[Factors contributing to the use of seclusion and restraint--a retrospective analysis in a Swiss clinic for child and adolescent psychiatry].
Despite of the inculpatory effects of coercive measures on both patients and clinicans, only few publications regarding the influencing factors on the use of seclusion and restraint could be found. This study intended to investigate clinic- and patient-related factors which contribute to increasing und intensified incidents of seclusion and restraint. All incidents of coercive measures in a Swiss clinic during the years 2002 and 2003 were evaluated restrospectively. Data included detailed information about each coercive incident as well as patients and personnel involved. Statistics were conducted with SPSS. Adolescent age, female gender, previous experiences of violence and diagnoses of the ICD-10-category F9 and F6 were linked with high frequencies and intensive coercive interventions on the side of patient-related factors. Regarding clinic-related factors a fairly different handling could be found comparing different wards. Besides psychopathological aspects of the patients and structural characteristics of the clinic different understandings of disease-management, the nature of the therapeutic relations and environmental factors contribute to frequency, intensity and kind of coercive measures. A detailed evaluation of the use of coercive interventions can help to prevent unnecessary and incriminatory violence.
Nitschke-Janssen
Meike
M
Asklepios Klinik Harburg, Abteilung für Kinder- u. Jugendpsychiatrie und- Psychotherapie, Hamburg. meike.nitschke@ak-harburg.lbk-hh.de
Branik
Emil
E
D000293:Adolescent; D000342:Affective Symptoms / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*; D002648:Child; D002653:Child Behavior Disorders / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*; D003068:Coercion; D019468:Disease Management; D005260:Female; D006778:Hospitals, Psychiatric / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D010356:Patient Isolation / Q000523:psychology* / Q000706:statistics & numerical data; D011209:Power, Psychological; D011369:Professional-Patient Relations; D012149:Restraint, Physical / Q000523:psychology* / Q000706:statistics & numerical data; D012189:Retrospective Studies; D012307:Risk Factors; D012931:Social Environment; D013557:Switzerland; D014600:Utilization Review / Q000706:statistics & numerical data; D014754:Violence / Q000517:prevention & control / Q000523:psychology