scholarly journals The Role of Mechanical Restraints in the Management of Disturbed Behaviour

1978 ◽  
Vol 23 (4) ◽  
pp. 209-218 ◽  
Author(s):  
Ezzat F. Guirguis ◽  
Henry B. Durost
Keyword(s):  
Mental Retardation ◽  
Staff Training ◽  
Psychiatric Patients ◽  
Psychiatric Hospitals ◽  
Violent Behaviour ◽  
Contentious Issue ◽  
Frequency Of Use ◽  
Psychiatric Units ◽  
Mechanical Restraints

The use of mechanical restraints for the management of disturbed or violent psychiatric patients continues to be a controversial issue. A survey of their use was carried out by means of a questionnaire sent to 370 psychiatric facilities in Canada to which there was a 62.2% response. General hospital psychiatric units, psychiatric hospitals and mental retardation centres accounted for 83.0% (191) of the returns and were the only facilities analyzed. The study showed that the vast majority still use mechanical restraints. The types of restraints in order of frequency of use included posey belts or shirts, isolation room, straps, sheets, strait jackets, wet or dry packs, hydrotherapy, and others. Violent behaviour is the main reason for which restraints are used. Medical orders, recording procedures and staff training in techniques of managing disturbed behaviour are reviewed. An important finding is the significant majority of facilities that have no stated policy permitting or forbidding the use of restraints. The findings are briefly related to Tuke's work in 1882 pointing to similarities in practice. Finally, the authors emphasize the need to deal with this contentious issue in an enlightened manner reflecting modern day demands.

Patient Rights and Law: tobacco smoking in psychiatric wards and the Israeli Prevention of Smoking Act

2004 ◽  
Vol 11 (5) ◽  
pp. 472-478 ◽  
Author(s):  
Ilya Kagan ◽  
Ronit Kigli-Shemesh ◽  
Nili Tabak ◽  
Moshe Z Abramowitz ◽  
Jacob Margolin
Keyword(s):  
Mental Health ◽  
Health System ◽  
Tobacco Smoking ◽  
Mental Health System ◽  
Psychiatric Patients ◽  
Psychiatric Hospitals ◽  
Moral Dilemmas ◽  
Public Places ◽  
Patients Rights

In August 2001, the Israeli Ministry of Health issued its Limitation of Smoking in Public Places Order, categorically forbidding smoking in hospitals. This forced the mental health system to cope with the issue of smoking inside psychiatric hospitals. The main problem was smoking by compulsorily hospitalized psychiatric patients in closed wards. An attempt by a psychiatric hospital to implement the tobacco smoking restraint instruction by banning the sale of cigarettes inside the hospital led to the development of a black market and cases of patient exploitation in return for cigarettes. This article surveys the literature dealing with smoking among psychiatric patients, the role of smoking in patients and the moral dilemmas of taking steps to prevent smoking in psychiatric hospitals. It addresses the need for public discussion on professional caregivers’ dilemmas between their commitment to uphold the law and their duty to act as advocates for their patients’ rights and welfare.

Shoplifting in the Mentally Ill: The role of bipolar affective disorder and mental retardation

2005 ◽  
Vol 45 (4) ◽  
pp. 317-320 ◽  
Author(s):  
Rachel S Y Cheng ◽  
Candy Lin ◽  
Marcella L Y Fok ◽  
Chi-Ming Leung
Keyword(s):  
Mental Retardation ◽  
Affective Disorder ◽  
Mentally Ill ◽  
Matched Control ◽  
Psychiatric Patients ◽  
Bipolar Affective Disorder ◽  
Mental Illnesses ◽  
Control Group ◽  
University Department

This study explores shoplifting behaviour in mentally ill patients, and evaluates the association between shoplifting and different mental illnesses in a local Chinese population. A comparison is made between shoplifting offenders and a matched control group of non-offenders among the psychiatric patients registered at a university department of psychiatry. Major depression, bipolar affective disorder (BAD) and mental retardation (MR) are the most common diagnoses among mentally ill shoplifters, while patients with a diagnosis of BAD or MR are at higher risk of committing an offence than patients with other diagnoses. Bipolar affective disorder has not been described as a risk factor for shoplifting behaviour in the psychiatric literature. Such a possibility should be seriously considered in the psychiatric assessment of shoplifting cases.

scholarly journals The reform of psychiatric care in Greece: 1983-1989

1992 ◽  
Vol 7 (6) ◽  
pp. 251-257 ◽  
Author(s):  
D Sarantidis ◽  
V Kladouchos ◽  
J Tripodianakis ◽  
R Giel ◽  
P Munk-Jorgensen
Keyword(s):  
Mental Health ◽  
Catchment Area ◽  
Psychiatric Care ◽  
Psychiatric Hospitals ◽  
General Hospitals ◽  
Health Delivery ◽  
Psychiatric Units ◽  
Health Delivery System ◽  
Quantitative Changes

SummaryWe have attempted to evaluate quantitative changes in the mental health delivery system in Greece, dictated by a fiveyear program to reform psychiatric care. By the end of the program, a number of psychiatric units in general hospitals, as well as community mental health centres, had been created, while the number of beds in psychiatric hospitals have been significantly reduced. Mental health services have become more accessible to the population, and served more patients. However, not all the objectives of the program have been met. Only about half of the initially proposed number of beds in the psychiatric units in general hospitals have been actually developed. The catchment area, a basic pre-requisite of the program, has not been put into effect. Finally, the noticeable trend towards a restriction of the role of psychiatric hospitals did not coincide with the development of adequate new services.

Disability, outcome and case-mix in acute psychiatric in-patient units

1997 ◽  
Vol 171 (3) ◽  
pp. 242-246 ◽  
Author(s):  
Brendon Boot ◽  
Wayne Hall ◽  
Gavin Andrews
Keyword(s):  
Length Of Stay ◽  
Short Form ◽  
Psychiatric Patients ◽  
Health Gain ◽  
Psychiatric Hospitals ◽  
Public Hospitals ◽  
Case Mix ◽  
Private Hospitals ◽  
Psychiatric Units ◽  
Routine Outcome Assessment

BackgroundEighteen acute in-patient psychiatric units in Australia funded a syndicate to measure case-mix, disability and outcome of treatment. This syndicate included eight units in public general hospitals, five in stand-alone public psychiatric hospitals and five in private psychiatric hospitals.MethodUp to 100 in-patients admitted consecutively to each hospital (1359 in all) were assigned to a Diagnosis-Related Group (DRG), rated on the Health of the Nation Outcome Scales (HoNOS) and asked to complete the Medical Outcomes Trust Short Form 36 (SF36). These scales were administered again at discharge. Demographic information and length of stay were also recorded. Disability was measured by scores on the HoNOS and SF36 at admission, and outcome was assessed by the change in scores between admission and discharge.ResultsThe public hospitals treated significantly more patients with schizophrenia and fewer with affective disorders, and their case load on admission was more disabled, on the whole, than that of the private hospitals. They achieved the same outcome or health gain as the private hospitals, but needed a shorter length of stay to do so. The addition of disability scores to DRG moderately increased the ability to predict length of stay.ConclusionsRoutine outcome assessment using reliable and valid instruments is practical, and could lead to improvements in the quality of care for psychiatric patients.

scholarly journals Organizational model of ensuring safety and quality of treatment of aggressive psychiatric patients in mental health nursing in Slovenia

2014 ◽  
Vol 48 (4) ◽  
Author(s):  
Branko Gabrovec ◽  
Branko Lobnikar
Keyword(s):  
Success Rate ◽  
Psychiatric Patients ◽  
Statistical Significance ◽  
Psychiatric Hospitals ◽  
Organizational Model ◽  
Mental Health Nursing ◽  
Functional Training ◽  
Proposed Model ◽  
Psychiatric Units

Introduction: The paper presents the organizational measures for managing violence in psychiatric settings and the study that introduces the preliminary success rate of the proposed model. Methods: For the purpose of this study a non-experimental sampling method was employed using a structured questionnaire as a data collection instrument. The sample covered the personnel most frequently exposed to violence namely, the nursing staff in closed and/or intensive psychiatric units in 5 Slovenian psychiatric hospitals, 3 psychiatric homes and 2 special education, and work and care centres. The data were statistically analysed with the SPSS v20 software package, with p < 0.05 indicating statistical significance. Results: The practical part of the functional training was conducted between 2010 and 2013 in specific psychiatric hospitals and wards. In a study carried out in 2013, preliminary results indicating the success rate of the proposed model were obtained. Discussion and conclusions: Health care workers in psychiatry are responsible for providing safe and high quality treatment even in cases of aggressive outbursts, but they lack the necessary functional knowledge to cope with aggression in the workplace. The paper presents an organizational model for ensuring the safety of the patients and the quality of their treatment in case of an aggressive outburst, along with the presentation of the required functional training.

Nutritional Intervention May Improve Body Mass Index of Malnourished Hospitalized Psychiatric Patients – A Preliminary Observation

2019 ◽  
Vol 18 (3) ◽  
pp. 256-259
Author(s):  
Hou Y.C. ◽  
Hsieh Y.L. ◽  
Tzeng I.S. ◽  
Kuo C.Y.
Keyword(s):  
Body Weight ◽  
Psychiatric Patients ◽  
Psychiatric Hospitals ◽  
Nutritional Intervention ◽  
Nutrition Intervention ◽  
Calorie Intake ◽  
Psychiatric Ward ◽  
Increased Risk ◽  
Total Calorie ◽  
Total Calorie Intake

Malnutrition is an important issue in hospitalized patients. Poor nutrition may lead to increased risk of morbidity and death, impaired mental and physical conditions, apathy, depression, self-neglect, increased risk of medical complications, increased risk of pressure ulcers, reduced immune response, delayed wound healing, longer hospital stays, and reduced quality of life. However, few studies have investigated malnutrition in psychiatric patients. Psychiatric patients are known to have an increased risk of malnutrition, but psychiatric hospitals rarely conduct physical examinations and nutritional assessments. In this preliminary study, patients from a psychiatric ward of the Taipei Tzu Chi Hospital were chosen using the Malnutrition Universal Screening Tool. We used the before-and-after analysis to test the effect of a nutrition intervention on the selected parameters. We found that patients who had an impaired nutritional status showed significant increases in body weight (mean: 43.6 ± 7.5 vs. 46.5 ± 8.2 kg; P < 0.001), BMI (mean: 16.8 ± 2.0 vs. 17.9 ± 2.1 kg/m2; P < 0.001), and total calorie intake (mean: 1128 ± 230 vs. 1378 ± 320 Kcal; P < 0.001). Nutritional intervention significantly improved body weight, BMI, and total calorie intake. Nutritional intervention may help prevent malnutrition and improve the management of psychiatric patients.

scholarly journals Arousability, Personality, and Decision-Making Ability in Dissociative Disorder

2021 ◽  
pp. 025371762098155
Author(s):  
Doyel Ghosh ◽  
Pritha Mukhopadhyay ◽  
Ishani Chatterjee ◽  
Prasanta Kumar Roy
Keyword(s):  
Decision Making ◽  
Iowa Gambling Task ◽  
Psychiatric Patients ◽  
Economic Status ◽  
Reaction Time Task ◽  
Conversion Disorder ◽  
Control Group ◽  
Cross Sectional ◽  
Personality Disposition

Background: There is a gap in understanding the pathogenesis of dissociative conversion disorder (DCD), despite the disorder having a strong historical root. The role of personality and neurocognitive factors are now highlighted; however, inconsistencies are reported. This study explores the personality disposition, arousability, and decision-making ability of patients with DCD, in reference to a healthy control group (HCG). Methods: In this cross-sectional study, the sample comprised ten adult psychiatric patients with DCD. Ten participants of the HCG were matched according to age, gender, education, economic status, domicile, religious background, and handedness. The study assessed personality disposition with Temperament and Character Inventory, arousability with reaction time task, and decision-making ability with the Iowa Gambling Task (IGT PEBL version). Results: The DCD group differed significantly on personality disposition related to both temperament and character. There was also evidence of easy arousability and frustration along with deficit in executive function related to decision-making ability. Conclusion: This study highlights the presence of both temperamental and characterological factors associated with DCD. Moreover, this study identifies the role of cognitive arousability and decision-making or feedback utilization ability in the psychopathology of DCD.

scholarly journals Variables Associated with the Use of Coercive Measures on Psychiatric Patients in Spanish Penitentiary Centers

2014 ◽  
Vol 2014 ◽  
pp. 1-7 ◽  
Author(s):  
E. Girela ◽  
A. López ◽  
L. Ortega ◽  
J. De-Juan ◽  
F. Ruiz ◽  
...  
Keyword(s):  
Mentally Ill ◽  
Psychiatric Patients ◽  
Psychiatric Inpatient ◽  
Psychiatric Hospitals ◽  
Coercive Measure ◽  
Coercive Measures ◽  
External Assessment ◽  
Mechanical Restraint ◽  
The Family ◽  
Inpatient Units

We have studied the use of coercive medical measures (forced medication, isolation, and mechanical restraint) in mentally ill inmates within two secure psychiatric hospitals (SPH) and three regular prisons (RP) in Spain. Variables related to adopted coercive measures were analyzed, such as type of measure, causes of indication, opinion of patient inmate, opinion of medical staff, and more frequent morbidity. A total of 209 patients (108 from SPH and 101 from RP) were studied. Isolation (41.35%) was the most frequent coercive measure, followed by mechanical restraint (33.17%) and forced medication (25.48%). The type of center has some influence; specifically in RP there is less risk of isolation and restraint than in SPH. Not having had any previous imprisonment reduces isolation and restraint risk while increases the risk of forced medication, as well as previous admissions to psychiatric inpatient units does. Finally, the fact of having lived with a partner before imprisonment reduces the risk of forced medication and communication with the family decreases the risk of isolation. Patients subjected to a coercive measure exhibited a pronounced psychopathology and most of them had been subjected to such measures on previous occasions. The mere fact of external assessment of compliance with human rights slows down the incidence of coercive measures.

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