Variations in definitions used for describing restrictive care practices (seclusion and restraint) in adult mental health inpatient units: a systematic review and content analysis.

Journal: Social psychiatry and psychiatric epidemiology

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Affiliated Institutions:  School of Primary and Allied Health Care, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia. zelalem.muluneh@monash.edu. School of Primary and Allied Health Care, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia.

Abstract summary 

The main purpose of this review was to (1) identify thematic elements within definitions used by recently published literature to describe the constructs of physical/mechanical restraint, seclusion and chemical restraint in adult mental health inpatient units.We conducted a comprehensive literature search of six databases (Scopus, MEDLINE, PsycINFO, Web of Science, Embase, and CINAHL-Plus). In this review, we conducted content analysis to synthesize evidence to understand and compare the commonalities and discrepancies in conceptual elements that were incorporated within the definitions of different forms of restrictive care practices.A total of 95 studies that provided definitions for different forms of restrictive care practices [physical/mechanical restraint (n = 72), seclusion (n = 65) and chemical restraint (n = 19)] were included in this review. Significant variations existed in the conceptual domains presented within the applied definitions of physical/mechanical restraint, seclusion, and chemical restraint. Conceptual themes identified in this review were methods of restrictive care practice, reasons and desired outcomes, the extent of patient restriction during restrictive care practice episodes, timing (duration, frequency, and time of the day), the level of patient autonomy, and the personnel implementing these practices.Inconsistencies in the terminologies and conceptual boundaries used to describe the constructs of different forms of restrictive care practices underscore the need to move forward in endorsing consensus definitions that reflect the diverse perspectives, ensuring clarity and consistency in practice and research. This will assist in validly measuring and comparing the actual trends of restrictive care practice use across different healthcare institutions and jurisdictions.

Authors & Co-authors:  Muluneh Zelalem Belayneh ZB Chavulak Jacinta J Lee Den-Ching A DA Petrakis Melissa M Haines Terry P TP

Study Outcome 

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Statistics
Citations :  Lickiewicz J, Adamczyk N, Hughes PP, Jagielski P, Stawarz B, Makara-Studzińska M (2021) Reducing aggression in psychiatric wards using Safewards—A Polish study. Perspect Psychiatr Care 57(1)
Authors :  5
Identifiers
Doi : 10.1007/s00127-024-02739-6
SSN : 1433-9285
Study Population
Male,Female
Mesh Terms
Other Terms
Classification;Coercion;Definition;Immobilization;Mental health;Perception;Restraint;Restrictive practice;Seclusion;Understanding
Study Design
Study Approach
Systemic Review
Country of Study
Publication Country
Germany