Descriptive study of mechanical restraint in acute psychiatric inpatient unit of Jerez De La Frontera: Analysis of a risk profile

Abstract

Introduction

Various medical and psychiatric conditions can determine the occurrence of disruptive behavior and aggression. Mechanical restraint is part of the strategies for managing these risks. Its use implies a multidisciplinary, phased and individualized for each case strategy, with attention to the ethical and legal issues surrounding this coercive intervention.

Objective

The objective of this work is the analysis of the profile of patients who required mechanical restraint during hospitalization in a psychiatric inpatient unit.

Methodology

Retrospective descriptive analysis by collecting data of patients, who required mechanical restraint during admission, between 2007 and 2014. The data sources were medical clinical history and nursing records. Variables analyzed were sex, age, clinical diagnosis at discharge and clinical state during the episode of mechanical restraint.

Results

Of the total sample of patients requiring restraint (n = 266), 66.92% were men. The mean age of patients was 38.01 years. Distribution of clinical diagnoses based on ICD-10 coding: 30.23% F60 personality disorder (n = 289), 19.56% diagnosed with F31 bipolar disorder (n = 187) and 14.02% F20 schizophrenia. Regarding the clinical characteristics of the episode, 49.47% of patients had an agitation/violent state and in 23.11% risk of impulsive self-injury was evident, 13.47% had confusional syndrome.

Conclusion

Data analyzed shows differences in frequency distribution because of patient profile and clinical diagnosis. Otherwise, organizational factors and appropriate amendments to this level appear to play a key role in minimizing the use of such coercive measures.

Disclosure of interest

The authors have not supplied their declaration of competing interest.