Methodological issues in monitoring the use of coercive measures

Janssen, W; Sande, R.R.W. van de; Noorthoorn, Eric; Nijman, Henk; Bowers, Len; Mulder, Cornelis L.; Smit, Annet; Widdershoven, Guy; Steinert, Tilman

doi:10.1016/j.ijlp.2011.10.008

Cited by 66 publications

(73 citation statements)

References 14 publications

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“…Because the routines and culture for hospital admission vary a lot, the use of restraint per inhabitant probably is the best measure to use [9]. However, most studies report the percentage of admitted patients.…”

Section: Use Of Restraintmentioning

confidence: 99%

“…Because there is a known variation during the year [9], we have covered the whole year and all seasons. Another important factor is that we have covered a period of several, consecutive years and not only reported 'point prevalence'.…”

Section: Study Limitations and Strengthsmentioning

confidence: 99%

“…The four wards in the study represented the only available inpatient acute psychiatric service for the whole catchment area of South-Trøndelag and thus the main use of restraint in the area. This allows us to calculate the frequency of restraint per 100,000 inhabitants in the catchment area, avoiding bias due to differences in the organization of psychiatric services as emphasized by Janssen et al [9]. Thus, a representative image of the use of restraint in this area is shown.…”

Section: Study Limitations and Strengthsmentioning

confidence: 99%

“…The need for a consensus on definitions has been discussed. A time frame of one year to avoid variation over the year and report on the number of incidents of restraint per 100,000 inhabitants in the hospital's catchment area are suggested [8,9]. National legislation regulates the use of different forms of coercion.…”

Section: Introductionmentioning

confidence: 99%

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Use of mechanical and pharmacological restraint over an eight-year period and its relation to clinical factors

Reitan

Helvik

Iversen

2017

Nordic Journal of Psychiatry

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Background: Use of restraint and finding the balance between security and ethics is a continuous dilemma in clinical psychiatry. In daily clinic and in planning health-care service, knowledge on the characteristics of restraint situations is necessary to optimize its use and avoid abuse. Methods: We describe characteristics in the use of pharmacological and mechanical restraint in psychiatric acute wards in a hospital in Middle Norway over an eight-year period. Data on all cases of mechanical and pharmacological restraint from 2004 to 2011 were retrospectively collected from handwritten protocols. Complementary information on the patients was obtained from the hospital patient administrative system. Results: Restraint in acute wards was used on 13 persons per 100,000 inhabitants annually. The percentage of admitted patients exposed to restraint was 1.7%, with a mean of 4.5 cases per exposed patient. Frequency per 100 admitted patients varied from 3.7 (in 2007) to 10 (in 2009). The majority of restraint cases concerned male patients under 50 years and with substance-abuse, psychotic, or affective disorders. Significantly more coercive means were used during daytime compared to night and morning. There was a significant increase in pharmacological coercion during spring and mechanical coercion during summer. Conclusions: Restraint was used on 1.7% of admitted patients, representing 13 per 100,000 inhabitants per year. Use of restraint was higher during certain periods of the day and was associated with the patient's diagnosis, age, gender, and legal status of hospitalization. There was a marked variation over the years.

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Section: Use Of Restraintmentioning

confidence: 99%

Section: Study Limitations and Strengthsmentioning

confidence: 99%

Section: Study Limitations and Strengthsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Use of mechanical and pharmacological restraint over an eight-year period and its relation to clinical factors

Reitan

Helvik

Iversen

2017

Nordic Journal of Psychiatry

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“…The absence of a standardized definition of coercion in mental health practice [16]; although many papers with suggestions and consensus of definitions have been published, a general standardized definition of coercion is not possible due to the very different aspects of coercion; . The different types of coercive measures used in different institutions and countries [32, [66][67][68][69][70]. In fact, a compulsory admission or forced medication may be perceived by patients as less detrimental than restraint or seclusion, and therefore a comparison of studies using different coercive measures may be biased.…”

Section: Prospective Cohort Studymentioning

confidence: 99%

Use of coercive measures in mental health practice and its impact on outcome: a critical review

Luciano

Sampogna

Vecchio

et al. 2014

Expert Review of Neurotherapeutics

102

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Although coercive measures have always been part of the psychiatric armamentarium, the ethical dilemma between the use of a "therapeutic" coercion and the loss of patients' dignity is one of the major controversial issues in mental health research and practice. The aims of the present review are to explore the existing literature on predictors of use of coercive measures and to explore the relationship between coercive measures and patient outcome. A literature search was conducted using MEDLINE, PsychyINFO, Scopus, Web of Knowledge and the Cochrane Database. In all selected papers, references were cross-checked to identify other possible eligible papers. The use of coercive measures was predicted by patients' clinical and socio-demographic features, staff characteristics and ward-related factors. Coercive measures have only a limited impact on patients' clinical and social outcome. At the current level of knowledge, coercion is still a controversial issue in mental health practice. Only few studies with a solid methodology have been carried out. Large multicenter and rigorous studies, with long-term follow-ups, are highly needed.

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