A Randomized Controlled Comparison of Seclusion and Mechanical Restraint in Inpatient Settings

Bergk, Jan; Einsiedler, Beate; Flammer, Erich; Steinert, Tilman

doi:10.1176/appi.ps.62.11.1310

Cited by 23 publications

(22 citation statements)

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“…3 More evaluation studies are clearly required in this area and it has been demonstrated that it is possible to conduct randomised trials comparing different forms of containment. 73 More evaluation information has the potential to quickly shape practice into a safer and more effective form.…”

Section: Nursing In a Side Room As An Alternative To Seclusionmentioning

confidence: 99%

Seclusion and Psychiatric Intensive Care Evaluation Study (SPICES): combined qualitative and quantitative approaches to the uses and outcomes of coercive practices in mental health services

Bowers

Cullen

Achilla

et al. 2017

Health Serv Deliv Res

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Health Services and Delivery ResearchISSN 2050-4349 (Print) ISSN 2050-4357 (Online) This journal is a member of and subscribes to the principles of the Committee on Publication Ethics (COPE) (www.publicationethics.org/).Editorial contact: journals.library@nihr.ac.ukThe full HS&DR archive is freely available to view online at www.journalslibrary.nihr.ac.uk/hsdr. Print-on-demand copies can be purchased from the report pages of the NIHR Journals Library website: www.journalslibrary.nihr.ac.uk Criteria for inclusion in the Health Services and Delivery Research journalReports are published in Health Services and Delivery Research (HS&DR) if (1) they have resulted from work for the HS&DR programme or programmes which preceded the HS&DR programme, and (2) they are of a sufficiently high scientific quality as assessed by the reviewers and editors. HS&DR programmeThe Health Services and Delivery Research (HS&DR) programme, part of the National Institute for Health Research (NIHR), was established to fund a broad range of research. It combines the strengths and contributions of two previous NIHR research programmes: the Health Services Research (HSR) programme and the Service Delivery and Organisation (SDO) programme, which were merged in January 2012.The HS&DR programme aims to produce rigorous and relevant evidence on the quality, access and organisation of health services including costs and outcomes, as well as research on implementation. The programme will enhance the strategic focus on research that matters to the NHS and is keen to support ambitious evaluative research to improve health services.For more information about the HS&DR programme please visit the website: http://www.nets.nihr.ac.uk/programmes/hsdr This reportThe research reported in this issue of the journal was funded by the HS&DR programme or one of its preceding programmes as project number 11/1024/02. The contractual start date was in March 2013. The final report began editorial review in January 2016 and was accepted for publication in December 2016. The authors have been wholly responsible for all data collection, analysis and interpretation, and for writing up their work. The HS&DR editors and production house have tried to ensure the accuracy of the authors' report and would like to thank the reviewers for their constructive comments on the final report document. However, they do not accept liability for damages or losses arising from material published in this report.This report presents independent research funded by the National Institute for Health Research (NIHR). The views and opinions expressed by authors in this publication are those of the authors and do not necessarily reflect those of the NHS, the NIHR, NETSCC, the HS&DR programme or the Department of Health. If there are verbatim quotations included in this publication the views and opinions expressed by the interviewees are those of the interviewees and do not necessarily reflect those of the authors, those of the NHS, the NIHR, NETSCC, the HS&DR programme or the Department of He...

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Section: Nursing In a Side Room As An Alternative To Seclusionmentioning

confidence: 99%

Seclusion and Psychiatric Intensive Care Evaluation Study (SPICES): combined qualitative and quantitative approaches to the uses and outcomes of coercive practices in mental health services

Bowers

Cullen

Achilla

et al. 2017

Health Serv Deliv Res

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“…Considering the seriousness and prevalence of the practice of coercion, the extent of the research to date on this topic is minimal (4). In part, this may be due to the ethical and practical reasons that make randomised controlled trials on coercion incredibly difficult or unfeasible (5). Despite this, observational cohort studies have provided valuable knowledge by comparing outcomes after different coercive experiences.…”

Section: Introductionmentioning

confidence: 99%

Quality of Life and Functioning One Year After Experiencing Accumulated Coercive Events During Psychiatric Admission

Shannon¹,

Roche²,

Madigan³

et al. 2015

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(2015). Quality of life and functioning one year after experiencing accumulated coercive events during psychiatric admission. Psychiatric Services, 66, 883-7. Corresponding AuthorStephen Shannon stshanno@gmail.com Abstract ObjectivesTo determine: the number of accumulated coercive events during admission and associations, functioning and quality of life one year after discharge and associations and whether accumulated coercive events were related to these outcomes. MethodsA prospective cohort study at three community services and an independent hospital was undertaken in Ireland. The accumulated coercive events score was based on legal status, perceived coercion and episodes of physical restraint, seclusion or forced medication. Results 110(68%) of all 162 participants experienced at least one coercive event. Lower functioning predicted more coercive events. One year after discharge, subjective quality of life was 63% of the highest possible score, objective quality of life improved for 15% and functioning improved for 70% of individuals. Accumulated coercive events did not predict these outcomes. ConclusionsCoercive events are common during psychiatric admission and appear unrelated to functioning and quality of life one year after discharge.

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“…Unfortunately, there is not enough evidence on the relative effectiveness and harm of specific interventions such as seclusion or restraint [7]. Recently two studies have been published, comparing the effectiveness and impact of seclusion and mechanical restraint [8,9]. Despite their excellent methodological designs (i.g.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of behavioral changes and subjective distress after exposure to coercive inpatient interventions

2012

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BackgroundThere is a lack of evidence to underpin decisions on what constitutes the most effective and least restrictive form of coercive intervention when responding to violent behavior. Therefore we compared ratings of effectiveness and subjective distress by 125 inpatients across four types of coercive interventions.MethodsEffectiveness was assessed through ratings of patient behavior immediately after exposure to a coercive measure and 24 h later. Subjective distress was examined using the Coercion Experience Scale at debriefing. Regression analyses were performed to compare these outcome variables across the four types of coercive interventions.ResultsUsing univariate statistics, no significant differences in effectiveness and subjective distress were found between the groups, except that patients who were involuntarily medicated experienced significant less isolation during the measure than patients who underwent combined measures. However, when controlling for the effect of demographic and clinical characteristics, significant differences on subjective distress between the groups emerged: involuntary medication was experienced as the least distressing overall and least humiliating, caused less physical adverse effects and less sense of isolation. Combined coercive interventions, regardless of the type, caused significantly more physical adverse effects and feelings of isolation than individual interventions.ConclusionsIn the absence of information on individual patient preferences, involuntary medication may be more justified than seclusion and mechanical restraint as a coercive intervention. Use of multiple interventions requires significant justification given their association with significant distress.

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A Randomized Controlled Comparison of Seclusion and Mechanical Restraint in Inpatient Settings

Cited by 23 publications

References 0 publications

Seclusion and Psychiatric Intensive Care Evaluation Study (SPICES): combined qualitative and quantitative approaches to the uses and outcomes of coercive practices in mental health services

Seclusion and Psychiatric Intensive Care Evaluation Study (SPICES): combined qualitative and quantitative approaches to the uses and outcomes of coercive practices in mental health services

Quality of Life and Functioning One Year After Experiencing Accumulated Coercive Events During Psychiatric Admission

Evaluation of behavioral changes and subjective distress after exposure to coercive inpatient interventions

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