Prevalence and risk factors for seclusion and restraint in old-age psychiatry inpatient units

Background and objectives Coercion in psychiatry is legally tolerated as a last resort. The reduction of the use of coercion is a shared goal of hospital administrators, medical and nursing staff and representatives of patients and families but requires the identification of risk factors for coercio...

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Veröffentlicht in:BMC psychiatry 2021-02, Vol.21 (1), p.82-82, Article 82
Hauptverfasser: Chieze, Marie, Kaiser, Stefan, Courvoisier, Delphine, Hurst, Samia, Sentissi, Othman, Fredouille, Jerome, Wullschleger, Alexandre
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container_end_page 82
container_issue 1
container_start_page 82
container_title BMC psychiatry
container_volume 21
creator Chieze, Marie
Kaiser, Stefan
Courvoisier, Delphine
Hurst, Samia
Sentissi, Othman
Fredouille, Jerome
Wullschleger, Alexandre
description Background and objectives Coercion in psychiatry is legally tolerated as a last resort. The reduction of the use of coercion is a shared goal of hospital administrators, medical and nursing staff and representatives of patients and families but requires the identification of risk factors for coercion. These risk factors in geriatric psychiatric inpatient settings are not well known, especially regarding seclusion. Through examining the prevalence of coercion and patients' characteristics, this study aims to identify risk factors for coercion in elderly people. Methods The use of coercion in the geriatric psychiatry division of Geneva University Hospital in 2017 was retrospectively analyzed. The incidence rate ratios were estimated with multivariable Poisson regressions to assess risk factors for coercion. Results Eighty-one of 494 patients (16.4%) experienced at least one coercive measure during their stay (mainly seclusion). The risk factors for coercion were younger age, male gender, being divorced or married, cognitive disorders, high item 1 of the Health of the Nation Outcome Scales (HoNOS) score (overactive, aggressive, disruptive or agitated behavior) at admission, previous psychiatric hospitalizations and involuntary referrals from the emergency department. Other disorders and global HoNOS scores were not associated with the use of coercion. Conclusion Higher risks of coercion were outlined in men with cognitive disorders, agitated behaviors, and previous psychiatric hospitalizations. They differed from those observed in younger adults in terms of age, civil status, disorders, global HoNOS scores and referrals. Therefore, geriatric psychiatric populations should be specifically investigated for the development of interventions aiming coercion reduction.
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The reduction of the use of coercion is a shared goal of hospital administrators, medical and nursing staff and representatives of patients and families but requires the identification of risk factors for coercion. These risk factors in geriatric psychiatric inpatient settings are not well known, especially regarding seclusion. Through examining the prevalence of coercion and patients' characteristics, this study aims to identify risk factors for coercion in elderly people. Methods The use of coercion in the geriatric psychiatry division of Geneva University Hospital in 2017 was retrospectively analyzed. The incidence rate ratios were estimated with multivariable Poisson regressions to assess risk factors for coercion. Results Eighty-one of 494 patients (16.4%) experienced at least one coercive measure during their stay (mainly seclusion). The risk factors for coercion were younger age, male gender, being divorced or married, cognitive disorders, high item 1 of the Health of the Nation Outcome Scales (HoNOS) score (overactive, aggressive, disruptive or agitated behavior) at admission, previous psychiatric hospitalizations and involuntary referrals from the emergency department. Other disorders and global HoNOS scores were not associated with the use of coercion. Conclusion Higher risks of coercion were outlined in men with cognitive disorders, agitated behaviors, and previous psychiatric hospitalizations. They differed from those observed in younger adults in terms of age, civil status, disorders, global HoNOS scores and referrals. Therefore, geriatric psychiatric populations should be specifically investigated for the development of interventions aiming coercion reduction.</description><identifier>ISSN: 1471-244X</identifier><identifier>EISSN: 1471-244X</identifier><identifier>DOI: 10.1186/s12888-021-03095-4</identifier><identifier>PMID: 33557780</identifier><language>eng</language><publisher>LONDON: Springer Nature</publisher><subject>Adult ; Age ; Aged ; Aggressive behavior ; Aggressiveness ; Care and treatment ; Coercion ; Cognitive ability ; Demographic aspects ; Emergency medical care ; Forecasts and trends ; Geriatric Psychiatry ; Geriatrics ; Hospitalization ; Hospitals, Psychiatric ; Humans ; Inpatients ; Isolation (Hospital care) ; Life Sciences &amp; Biomedicine ; Male ; Medical equipment ; Mental disorders ; Mental Disorders - epidemiology ; Mental Disorders - therapy ; Mentally ill aged ; Nursing ; Older people ; Patient Isolation ; Patients ; Population ; Prevalence ; Psychiatry ; Restraint ; Restraint, Physical ; Retrospective Studies ; Risk Factors ; Science &amp; Technology ; Seclusion ; Violence</subject><ispartof>BMC psychiatry, 2021-02, Vol.21 (1), p.82-82, Article 82</ispartof><rights>COPYRIGHT 2021 BioMed Central Ltd.</rights><rights>2021. This work is licensed under http://creativecommons.org/licenses/by/4.0/ (the “License”). 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The reduction of the use of coercion is a shared goal of hospital administrators, medical and nursing staff and representatives of patients and families but requires the identification of risk factors for coercion. These risk factors in geriatric psychiatric inpatient settings are not well known, especially regarding seclusion. Through examining the prevalence of coercion and patients' characteristics, this study aims to identify risk factors for coercion in elderly people. Methods The use of coercion in the geriatric psychiatry division of Geneva University Hospital in 2017 was retrospectively analyzed. The incidence rate ratios were estimated with multivariable Poisson regressions to assess risk factors for coercion. Results Eighty-one of 494 patients (16.4%) experienced at least one coercive measure during their stay (mainly seclusion). The risk factors for coercion were younger age, male gender, being divorced or married, cognitive disorders, high item 1 of the Health of the Nation Outcome Scales (HoNOS) score (overactive, aggressive, disruptive or agitated behavior) at admission, previous psychiatric hospitalizations and involuntary referrals from the emergency department. Other disorders and global HoNOS scores were not associated with the use of coercion. Conclusion Higher risks of coercion were outlined in men with cognitive disorders, agitated behaviors, and previous psychiatric hospitalizations. They differed from those observed in younger adults in terms of age, civil status, disorders, global HoNOS scores and referrals. 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Technology</topic><topic>Seclusion</topic><topic>Violence</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Chieze, Marie</creatorcontrib><creatorcontrib>Kaiser, Stefan</creatorcontrib><creatorcontrib>Courvoisier, Delphine</creatorcontrib><creatorcontrib>Hurst, Samia</creatorcontrib><creatorcontrib>Sentissi, Othman</creatorcontrib><creatorcontrib>Fredouille, Jerome</creatorcontrib><creatorcontrib>Wullschleger, Alexandre</creatorcontrib><collection>Web of Knowledge</collection><collection>Web of Science Core Collection</collection><collection>Science Citation Index Expanded</collection><collection>Social Sciences Citation Index</collection><collection>Web of Science Primary (SCIE, SSCI &amp; AHCI)</collection><collection>Web of Science - Social Sciences Citation Index – 2021</collection><collection>Web of Science - Science Citation Index Expanded - 2021</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Neurosciences Abstracts</collection><collection>Health &amp; 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The reduction of the use of coercion is a shared goal of hospital administrators, medical and nursing staff and representatives of patients and families but requires the identification of risk factors for coercion. These risk factors in geriatric psychiatric inpatient settings are not well known, especially regarding seclusion. Through examining the prevalence of coercion and patients' characteristics, this study aims to identify risk factors for coercion in elderly people. Methods The use of coercion in the geriatric psychiatry division of Geneva University Hospital in 2017 was retrospectively analyzed. The incidence rate ratios were estimated with multivariable Poisson regressions to assess risk factors for coercion. Results Eighty-one of 494 patients (16.4%) experienced at least one coercive measure during their stay (mainly seclusion). The risk factors for coercion were younger age, male gender, being divorced or married, cognitive disorders, high item 1 of the Health of the Nation Outcome Scales (HoNOS) score (overactive, aggressive, disruptive or agitated behavior) at admission, previous psychiatric hospitalizations and involuntary referrals from the emergency department. Other disorders and global HoNOS scores were not associated with the use of coercion. Conclusion Higher risks of coercion were outlined in men with cognitive disorders, agitated behaviors, and previous psychiatric hospitalizations. They differed from those observed in younger adults in terms of age, civil status, disorders, global HoNOS scores and referrals. Therefore, geriatric psychiatric populations should be specifically investigated for the development of interventions aiming coercion reduction.</abstract><cop>LONDON</cop><pub>Springer Nature</pub><pmid>33557780</pmid><doi>10.1186/s12888-021-03095-4</doi><tpages>10</tpages><orcidid>https://orcid.org/0000-0002-3013-2034</orcidid><oa>free_for_read</oa></addata></record>
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subjects Adult
Age
Aged
Aggressive behavior
Aggressiveness
Care and treatment
Coercion
Cognitive ability
Demographic aspects
Emergency medical care
Forecasts and trends
Geriatric Psychiatry
Geriatrics
Hospitalization
Hospitals, Psychiatric
Humans
Inpatients
Isolation (Hospital care)
Life Sciences & Biomedicine
Male
Medical equipment
Mental disorders
Mental Disorders - epidemiology
Mental Disorders - therapy
Mentally ill aged
Nursing
Older people
Patient Isolation
Patients
Population
Prevalence
Psychiatry
Restraint
Restraint, Physical
Retrospective Studies
Risk Factors
Science & Technology
Seclusion
Violence
title Prevalence and risk factors for seclusion and restraint in old-age psychiatry inpatient units
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