دورية أكاديمية

Do improved structural surroundings reduce restrictive practices in psychiatry?

التفاصيل البيبلوغرافية
العنوان: Do improved structural surroundings reduce restrictive practices in psychiatry?
المؤلفون: Harpøth A; Department of Forensic Psychiatry, Aarhus University Hospital Psychiatry, Skejby, Denmark., Kennedy H; Trinity College, Dublin University, Dublin, Ireland.; National Forensic Mental Health Service, Dundrum, Ireland.; Department of Clinical Medicine, Faculty of Health, Aarhus University, Aarhus, Denmark., Terkildsen MD; Department of Forensic Psychiatry, Aarhus University Hospital Psychiatry, Skejby, Denmark.; DEFACTUM, Central Denmark Region, Aarhus, Denmark., Nørremark B; Department of Forensic Psychiatry, Aarhus University Hospital Psychiatry, Skejby, Denmark., Carlsen AH; Department of Forensic Psychiatry, Aarhus University Hospital Psychiatry, Skejby, Denmark., Sørensen LU; Department of Forensic Psychiatry, Aarhus University Hospital Psychiatry, Skejby, Denmark. lisbeth.uhrskov@ps.rm.dk.; Department of Clinical Medicine, Faculty of Health, Aarhus University, Aarhus, Denmark. lisbeth.uhrskov@ps.rm.dk.
المصدر: International journal of mental health systems [Int J Ment Health Syst] 2022 Nov 20; Vol. 16 (1), pp. 53. Date of Electronic Publication: 2022 Nov 20.
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: BioMed Central Country of Publication: England NLM ID: 101294224 Publication Model: Electronic Cited Medium: Print ISSN: 1752-4458 (Print) Linking ISSN: 17524458 NLM ISO Abbreviation: Int J Ment Health Syst Subsets: PubMed not MEDLINE
أسماء مطبوعة: Original Publication: London : BioMed Central, 2007-
مستخلص: Background and Objectives: There is sparse evidence that modern hospital architecture designed to prevent violence and self-harm can prevent restrictive practices (RP). We examine if the use of RPs was reduced by the structural change of relocating a 170-year-old psychiatric university hospital (UH) in Central Denmark Region (CDR) to a new modern purpose-built university hospital.
Methods: The dataset includes all admissions (N = 19.567) and RPs (N = 13.965) in the self-contained CDR one year before and after the relocation of the UH. We compare RPs at the UH a year prior to and after relocation on November 16th (November 2017, November 2019) with RPs at the other psychiatric hospitals (RH) in CDR. We applied linear regression analysis to assess the development in the monthly frequency of RPs pre- and post-relocation and examine underlying trends.
Results: At UH, RPs performed decreased from 4073 to 2585 after relocation, whereas they remained stable (from 3676 to 3631) at RH. Mechanical restraint and involuntary acute medication were aligned at both UH and RH. Using linear regression analysis, we found an overall significant decrease in the use of all restrictive practices at UH with an inclination of -9.1 observations (95% CI - 12.0; - 6.3 p < 0.0001) per month throughout the two-year follow-up. However, the decrease did not deviate significantly from the already downward trend observed one year before relocation. Similar analyses performed for RH showed a stable use of coercion.
Conclusion: The naturalistic features of the design preclude any definitive conclusion whether relocation to a new purpose-built psychiatric hospital decreased the RPs. However, we argue that improving the structural environment at the UH had a sustained effect on the already declining use of RPs, particularly mechanical restraint and involuntary acute medication.
(© 2022. The Author(s).)
References: BMC Psychiatry. 2020 Oct 23;20(1):515. (PMID: 33097036)
J Psychiatr Res. 2018 Oct;105:147-152. (PMID: 30223184)
PLoS One. 2021 Oct 8;16(10):e0258346. (PMID: 34624057)
Int J Soc Psychiatry. 2018 May;64(3):258-265. (PMID: 29480051)
Health Inf Manag. 2002 Dec;30(4):1-4. (PMID: 29338340)
J Psychiatr Ment Health Nurs. 2014 Aug;21(6):499-508. (PMID: 24548312)
Dtsch Arztebl Int. 2019 May 10;116(19):336-343. (PMID: 31288909)
Int Psychiatry. 2012 Nov 01;9(4):88-90. (PMID: 31508138)
BMJ. 2021 Sep 30;374:n2061. (PMID: 34593508)
Scand J Public Health. 2011 Jul;39(7 Suppl):54-7. (PMID: 21775352)
Acta Psychiatr Scand. 2020 Jul;142(1):27-39. (PMID: 31953847)
HERD. 2022 Jul;15(3):315-328. (PMID: 35016562)
J Healthc Eng. 2019 Jan 6;2019:4076259. (PMID: 30723538)
Can J Psychiatry. 2001 Jun;46(5):433-7. (PMID: 11441783)
Int J Ment Health Syst. 2018 Oct 20;12:58. (PMID: 30377440)
Psychiatr Serv. 2016 Dec 1;67(12):1321-1327. (PMID: 27364814)
Nord J Psychiatry. 2020 Oct;74(7):489-496. (PMID: 32248726)
West J Emerg Med. 2019 Jul 22;20(5):690-695. (PMID: 31539324)
Soc Psychiatry Psychiatr Epidemiol. 2010 Sep;45(9):889-97. (PMID: 19727530)
J Psychosoc Nurs Ment Health Serv. 2016 Oct 1;54(10):32-39. (PMID: 27699424)
Br J Psychiatry. 2014 Sep;205(3):171-6. (PMID: 25179622)
J Clin Epidemiol. 2014 Mar;67(3):267-77. (PMID: 24275499)
Soc Psychiatry Psychiatr Epidemiol. 2007 Feb;42(2):140-5. (PMID: 17180296)
J Psychiatr Ment Health Nurs. 2022 Jun;29(3):493-503. (PMID: 34897910)
Front Psychiatry. 2019 Jul 16;10:491. (PMID: 31404294)
World Psychiatry. 2005 Oct;4(3):168-72. (PMID: 16633543)
BMJ Open. 2019 Dec 23;9(12):e030230. (PMID: 31874869)
BMC Psychiatry. 2013 Jun 18;13:169. (PMID: 23773398)
Nord J Psychiatry. 2016 Nov;70(8):606-10. (PMID: 27286476)
BMC Health Serv Res. 2021 Oct 04;21(1):1037. (PMID: 34602063)
Br J Anaesth. 2013 Apr;110(4):529-44. (PMID: 23454826)
PLoS One. 2013;8(2):e54900. (PMID: 23418432)
Ugeskr Laeger. 2002 Sep 30;164(40):4664-7. (PMID: 12380120)
BMJ Open. 2021 Jul 7;11(7):e046647. (PMID: 34233981)
BMC Health Serv Res. 2020 Feb 27;20(1):147. (PMID: 32106847)
Psychiatr Serv. 2009 Feb;60(2):231-9. (PMID: 19176418)
Nervenarzt. 2017 Jan;88(1):70-77. (PMID: 26820456)
Psychiatry Res. 2013 Jan 30;205(1-2):48-53. (PMID: 22951334)
معلومات مُعتمدة: 1-30-74-74-19 Central Denmark Region Psychiatric Research Foundation
فهرسة مساهمة: Keywords: Coercion; Mechanical restraint; Psychiatry; Restrictive practices; Structural safety
تواريخ الأحداث: Date Created: 20221120 Latest Revision: 20221213
رمز التحديث: 20240628
مُعرف محوري في PubMed: PMC9677911
DOI: 10.1186/s13033-022-00562-7
PMID: 36404331
قاعدة البيانات: MEDLINE
الوصف
تدمد:1752-4458
DOI:10.1186/s13033-022-00562-7