| The practice of seclusion and time-out on English acute psychiatric wards: the City-128 Study. | |
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MedLine Citation:
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PMID: 20650373 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Seclusion is widely used internationally to manage disturbed behavior by psychiatric patients, although many countries are seeking to reduce or eliminate this practice. Time-out has been little described and almost completely unstudied. AIM AND METHOD: To assess the relationship of seclusion and time-out to conflict behaviors, the use of containment methods, service environment, physical environment, patient routines, staff characteristics, and staff group variables. Data from a multivariate cross-sectional study of 136 acute psychiatric wards in England were used to conduct this analysis. RESULTS: Seclusion is used infrequently on English acute psychiatric wards (0.05 incidents per day), whereas time-out use was more frequent (0.31 incidents per day). Usage of seclusion was strongly associated with the availability of a seclusion room. Seclusion was associated with aggression, alcohol use, absconding, and medication refusal, whereas time-out was associated with these and other more minor conflict behaviors. Both were associated with the giving of "as required" medication, coerced intramuscular medication, and manual restraint. Relationships with exit security for the ward were also found. CONCLUSIONS: Given its low usage rate, the scope for seclusion reduction in English acute psychiatry may be small. Seclusion reduction initiatives need to take a wider range of factors into account. Some substitution of seclusion with time-out may be possible, but a rigorous trial is required to establish this. The safety of intoxicated patients in seclusion requires more attention. |
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Authors:
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Len Bowers; Marie Van Der Merwe; Henk Nijman; Bridget Hamilton; Eric Noorthorn; Duncan Stewart; Eimear Muir-Cochrane |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't Date: 2009-11-10 |
Journal Detail:
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Title: Archives of psychiatric nursing Volume: 24 ISSN: 1532-8228 ISO Abbreviation: Arch Psychiatr Nurs Publication Date: 2010 Aug |
Date Detail:
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Created Date: 2010-07-23 Completed Date: 2010-11-09 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8708534 Medline TA: Arch Psychiatr Nurs Country: United States |
Other Details:
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Languages: eng Pagination: 275-86 Citation Subset: IM; N |
Copyright Information:
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2010 Elsevier Inc. All rights reserved. |
Affiliation:
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City University, London, United Kingdom. l.bowers@city.ac.uk |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Acute Disease Cross-Sectional Studies England Female Humans Male Mental Disorders / psychology, therapy* Poisson Distribution Psychiatric Department, Hospital* / manpower Social Isolation / psychology* Trust |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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