Kuppili Pooja Patnaik, Vengadavaradan Ashvini, Bharadwaj Balaji
Black Country Partnership Foundation NHS Trust, Wolverhampton, United Kingdom.
Dept. of Psychiatry, Jawaharlal Institute of Post Graduate Medical Education and Research, Dhanvanthri Nagar, Puducherry, India.
Indian J Psychol Med. 2022 Jul;44(4):359-365. doi: 10.1177/02537176211061304. Epub 2022 Feb 3.
There is limited Indian data on the epidemiology of hospital-based restraint practices and the knowledge and attitude of caregivers toward restraint. Therefore, this study aimed to report the frequency and pattern of restraints in a general hospital psychiatry setting and assess the knowledge and attitude about restraint practices among caregivers of patients.
We calculated the frequency of restraints (physical and chemical) over one year. The knowledge and attitude toward restraint were assessed in 75 caregivers each of patients from inpatient and outpatient settings, using a questionnaire designed by the authors and pretested in a pilot study.
The frequency of any form of restraint was 19%. The frequency of chemical and physical restraints was 19% and 0.5%, respectively. Less than 20% of caregivers in both groups reported that restraint was either stigmatizing (5.33% inpatient caregivers vs. 12% outpatient caregivers), cruel (8% inpatient caregivers vs. 15.33% outpatient caregivers), or a measure of punishment (9% inpatient caregivers vs. 16% outpatient caregivers). No significant difference was found between knowledge and attitude about restraint between caregivers of outpatients and inpatients, except for a significantly greater number of caregivers of outpatients reporting that the restraint practices in the hospital were similar to those adopted by faith healers or religious/spiritual centers.
The frequency of either physical or chemical restraint was less compared to the existing international and Indian data. In addition, most caregivers of patients of both outpatients and inpatients did not report a negative attitude toward restraints.
关于基于医院的约束措施的流行病学以及护理人员对约束的认知和态度,印度的数据有限。因此,本研究旨在报告综合医院精神科环境中约束措施的频率和模式,并评估患者护理人员对约束措施的认知和态度。
我们计算了一年中约束措施(身体约束和药物约束)的频率。使用作者设计并在一项试点研究中进行预测试的问卷,对75名住院患者和门诊患者的护理人员进行了关于约束的认知和态度评估。
任何形式的约束频率为19%。药物约束和身体约束的频率分别为19%和0.5%。两组中不到20%的护理人员报告称,约束措施带有污名化(住院患者护理人员为5.33%,门诊患者护理人员为12%)、残忍(住院患者护理人员为8%,门诊患者护理人员为15.33%)或惩罚手段(住院患者护理人员为9%,门诊患者护理人员为16%)。门诊患者和住院患者的护理人员在对约束的认知和态度方面没有显著差异,只是门诊患者的护理人员中,报告医院的约束措施与信仰治疗师或宗教/精神中心所采用的措施相似的人数明显更多。
与现有的国际和印度数据相比,身体或药物约束的频率较低。此外,门诊患者和住院患者的大多数护理人员对约束措施均未表现出负面态度。