Flannery Raymond B, Walker Andrew P
Massachusetts Department of Mental Health, Worcester State Hospital, MA 01604, USA.
Int J Emerg Ment Health. 2008 Summer;10(3):191-6.
Research on the demographic and precipitant characteristics of restrained patients has documented that younger male/female patients diagnosed with schizophrenia, affective disorder, or personality disorder are at risk of being restrained when acutely psychotic or confronted with excess sensory stimulation or denial of services. However many patients with these same characteristics are not restrained Thus, these variables have yielded little predictive power. This study compared restrained/nonrestrained subjects on the demographic, precipitant variables and added three clinical variables (past violence to others, personal victimization, and substance use disorder) to assess the possible predictive power of clinical variables. Demographic and precipitant variables were similar to previous research findings. Violence toward others in combination with personal victimization was associated with higher restraint usage. The implications of the findings for emergency services are outlined.
对被约束患者的人口统计学和诱发因素特征的研究表明,被诊断患有精神分裂症、情感障碍或人格障碍的年轻男性/女性患者,在急性精神病发作时、面对过多的感官刺激或被拒绝提供服务时,有被约束的风险。然而,许多具有这些相同特征的患者并未受到约束。因此,这些变量几乎没有预测能力。本研究比较了被约束/未被约束受试者的人口统计学、诱发因素变量,并增加了三个临床变量(过去对他人的暴力行为、个人受害情况和物质使用障碍),以评估临床变量的可能预测能力。人口统计学和诱发因素变量与先前的研究结果相似。对他人的暴力行为与个人受害情况相结合,与更高的约束使用率相关。文中概述了这些研究结果对急诊服务的意义。