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A Lora, A Lesage, S Pathare, I Levav
AIMS: Information is crucial in mental healthcare, yet it remains undervalued by stakeholders. Its absence undermines rationality in planning, makes it difficult to monitor service quality improvement, impedes accountability and human rights monitoring. For international organizations (e.g., WHO, OECD), information is indispensable for achieving better outcomes in mental health policies, services and programs. This article reviews the importance of developing system level information with reference to inputs, processes and outputs, analyzes available tools for collecting and summarizing information, highlights the various goals of information gathering, discusses implementation issues and charts the way forward...
October 26, 2016: Epidemiology and Psychiatric Sciences
A E Cullen, L Bowers, M Khondoker, S Pettit, E Achilla, L Koeser, L Moylan, J Baker, A Quirk, F Sethi, D Stewart, P McCrone, A D Tulloch
AIMS: Within acute psychiatric inpatient services, patients exhibiting severely disturbed behaviour can be transferred to a psychiatric intensive care unit (PICU) and/or secluded in order to manage the risks posed to the patient and others. However, whether specific patient groups are more likely to be subjected to these coercive measures is unclear. Using robust methodological and statistical techniques, we aimed to determine the demographic, clinical and behavioural predictors of both PICU and seclusion...
October 20, 2016: Epidemiology and Psychiatric Sciences
Morgan C Shields, Meredith B Rosenthal
OBJECTIVE: Little is known about the quality of inpatient psychiatric care. This study examined associations between performance on seven measures of inpatient psychiatric quality and hospital ownership. METHODS: The study design was a cross-sectional analysis of The Joint Commission's 2014 inpatient psychiatric hospital quality measures. The measures evaluate admission screening for violence risk, substance use, psychological trauma history, and patient strengths; use of seclusion and restraint; the practice of discharging patients on multiple antipsychotics; providing appropriate justification when patients are discharged on multiple antipsychotics; creation of continuing care plans; and transmission of care plans to the next level of care...
October 17, 2016: Psychiatric Services: a Journal of the American Psychiatric Association
Joseph M Johnson, Chris Y Wu, Gerald Scott Winder, Michael I Casher, Vincent D Marshall, Jolene R Bostwick
Objective This study examines the association between cannabis use and the hospital course of patients admitted to the psychiatric inpatient unit with a diagnosis of schizophrenia, schizoaffective disorder, or bipolar disorder. Many confounding variables potentially contribute to the clinical presentation of hospitalized patients in the psychiatric unit. Illicit drug use, in particular, has been associated with acute agitation, and questions can be raised as to what lasting effects drug use prior to admission may have throughout a patient's hospital stay...
October 6, 2016: Journal of Dual Diagnosis
Sanaz Riahi, Ian C Dawe, Melanie I Stuckey, Philip E Klassen
Implementation of the Six Core Strategies to Reduce the Use of Seclusion and Restraint (Six Core Strategies) at a recovery-oriented, tertiary level mental health care facility and the resultant changes in mechanical restraint and seclusion incidents are described. Strategies included increased executive participation; enhanced staff knowledge, skills, and attitudes; development of restraint orders and decision support in the electronic medical record to enable informed debriefing and tracking of events; and implementation of initiatives to include service users and their families in the plan of care...
October 1, 2016: Journal of Psychosocial Nursing and Mental Health Services
Joshua C Felver, Richard Jones, Matthew A Killam, Christopher Kryger, Kristen Race, Laura Lee McIntyre
This research explored the effectiveness of a manualized contemplative intervention among children receiving intensive residential psychiatric care. Ten children with severe psychiatric disabilities received 12 sessions (30-45 min) of "Mindful Life: Schools" (MLS) over the course of a month. Facility-reported data on the use of physical intervention (i.e., seclusions and restraints) were analyzed. Acceptability questionnaires and broad-band behavioral questionnaire data were also collected from children and their primary clinicians...
October 1, 2016: Prevention Science: the Official Journal of the Society for Prevention Research
Vijay Danivas, Muffadal Bharmal, Paul Keenan, Steven Jones, Samuel Christaprasad Karat, Kumaran Kalyanaraman, Martin Prince, Caroline H D Fall, Murali Krishna
PURPOSE: Limited availability of specialist services places a considerable burden on caregivers of Persons with Dementia (PwD) in Low- and Middle-Income Countries (LMICs). There are limited qualitative data on coercive behavior towards PwD in an LMIC setting. AIM: The aim of this study was to find relevant themes of the lived experience of relatives as caregivers for PwD in view of their use of coercive measures in community setting in South India. METHOD: Primary caregivers (n = 13) of PwDs from the Mysore study of Natal effects on Ageing and Health (MYNAH) in South India were interviewed to explore the nature and impact of coercion towards community dwelling older adults with dementia...
September 29, 2016: Social Psychiatry and Psychiatric Epidemiology
R C Vermeulen, H L I Nijman, R van de Sande, H A G M Lohuis-Heesink
BACKGROUND: Dutch mental health care institutes are currently making a tremendous effort to reduce the number of coercive measures they impose, such as seclusion. Despite this effort, a group of patients are still being subjected to enforced medication or seclusion. AIM: To obtain more knowledge about which patient characteristics are associated with coercive measures and thereby to identify signs that could be acted upon at an earlier stage to prevent deterioration of the patient's condition and reduce the need for coercive measures...
2016: Tijdschrift Voor Psychiatrie
Raj K Kalapatapu, Gordon M Giles
PURPOSE: The Relational Neurobehavioral Approach (RNA) is a set of non-aversive intervention methods to manage individuals with brain injury-related aggression. New data on interventions used in the RNA and on how the RNA interventions can be used with patients with acquired brain injury (ABI) who have differing levels of functional impairment are provided in this paper. METHOD: The study was conducted over a 6-week period in a secure 65-bed program for individuals with ABI that is housed in two units of a skilled nursing facility (SNF)...
September 16, 2016: Disability and Rehabilitation
Briana Marie Andrassy
PROBLEM: Restraints and/or seclusions (R/S) are events that have the potential to cause patient injury, staff injury, re-traumatization, and even death. There is a gap in available data regarding alternative strategies for reducing R/S. METHOD: A 140-bed children and adolescent residential treatment hospital implemented a "Feelings Thermometer Scale" on each unit. The "Feelings Thermometer" allowed the resident to point to a face on the scale to rate how they were feeling from "Cool" to "On Fire!" Once the resident identified with a feeling and rating, options were offered for alternative cool down locations corresponding to each level of escalation...
August 2016: Journal of Child and Adolescent Psychiatric Nursing
Judy Yuen-Man Siu
BACKGROUND: Diseases often carry cultural meanings and metaphors, and these meanings can influence illness experiences and behavioral responses. OBJECTIVES: This research investigated how old cultural stereotypes and new social understandings of overactive bladder (OAB) intertwined to influence sick role adaptation and behavioral responses among those with OAB. METHODS: A qualitative approach using in-depth individual, semistructured interviews was adopted...
September 2016: Nursing Research
Joanne DeSanto Iennaco, Robin Whittemore, Jane Dixon
The aim of this study was to identify aggressive event incidence rates in the inpatient psychiatric setting, describe characteristics of events and differences based on aggression target and type (verbal vs. physical). A longitudinal study was carried out of aggressive events identified by workers in four inpatient psychiatric units using the Staff Observation of Aggression Scale-Revised (SOAS-R) over 6 weeks. A total of 113 aggressive events were recorded resulting in a rate of 13.27 events per bed per year...
August 25, 2016: Psychiatric Quarterly
S A Kinner, C Harvey, B Hamilton, L Brophy, C Roper, B McSherry, J T Young
AIMS: There are growing calls to reduce, and where possible eliminate, the use of seclusion and restraint in mental health settings, but the attitudes and beliefs of consumers, carers and mental health professionals towards these practices are not well understood. The aim of this study was to compare the attitudes of mental health service consumers, carers and mental health professionals towards seclusion and restraint in mental health settings. In particular, it aimed to explore beliefs regarding whether elimination of seclusion and restraint was desirable and possible...
August 12, 2016: Epidemiology and Psychiatric Sciences
Erich Flammer, Tilman Steinert
OBJECTIVE: In the German federal state of Baden-Wuerttemberg, involuntary medication of psychiatric inpatients was illegal during eight months from July 2012 until February 2013. The authors examined whether the number and duration of mechanical coercive measures (seclusion and restraint) and the number and severity of violent incidents changed in this period. METHODS: A cross-sectional analysis was conducted of admission-related routine data collected in seven psychiatric hospitals in three time periods (period 1, July 2011-February 2012; period 2, July 2012-February 2013; and period 3, July 2013-February 2014)...
August 1, 2016: Psychiatric Services: a Journal of the American Psychiatric Association
Rebecca Bromwich
The mobile revolution is a watershed event across many fields, including health care. Now, electronic data storage, digital photography, smart phones and tablet devices present new opportunities for educators, researchers, and health care providers. Mobile technologies allow for new possibilities for physician collaboration as well as patient diagnosis, treatment and study. However, while it presents new opportunities, the mobile technological revolution in health care has brought about new risks to patient privacy...
May 2016: Health Law in Canada
Makiko Sato, Toshie Noda, Naoya Sugiyama, Fumihiro Yoshihama, Michi Miyake, Hiroto Ito
Aggressive behaviour by psychiatric patients is a serious issue in clinical practice, and adequate management of such behaviour is required, with careful evaluation of the factors causing the aggression. To examine the characteristics of aggressive incidents by ward type, a cross-sectional descriptive study was conducted for 6 months between April 2012 and June 2013 using the Staff Observation Aggression Scale - Revised, Japanese version (SOAS-R) in 30 wards across 20 Japanese psychiatric hospitals. Participating wards were categorized into three types based on the Japanese medical reimbursement system: emergency psychiatric, acute psychiatric, and standard wards (common in Japan, mostly treating non-acute patients)...
July 22, 2016: International Journal of Mental Health Nursing
Alessandro Abbouda, Irene Abicca, Claudia Fabiani, Nicolò Scappatura, Pablo Peña-García, Rossana Scrivo, Roberta Priori, Maria Pia Paroli
PURPOSE: To compare clinical features of uveitis in patients affected by psoriasis and psoriatic arthritis (PsA). METHODS: A retrospective case-control study. RESULTS: 117 patients were affected by uveitis and psoriasis or PsA (92 and 25 patients, respectively) from 2003 to 2013. Axial PsA was associated with unilateral uveitis onset compared to the peripheral pattern (p < 0.03). The prevalence of eyes with at least one complication involving anterior segment was significantly more represented in the PsA group than the psoriasis one (p = 0...
July 15, 2016: Seminars in Ophthalmology
Sara Bayramzadeh
OBJECTIVES: This article aims to understand the incident patterns in relation to different types of spaces within a psychiatric unit, which are discussed using the five levels of safety framework. BACKGROUND: Implementing measures to improve patient safety is essential particularly in a psychiatric hospital, where limited research has been conducted on inpatient safety. Therefore, this article aims to understand the incident patterns from the lens of the five levels of safety framework, which categorizes spaces according to the level of patient supervision in psychiatric facilities, as follows: service areas, corridors, dayrooms, patient rooms and bathrooms, seclusions and admissions...
July 13, 2016: HERD
Sheetal Sharma, Edwin van Teijlingen, Vanora Hundley, Catherine Angell, Padam Simkhada
BACKGROUND: Pregnancy and childbirth are socio-cultural events that carry varying meanings across different societies and cultures. These are often translated into social expectations of what a particular society expects women to do (or not to do) during pregnancy, birth and/or the postnatal period. This paper reports a study exploring beliefs around childbirth in Nepal, a low-income country with a largely Hindu population. The paper then sets these findings in the context of the wider global literature around issues such as periods where women are viewed as polluted (or dirty even) after childbirth...
2016: BMC Pregnancy and Childbirth
Eric O Noorthoorn, Yolande Voskes, Wim A Janssen, Cornelis L Mulder, Roland van de Sande, Henk L I Nijman, Annet Smit, Adriaan W Hoogendoorn, Annelea Bousardt, Guy A M Widdershoven
OBJECTIVE: In 2006, a goal of reducing seclusion in Dutch hospitals by at least 10% each year was set. More than 100 reduction projects in 55 hospitals have been conducted, with €35 million in funding. This study evaluated the results. METHODS: Data (2008 to 2013) were from a national register. Multilevel logistic regression examined determinants of seclusion. RESULTS: Hospital participation in the register ranged from eight in 2008 to 66 in 2013, and admissions ranged from 11,300 to 113,290...
July 1, 2016: Psychiatric Services: a Journal of the American Psychiatric Association
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