Restraint prevalence and perceived coercion among psychiatric inpatients from South India: A prospective study

Gowda, Guru S; Lepping, Peter; Noorthoorn, Eric; Ali, Syed Ahmad; Kumar, Channaveerachari Naveen; Raveesh, Bevinahalli Nanjegowda; Math, Suresh Bada

doi:10.1016/j.ajp.2018.05.024

Cited by 31 publications

(46 citation statements)

References 37 publications

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“…Most studies (n=42) reported on restraint and seclusion techniques. The pooled prevalence for coercive interventions was 47.8% (95% CI 0.38 to 0.57) with high heterogeneity (I 2 100.0%) in 12 studies136–147 (online supplementary file 6).…”

Section: Resultsmentioning

confidence: 99%

“…Thirty-two studies focused on coercion; one study examined prevalence of coercive measures141 and one study explored how the experience of staff might contribute to the use of restrictive practices 210. The attitudes of staff,142 144 211–222 patients145 223–226 and mixed groups143 168 227–230 towards coercion were explored in 25 studies, and 5 studies examined the process of coercive interventions139 140 231 232 and rules of engagement in caring for aggressive patients 233…”

Section: Resultsmentioning

confidence: 99%

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Patient safety in inpatient mental health settings: a systematic review

et al. 2019

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ObjectivesPatients in inpatient mental health settings face similar risks (eg, medication errors) to those in other areas of healthcare. In addition, some unsafe behaviours associated with serious mental health problems (eg, self-harm), and the measures taken to address these (eg, restraint), may result in further risks to patient safety. The objective of this review is to identify and synthesise the literature on patient safety within inpatient mental health settings using robust systematic methodology.DesignSystematic review and meta-synthesis. Embase, Cumulative Index to Nursing and Allied Health Literature, Health Management Information Consortium, MEDLINE, PsycINFO and Web of Science were systematically searched from 1999 to 2019. Search terms were related to ‘mental health’, ‘patient safety’, ‘inpatient setting’ and ‘research’. Study quality was assessed using the Hawker checklist. Data were extracted and grouped based on study focus and outcome. Safety incidents were meta-analysed where possible using a random-effects model.ResultsOf the 57 637 article titles and abstracts, 364 met inclusion criteria. Included publications came from 31 countries and included data from over 150 000 participants. Study quality varied and statistical heterogeneity was high. Ten research categories were identified: interpersonal violence, coercive interventions, safety culture, harm to self, safety of the physical environment, medication safety, unauthorised leave, clinical decision making, falls and infection prevention and control.ConclusionsPatient safety in inpatient mental health settings is under-researched in comparison to other non-mental health inpatient settings. Findings demonstrate that inpatient mental health settings pose unique challenges for patient safety, which require investment in research, policy development, and translation into clinical practice.PROSPERO registration numberCRD42016034057.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Patient safety in inpatient mental health settings: a systematic review

et al. 2019

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“…Physical restraint can be defined as any device, material, or equipment attached to or placed near a person's body and which cannot be controlled or easily removed by the person and which deliberately prevents or is deliberately intended to prevent a person's free body movement to a position of choice and/or a person's normal access to their body parts. [ 3 4 5 ] The most common examples of physical restraint include bedside rails, tucking very tightly in sheets, limb ties, straps, belts. [ 3 6 ]…”

Section: Types Of Restraintsmentioning

confidence: 99%

“…The predominant type of restraint that has been constantly discussed in the literature is mechanical and physical restraints. The practice of restraint and attempts to reduce its use by alternative methods have been attempted in various clinical settings such as (a) acute psychiatry ward,[ 4 7 ] (b) long stay homes for mentally retarded and patients suffering from severe and chronic mental illness, (c) child psychiatry wards,[ 8 ] and (d) elderly care nursing homes. [ 7 ] Restraint in acute psychiatry ward is predominantly used as a means to control aggression and in turn decrease the harm to self and others,[ 9 10 11 ] whereas in child psychiatry wards and long-stay homes, it is used to control problem behaviors.…”

Section: Types Of Restraintsmentioning

confidence: 99%

“…Much has been published about the physical consequences whereas little is known about psychological and social consequences. [ 4 ] Even those literature which speak about the restraint's ethical issues and considerations are predominantly about the ethical issues around the physical restraint. Use of restraints is further affected by differences in legislation, education, culture, and the settings in which such restraints are used.…”

Section: Restraint: Why Not?mentioning

confidence: 99%

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Alternatives to use of restraint: A path toward humanistic care

Raveesh

Gowda

2019

Indian J Psychiatry

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Ethnic disparities in the use of restrictive practices in adult mental health inpatient settings: a scoping review

Pedersen

Gildberg

Baker

et al. 2022

Soc Psychiatry Psychiatr Epidemiol

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Purpose To identify and summarise extant knowledge about patient ethnicity and the use of various types of restrictive practices in adult mental health inpatient settings. Methods A scoping review methodological framework recommended by the JBI was used. A systematic search was conducted in APA PsycINFO, CINAHL with Full Text, Embase, PubMed and Scopus. Additionally, grey literature searches were conducted in Google, OpenGrey and selected websites, and the reference lists of included studies were explored. Results Altogether, 38 studies were included: 34 were primary studies; 4, reviews. The geographical settings were as follows: Europe ( n = 26), Western Pacific ( n = 8), Americas ( n = 3) and South-East Asia ( n = 1). In primary studies, ethnicity was reported according to migrant/national status ( n = 16), mixed categories ( n = 12), indigenous vs. non-indigenous ( n = 5), region of origin ( n = 1), sub-categories of indigenous people ( n = 1) and religion ( n = 1). In reviews, ethnicity was not comparable. The categories of restrictive practices included seclusion, which was widely reported across the studies ( n = 20), multiple restrictive practices studied concurrently ( n = 17), mechanical restraint ( n = 8), rapid tranquillisation ( n = 7) and manual restraint ( n = 1). Conclusions Ethnic disparities in restrictive practice use in adult mental health inpatient settings has received some scholarly attention. Evidence suggests that certain ethnic minorities were more likely to experience restrictive practices than other groups. However, extant research was characterised by a lack of consensus and continuity. Furthermore, widely different definitions of ethnicity and restrictive practices were used, which hampers researchers’ and clinicians’ understanding of the issue. Further research in this field may improve mental health practice. Supplementary Information The online version contains supplementary material available at 10.1007/s00127-022-02387-8.

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Restraint prevalence and perceived coercion among psychiatric inpatients from South India: A prospective study

Cited by 31 publications

References 37 publications

Patient safety in inpatient mental health settings: a systematic review

Patient safety in inpatient mental health settings: a systematic review

Alternatives to use of restraint: A path toward humanistic care

Ethnic disparities in the use of restrictive practices in adult mental health inpatient settings: a scoping review

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