Objective: Restraint can be described as mechanical and/or physical interventions intending to limit a patients body movements and to control his/her behaviors in therapeutical settings. Restraint is generally practiced to prevent patients from harming themselves and/or others in psychiatry clinics. Nowadays it is aimed to minimize restraint and seclusion practices due to their potentially harmful effects. Accordingly, there is a need for further studies investigating topics such as the use of different restraint methods, the factors affecting the decision of restraint, and potential benefits and harms of restraint. In this study, we aimed to determine current rates of physical restraints in patients hospitalized in acute psychiatric clinics and to investigate sociodemographic and clinical variables which may be related with restraint practices.
Method: The study was conducted in two psychiatric inpatient units (64-bed male unit and 28-bed female unit) of Bakirkoy Prof. Dr. Mazhar Osman Training and Research Hospital for Psychiatry, Neurology and Neurosurgery, in the period between March 1 and May 31 2015. Sociodemographic and clinical data forms were completed using case files and restraint records.
Results: A total number of 481 inpatients (351 male and 130 female) were treated between these dates in these clinics. The number of restrained patients was 98 (20.3%) and the total number of restraints was 174. Among male patients, the number of restrained cases was 90 (25.7%), among female patients it was found to be 8 (6.2%). There was no significant difference in terms of sociodemographic characteristics between restrained and unrestrained patients. The duration of the illness and the electroconvulsive therapy rates were found to be significantly different between restrained and unrestrained patients. Psychoactive substance abuse (44.4%) was higher in restrained male patients compared to unrestrained patients. Also, restraint rates were higher in patients having a diagnosis of substance-related disorder compared to other diagnoses. Restraints occurred most commonly in the first day (48%) of hospitalization.
Conclusions: The studies carried out in psychiatric hospitals suggested major differences in the rates of restraints among different countries and institutions. In our study, a higher retraint rate (%20,3) is obtained compared to other studies. Consistently with the literature, psychoactive substance abuse was higher in restrained patients, and restraints occurred most commonly in the first day of hospitalization. Many factors including psychoactive substance abuse should be considered to reduce restraint rates which are still quite high especially in mental health hospitals.
Psychiatric clinic, psychosis, restraint, mental health
Article Language: Turkish English