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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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 & 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</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”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>The Author(s) 2021</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>true</woscitedreferencessubscribed><woscitedreferencescount>7</woscitedreferencescount><woscitedreferencesoriginalsourcerecordid>wos000617464800003</woscitedreferencesoriginalsourcerecordid><citedby>FETCH-LOGICAL-c629t-2bf7d875c2a7fb7d94faae6212cf7703e5bb2b0aa98843030512d6be19806bf53</citedby><cites>FETCH-LOGICAL-c629t-2bf7d875c2a7fb7d94faae6212cf7703e5bb2b0aa98843030512d6be19806bf53</cites><orcidid>0000-0002-3013-2034</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7869451/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7869451/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,315,729,782,786,866,887,2104,2116,27931,27932,39264,39265,53798,53800</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33557780$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><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><title>Prevalence and risk factors for seclusion and restraint in old-age psychiatry inpatient units</title><title>BMC psychiatry</title><addtitle>BMC PSYCHIATRY</addtitle><addtitle>BMC Psychiatry</addtitle><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.</description><subject>Adult</subject><subject>Age</subject><subject>Aged</subject><subject>Aggressive behavior</subject><subject>Aggressiveness</subject><subject>Care and treatment</subject><subject>Coercion</subject><subject>Cognitive ability</subject><subject>Demographic aspects</subject><subject>Emergency medical care</subject><subject>Forecasts and trends</subject><subject>Geriatric Psychiatry</subject><subject>Geriatrics</subject><subject>Hospitalization</subject><subject>Hospitals, Psychiatric</subject><subject>Humans</subject><subject>Inpatients</subject><subject>Isolation (Hospital care)</subject><subject>Life Sciences & Biomedicine</subject><subject>Male</subject><subject>Medical equipment</subject><subject>Mental disorders</subject><subject>Mental Disorders - epidemiology</subject><subject>Mental Disorders - therapy</subject><subject>Mentally ill aged</subject><subject>Nursing</subject><subject>Older people</subject><subject>Patient Isolation</subject><subject>Patients</subject><subject>Population</subject><subject>Prevalence</subject><subject>Psychiatry</subject><subject>Restraint</subject><subject>Restraint, Physical</subject><subject>Retrospective Studies</subject><subject>Risk Factors</subject><subject>Science & Technology</subject><subject>Seclusion</subject><subject>Violence</subject><issn>1471-244X</issn><issn>1471-244X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>GIZIO</sourceid><sourceid>HGBXW</sourceid><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>DOA</sourceid><recordid>eNqNkk1v1DAQhiMEoh_wBzigSFwqVSm2Y8fOBala8VGpEhxA4oKsiWNvvWTtxU6K9t8z25SlizigHGLNPPOOZ_wWxQtKLihVzetMmVKqIoxWpCatqPij4phySSvG-dfHD85HxUnOK0KoVII-LY7qWggpFTkuvn1K9hYGG4wtIfRl8vl76cCMMeXSxVRma4Yp-xjmtM1jAh_G0ocyDn0FS1tu8tbceBjTFqMbGL3F_BT8mJ8VTxwM2T6__58WX969_bz4UF1_fH-1uLyuTMPasWKdk72SwjCQrpN9yx2AbRhlxklJaiu6jnUEoFWK1ziroKxvOktbRZrOifq0uJp1-wgrvUl-DWmrI3h9F4hpqSGN3gxW75oAFwLleo4dWl53FFijQKmuhR613sxam6lb297gMAmGA9HDTPA3ehlvtVRNywVFgbN7gRR_TLgwvfbZ2GGAYOOUNeNKSnwZJhF99Re6ilMKuCqkWsqpEkL9oZb4UNoHF7Gv2Ynqy0bUQtaM1khd_IPCr7drb2KwzmP8oIDNBSbFnJN1-xkp0TuD6dlgGg2m7wymORa9fLidfclvRyFwPgM_bRddNn5nrT1GCGmo5A1XeCK7O6j_pxd-RHPFsIhTGOtfic_sGg</recordid><startdate>20210208</startdate><enddate>20210208</enddate><creator>Chieze, Marie</creator><creator>Kaiser, Stefan</creator><creator>Courvoisier, Delphine</creator><creator>Hurst, Samia</creator><creator>Sentissi, Othman</creator><creator>Fredouille, Jerome</creator><creator>Wullschleger, Alexandre</creator><general>Springer Nature</general><general>BioMed Central Ltd</general><general>BioMed 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and risk factors for seclusion and restraint in old-age psychiatry inpatient units</title><author>Chieze, Marie ; Kaiser, Stefan ; Courvoisier, Delphine ; Hurst, Samia ; Sentissi, Othman ; Fredouille, Jerome ; Wullschleger, Alexandre</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c629t-2bf7d875c2a7fb7d94faae6212cf7703e5bb2b0aa98843030512d6be19806bf53</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Adult</topic><topic>Age</topic><topic>Aged</topic><topic>Aggressive behavior</topic><topic>Aggressiveness</topic><topic>Care and treatment</topic><topic>Coercion</topic><topic>Cognitive ability</topic><topic>Demographic aspects</topic><topic>Emergency medical care</topic><topic>Forecasts and trends</topic><topic>Geriatric Psychiatry</topic><topic>Geriatrics</topic><topic>Hospitalization</topic><topic>Hospitals, Psychiatric</topic><topic>Humans</topic><topic>Inpatients</topic><topic>Isolation (Hospital care)</topic><topic>Life Sciences & Biomedicine</topic><topic>Male</topic><topic>Medical equipment</topic><topic>Mental disorders</topic><topic>Mental Disorders - epidemiology</topic><topic>Mental Disorders - therapy</topic><topic>Mentally ill aged</topic><topic>Nursing</topic><topic>Older people</topic><topic>Patient Isolation</topic><topic>Patients</topic><topic>Population</topic><topic>Prevalence</topic><topic>Psychiatry</topic><topic>Restraint</topic><topic>Restraint, Physical</topic><topic>Retrospective Studies</topic><topic>Risk Factors</topic><topic>Science & 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, 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Alexandre</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Prevalence and risk factors for seclusion and restraint in old-age psychiatry inpatient units</atitle><jtitle>BMC psychiatry</jtitle><stitle>BMC PSYCHIATRY</stitle><addtitle>BMC Psychiatry</addtitle><date>2021-02-08</date><risdate>2021</risdate><volume>21</volume><issue>1</issue><spage>82</spage><epage>82</epage><pages>82-82</pages><artnum>82</artnum><issn>1471-244X</issn><eissn>1471-244X</eissn><abstract>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.</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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