被隔离和机械约束的精神病患者的临床和人口统计学特征：一项回顾性研究。
Clinical and demographic characteristics of secluded and mechanically restrained mentally ill patients: a retrospective study.
作者信息
Miodownik Chanoch, Friger Michael D, Orev Eyal, Gansburg Yisroel, Reis Nadav, Lerner Vladimir
机构信息
Be'er Sheva Mental Health Center, Faculty of Health Sciences, Ben-Gurion University of the Negev, Box 4600, 84170, Be'er-Sheva, PO, Israel.
Department of Public Health, Faculty of Health Sciences, Ben-Gurion University of the Negev, Be'er Sheva, Israel.
出版信息
Isr J Health Policy Res. 2019 Feb 1;8(1):9. doi: 10.1186/s13584-018-0274-4.
BACKGROUND
Restraint or seclusion measures in acute psychiatric care are used as a last resort when all other methods for removal of physical threat have failed. The purpose of this study is to find a correlation between coercive measures, demographic characteristics within this patient group, and factors associated with shortened periods of restriction.
METHODS
This is a one-year retrospective study conducted in a male acute closed ward of a psychiatric hospital in Israel. The data from January 1, 2014 to December 31, 2014 were retrieved from the records of patients who underwent restraint and/or seclusion interventions during this period. The analyzed data included age, psychiatric diagnosis, marital status, education, race, ethnicity, length of hospital stay, legal status during admission, type of coercive measure (mechanical restraint, seclusion), number and duration of coercive episodes, reasons for coercion, time of event, number of previous hospitalizations, aggression in past and present treatment, and treatment during events.
RESULTS
During this time period, there were 563 admissions in the study ward. Over this period, 176 subjects (31.3%) underwent 488 restraints and/or seclusions. 98% were aggressive in the past. (Although some results reached statistical significance, we prefer to emphasize here only the most important results, while the others will be presented in the text.) Patients with personality disorders were physically limited for the longest time, while schizophrenia patients were restricted for the shortest time compared with other diagnoses (p = 0.007). A negative correlation was found between the length of coercion and the number of academic female nurses on duty (p = 0.005), as well as the administration of sedative medications during the restricting procedure.
CONCLUSIONS
We believe that the presence of registered, academic female nurses on duty and medication administration during coercive measures can reduce the length of restriction.
背景
在急性精神科护理中，约束或隔离措施是在所有其他消除身体威胁的方法均告失败时才使用的最后手段。本研究的目的是找出强制手段、该患者群体的人口统计学特征以及与缩短限制期相关的因素之间的相关性。
方法
这是一项在以色列一家精神病医院的男性急性封闭病房进行的为期一年的回顾性研究。从2014年1月1日至2014年12月31日期间接受约束和/或隔离干预的患者记录中检索数据。分析的数据包括年龄、精神科诊断、婚姻状况、教育程度、种族、民族、住院时间、入院时的法律状态、强制手段类型（机械约束、隔离）、强制事件的次数和持续时间、强制原因、事件发生时间、既往住院次数、过去和当前治疗中的攻击行为以及事件期间的治疗情况。
结果
在此期间，研究病房有563例入院患者。在此期间，176名受试者（31.3%）接受了488次约束和/或隔离。98%的人过去有攻击行为。（尽管一些结果达到了统计学意义，但我们在此仅强调最重要的结果，其他结果将在正文中呈现。）与其他诊断相比，人格障碍患者身体受限的时间最长，而精神分裂症患者受限的时间最短（p = 0.007）。发现强制时间长度与在职学术女性护士人数之间存在负相关（p = 0.005），以及在限制程序期间使用镇静药物之间也存在负相关。
结论
我们认为，在职的注册学术女性护士的存在以及在强制措施期间给药可以缩短限制时间。
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