Wolf Theresa, Fabel Philine, Kraschewski Adrian, Jockers-Scherübl Maria C
Department of Psychiatry and Psychotherapy, Academic Teaching Hospital of the Charité Berlin, Oberhavel Kliniken GmbH, Hennigsdorf, Germany.
Front Psychiatry. 2021 Jul 9;12:685779. doi: 10.3389/fpsyt.2021.685779. eCollection 2021.
This article examines the influence of the implementation of Soteria elements on coercive measures in an acute psychiatric ward after reconstruction in 2017, thereby comparing the year 2016 to the year 2019. The special feature is that this is the only acute psychiatric ward in Hennigsdorf Hospital, connected now both spatially and therapeutically to an open ward and focusing on the treatment of patients suffering from schizophrenia and schizophrenia spectrum disorders. The following parameters were examined: aggressive assaults, use of coercion (mechanical restraints), duration of treatment in open or locked ward, type of discharge, coercive medication, and dosage of applied antipsychotics. For this purpose, the data of all legally accommodated patients in the year 2016 (before the reconstruction) and 2019 (after the reconstruction) were statistically analyzed in a pre-post mirror quasi-experimental design. In 2019, the criteria of the Soteria Fidelity Scale for a ward with Soteria elements were reached. In comparison to 2016 with a comparable care situation and a comparable patient clientele, there was now a significant decrease in aggressive behavior toward staff and fellow patients, a significantly reduced number of fixations, a significantly reduced overall duration of inpatient stay, and a significant increase in treatment time in the open area of our acute ward. The establishment of Soteria elements in the acute psychiatric ward leads to a verifiable less violent environment of care for severely ill patients and to a drastic reduction in coercive measures.
本文探讨了2017年重建后，索泰里亚模式元素的实施对急性精神科病房强制手段的影响，从而对2016年和2019年进行了比较。其特殊之处在于，这是亨尼希斯多夫医院唯一的急性精神科病房，目前在空间和治疗方面都与开放式病房相连，专注于治疗精神分裂症及精神分裂症谱系障碍患者。研究考察了以下参数：攻击性行为、强制手段的使用（机械约束）、在开放式或封闭式病房的治疗时长、出院类型、强制用药以及抗精神病药物的使用剂量。为此，采用前后对照的准实验设计，对2016年（重建前）和2019年（重建后）所有合法收治患者的数据进行了统计分析。2019年，具备索泰里亚模式元素的病房达到了索泰里亚保真度量表的标准。与2016年相比，在护理情况和患者群体相当的情况下，对工作人员和其他患者的攻击性行为显著减少，约束次数显著减少，住院总时长显著缩短，急性病房开放区域的治疗时间显著增加。在急性精神科病房引入索泰里亚模式元素，为重症患者营造了一个可验证的暴力程度更低的护理环境，并大幅减少了强制手段的使用。
