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©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
Determinants of mechanical restraint in an acute psychiatric care unit
Khadija El-Abidi, Antonio R Moreno-Poyato, Alba Toll Privat, David Corcoles Martinez, Rosa Aceña-Domínguez, Victor Pérez-Solà, Anna Mané
Khadija El-Abidi, Alba Toll Privat, David Corcoles Martinez, Rosa Aceña-Domínguez, Victor Pérez-Solà, Department of Psychiatry, Institut de Neuropsiquiatria i Addiccions, Parc de Salut Mar, Barcelona 08003, Spain
Antonio R Moreno-Poyato, Public Health, Mental and Maternal and Child Health, School of Nursing, Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona 08907, Spain
Antonio R Moreno-Poyato, Alba Toll Privat, David Corcoles Martinez, Victor Pérez-Solà, Anna Mané, Biomedical Research, Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona 08003, Spain
Alba Toll Privat, David Corcoles Martinez, Victor Pérez-Solà, Anna Mané, Biomedical Research, Center for Biomedical Research in Mental Health Network, Barcelona 08003, Spain
Anna Mané, Department of Psychiatry, Institut de Neuropsiquiatria i Addiccions, Centre Fòrum, Barcelona 08019, Spain
Author contributions: El-Abidi K is the principal investigator of the study, and contributed to the data collection, write all the article, take the discussion and conclusions; Mané A is the study coordination, contributed to analysis of results; Moreno-Poyato AR bibliographic reviewed for the introduction; Toll Privat A helped with the data collection; Corcoles Martinez D contributed to the analysis and interpretation of results with SPSS; Pérez-Solà V and Aceña-Domínguez R contributed to the article review.
Institutional review board statement: The study was reviewed and approved by the Comité de Ética de la Investigación con Medicamentos del Parc de Salut Mar Institutional Review Board (Approval No.2019/8524/I).
Informed consent statement: The use of written informed consent in this study was not necessary given the nature of the study.
Conflict-of-interest statement: No conflict of interest has been declared by the authors.
Data sharing statement: Technical appendix, statistical code, and dataset available from the corresponding author at amane@parcdesalutmar.cat.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
http://creativecommons.org/Licenses/by-nc/4.0/ Corresponding author: Anna Mané, MD, MSc, PhD, Doctor, Department of Psychiatry, Institut de Neuropsiquiatria i Addiccions, Centre Fòrum, Calle Llull, 410, Barcelona 08019, Spain. amane@parcdesalutmar.cat
Received: April 22, 2021
Peer-review started: April 22, 2021
First decision: June 17, 2021
Revised: June 28, 2021
Accepted: September 3, 2021
Article in press: September 3, 2021
Published online: October 19, 2021
ARTICLE HIGHLIGHTS
Research background
The use of mechanical restraint (MR) in hospitalized psychiatric patients remains controversial due to the numerous ethical, legal, and clinical questions associated with this practice. Many efforts have been made to reduce the use of MR. Nevertheless, it remains widely used in acute psychiatric care settings throughout Europe.
Research motivation
It’s essential to identify the patients most likely to require MR or those likely to require a more prolonged duration of MR.
Research objectives
The main objective is to determine the proportion of patients subjected to MR and the duration thereof in two acute care psychiatric units. Secondly, to identify the variables associated with the use and duration of MR.
Research methods
Descriptive study of all patients admitted to the acute psychiatric units at the Parc de Salut Mar. The number and percentage of patients subjected to MR and the duration of each episode were assessed. Multivariate analyses were performed to evaluate the determinants of MR and its course.
Research results
The results show that the use of MR is very frequent. The diagnosis of psychotic disorder and the presence of a language barrier were associated with a greater risk of MR. The male sex was associated with longer restraint periods
Research conclusions
Despite efforts to reduce or eliminate the use of MR, the results of this study show that these procedures remain widely used in the acute care units at our hospital. Its determining factors are the psychotic disorder and the language barrier. The factors of a prolonged MR is the male sex.
Research perspectives
It is important to develop specific protocols to further reduce the use of MR.
