It appears that the role of the staff and the environmental conditions, which are potentially modifiable, affect the subjective experience of these measures. There was considerable heterogeneity among studies in terms of coercive measures experienced by participants and study designs.

The main implication of the study is to support the effectiveness of specific intervention programs based on different measures to reduce mechanical restraint and without contemplating all the strategies that are considered effective.

Coercive measures are frequently used in psychiatric hospitalization. However, there are few studies that analyse perceived coercion, post‐traumatic stress, and subjective satisfaction with the hospitalization treatment associated with different types of coercive measures. The sample consisted of 111 patients admitted to two psychiatric units and divided into three groups based on the measure applied: involuntary medication (N = 41), mechanical restraint (N = 32), and combined measures (mechanical restraint and involuntary medication; N = 38). The outcome variables were perceived coercion evaluated with the Coercion Experience Scale (CES), post‐traumatic stress evaluated with the Davidson Trauma Scale (DTS), and satisfaction with the treatment evaluated with the Client's Assessment of Treatment (CAT). The results found higher levels of perceived coercion associated with the use of mechanical restraint (P = 0.002) and combined measures (P < 0.001) in comparison with involuntary medication. Additionally, in relation to post‐traumatic stress, mechanical restraint (P = 0.013) and combined measures (P = 0.004) were more stressful compared to involuntary medication. Finally, the use of combined measures was associated with lower satisfaction with inpatient psychiatric treatment compared to the use of involuntary medication (P = 0.006). The following recommendation would be consistent with the results found: if a patient does not specify a preference for some type of measure, involuntary medication could be used and mechanical restraint avoided, especially when used in combination with involuntary medication.

Accessible summary What is known on the subject? A relevant number of restraint prevention programmes have been developed internationally. In Spain, there is no harmonized policy to prevent the use of restraint. More studies are necessary to establish which programmes and components are necessary to prevent restraint. What does the paper add to existing knowledge? There was a significant decreasing trend in the total number of mechanical restraint hours during the implementation of the intervention. There was no significant decreasing trend in the number of mechanical restraint episodes. What are the implications for practice? Interventions at a regional level aimed at preventing mechanical restraint are feasible in the Spanish context. All components of the Six Core Strategies could be necessary to prevent episodes of mechanical restraint. Abstract IntroductionMechanical restraint (MR) is used in many countries, including Spain, where non‐harmonized policies between autonomous communities exist. There is a lack of research about interventions at regional levels to reduce their use. AimTo analyse data on key outcomes during the implementation of a multicomponent intervention in Andalusia (Spain) to reduce the use of MR. MethodEpisodes in a period of 30 months in all wards (N = 20) were analysed. The intervention consisted of five strategies: (a) leadership, (b) analysis of the situation, (c) awareness training for the heads of the wards, (d) unified record of MR and (e) staff training. We analysed the monthly trend of restraint hours and restraint episodes/1,000 bed days using segmented regression. ResultsThere were 206.32 restraint hours and 12.96 restraint episodes/1,000 bed days during the study period. A significant decreasing trend was observed in restraint hours (−1.79%, p < .001), but not in the number of restraint episodes (−0.45%; p = .149). DiscussionThe results coincide with other international studies; however, studies with better designs are required to evaluate the effectiveness of the intervention. Implications for PracticeInterventions at a regional level aimed at preventing MR are feasible in the Spanish context.

No abstract

La transición legislativa e ideológica producida en los últimos años en España ha favorecido el desarrollo del modelo comunitario de atención a la salud mental. No obstante, aún persiste una fuerte resistencia a la inclusión de abordajes comunitarios en la atención de las personas con problemas de salud mental y a la implementación de una atención y unos cuidados integrados de enfoque salutogénico. El propósito del siguiente artículo es describir la evolución del modelo comunitario de atención a la salud mental en el sistema nacional de salud español y evaluar su estado actual. Inicialmente se realizó una revisión de los planes y estrategias de salud mental nacional publicados y luego se evaluaron tomando como referencia el Documento de consenso sobre los principios fundamentales y elementos clave de la salud mental comunitaria, que establece los criterios de valoración de la calidad de la atención comunitaria. Ante la falta de planes o estrategias actualizados, se incluyeron informes y recomendaciones internacionales. Los resultados se agruparon en: 1) perspectiva social, en la que se evidencia la controversia sobre la capacidad de las personas usuarias para tomar decisiones a pesar del reconocimiento de sus derechos como agentes morales autónomos; 2) perspectiva de la centralidad de las personas usuarias de los servicios de atención a la salud mental, en la que se plasma la resistencia a la implementación de una atención y unos cuidados comunitarios integrados; y 3) perspectiva profesional en relación con la efectividad de las intervenciones y la red comunitaria de principios de atención, que señala la necesidad de transformar las instituciones para realizar intervenciones comunitarias en salud mental basadas en la evidencia y de manera intersectorial, integral, integrada e integradora.

<p>  </p> <p>The growing global movement of internationalization in universities stimulated the idea of building the Nursing Knowledge Network (NKN) as a collective and innovative work. A work whose primary interest is all forms of nursing knowledge. International collaboration has become increasingly important for the formation of a global and supportive community in knowledge sharing (Beaver, 2001; Gheno et al., 2020). The internationalization of Science and Technology is considered a necessary condition for the development of scientific practice, as well as a means for improving the quality of knowledge production in the formation of human resources, in the circulation of information, and in the projection of research results (Red Iberoamericana de Indicadores de Ciência y Tecnología, 2007). Among these, intellectual capital is the most precious asset of institutions since it demands institutional and personal efforts and time to reach maturity.</p> <p><br></p> <p>This report presents a summary of the findings of a preliminary environmental scan of the intellectual capital, technical resources, and financial resources of universities, as well as infrastructure for the participation of the collaborating universities in the process of organization, structuring and future operationalization of the NKN. It should be noted that the resources reported in this work represent the perspective of the faculty who responded to the questionnaire. In this sense, they may not represent an official institutional response, the existing resources in their entirety, or characterize the collective thinking of their educators and researchers. </p> <p><br></p> <p>Sixty invitation letters were sent, of which 42 were accepted, indicating a participation rate of 70% in the environmental scan. Questionnaires were created in English, Spanish, French and Portuguese, and shared online. Gathered information suggests there is a strong desire and need for continued research collaboration among international scientific communities that can help overcome language barriers and limitations imposed by financial restrictions. As well, it was found that policy, research promotion and development, and advances in research design and dissemination are needed to strengthen Nursing research. Based on this information, future exchanges of knowledge, through asynchronous means, without the need for simultaneous participation in the teaching-learning process, can occur. This will allow for collaboration between members located in low-, middle- and high-income countries. This baseline information suggests the possibility to exchange expertise, learn new alternatives for collaborative problem-solving techniques, and the production of many forms of knowledge rooted in local cultural and socioeconomic realities.</p>

No abstract