels of an organization and a willingness to learn. To facilitate comparisons, future models should evaluate different standardized parameters.
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