De-escalation techniques used, and reasons for seclusion and restraint, in a forensic psychiatric hospital
| Autor: | Jari Tiihonen, Eila Repo-Tiihonen, Katri Vehviläinen-Julkunen, Olavi Louheranta, Satu Kuivalainen, Anu Putkonen |
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| Rok vydání: | 2017 |
| Předmět: |
Adult
Hospitals Psychiatric Male Restraint Physical medicine.medical_specialty Future studies Mental Health Act Violence Patient Isolation 03 medical and health sciences 0302 clinical medicine Forensic psychiatry medicine Psychiatric hospital Humans 030212 general & internal medicine Psychiatry Finland Retrospective Studies Inpatient care Descriptive statistics business.industry Mental Disorders Forensic Psychiatry 030227 psychiatry Cross-Sectional Studies Female Pshychiatric Mental Health Seclusion business De-escalation Clinical psychology |
| Zdroj: | International journal of mental health nursing. 26(5) |
| ISSN: | 1447-0349 |
| Popis: | In Finland, the Mental Health Act determines the legal basis for seclusion and restraint. Restrictive measures are implemented to manage challenging situations and should be used as a last resort in psychiatric inpatient care. In the present study, we examined the reasons for seclusion and restraint, as well as whether any de-escalation techniques were used to help patients calm down. Seclusion and restraint files from a 4-year period (1 June 2009–31 May 2013) were retrospectively investigated and analysed by content analysis. Descriptive statistics were calculated. A total of 144 episodes of seclusion and restraint were included to analyse the reasons for seclusion and restraint, and 113 episodes were analysed to examine unsuccessful de-escalation techniques. The most commonly-used techniques were one-to-one interaction with a patient (n = 74, 65.5% of n = 113) and administration of extra medication (n = 37, 32.7% of n = 113). The reasons for seclusion and restraint were threatening harmful behaviour (n = 51, 35.4% of n = 144), direct harmful behaviour (n = 43, 29.9%), indirect harmful behaviour (n = 42, 29.1%), and other behaviours (n = 8, 5.6%). In general, the same de-escalation techniques were used with most patients. Most episodes of seclusion or restraint were due to threats of violence or direct violence. Individual means of self-regulation and patient guidance on these techniques are needed. Additionally, staff should be educated on a diverse range of de-escalation techniques. Future studies should focus on examining de-escalation techniques for the prevention of seclusion. |
| Databáze: | OpenAIRE |
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