Department of Psychiatry, School of Medicine, University College Dublin, Dublin, Ireland.
Children's Health Ireland at Crumlin, Dublin, D12N512, Ireland.
Ir J Med Sci. 2023 Dec;192(6):2929-2936. doi: 10.1007/s11845-023-03316-7. Epub 2023 Feb 23.
There has been a global effort to reduce the use of restrictive interventions (RIs) in healthcare settings. In order to reduce unnecessary RIs, it is essential to understand their use in mental health settings. To date, there have been few studies examining the use of RIs in child and adolescent mental health settings, with no such studies in Ireland.
The purpose of this study is to examine the prevalence and frequency of physical restraints and seclusion and to identify any associated demographic and clinical characteristics.
This is a 4-year retrospective study of the use of seclusion and physical restraint in an Irish child and adolescent psychiatric inpatient unit from 2018 to 2021. Computer-based data collection sheets and patient records were retrospectively reviewed. Eating disorder and non-eating disorder samples were analysed.
Of 499 hospital admissions from 2018 to 2021, 6% (n = 29) had at least one episode of seclusion and 18% (n = 88) had at least one episode of physical restraint. Age, gender and ethnicity were not significantly associated with rates of RI. Unemployment, prior hospitalization, involuntary legal status and longer length of stay were significantly associated with higher rates of RIs in the non-eating disorder group. Involuntary legal status was associated with higher rates of physical restraint in the eating disorder group. Patients with a diagnosis of eating disorder and psychosis had the highest prevalence of physical restraints and seclusions respectively.
Identifying youth who are at greater risk of requiring RIs may allow early and targeted intervention and prevention.
全球范围内一直在努力减少医疗环境中限制干预措施（RIs）的使用。为了减少不必要的 RIs，了解其在精神卫生环境中的使用情况至关重要。迄今为止，很少有研究检查 RIs 在儿童和青少年心理健康环境中的使用情况，爱尔兰也没有此类研究。
本研究旨在检查身体约束和隔离的使用频率和流行率，并确定任何相关的人口统计学和临床特征。
这是一项为期 4 年的回顾性研究，研究了 2018 年至 2021 年期间爱尔兰儿童和青少年精神病住院患者使用隔离和身体约束的情况。使用计算机数据收集表和病历进行回顾性分析。对饮食障碍和非饮食障碍样本进行了分析。
在 2018 年至 2021 年期间的 499 次住院中，有 6%（n=29）至少发生过一次隔离事件，18%（n=88）至少发生过一次身体约束事件。年龄、性别和种族与 RI 发生率无显著相关性。失业、既往住院、非自愿法律地位和住院时间延长与非饮食障碍组 RI 发生率较高显著相关。非饮食障碍组中，非自愿法律地位与身体约束率较高相关。患有饮食障碍和精神病的患者分别具有身体约束和隔离的最高患病率。
识别需要 RI 的风险较高的青年可能会允许早期和有针对性的干预和预防。
