title: [Determinants of seclusion in a psychiatric institution: a naturalistic and exploratory study].
abstract: BACKGROUND
  Seclusion of a psychiatric patient is a multifactorial process in which patient, staff and ward variables all play a role. So far, few studies have investigated to what extent these variables in combination can be the determinants of seclusion.
  
  
  OBJECTIVE
  To investigate, in a multivariate study, what influence certain patient, staff and ward variables had on the decision to seclude a psychiatric patient and to use the findings to support specific interventions which could reduce the total number of seclusions in our institution.
  
  
  METHODS
  We based our study on 78 secluded patients and 96 similar control-patients (not secluded at that time) and we collected data from these patients with regard to some quantified patient, staff and ward variables. In this retrospective cross-sectional study we performed a multivariate logistic regression analysis on the data. This enabled us to study associative links but not causal links.
  
  
  RESULTS
  Seclusion was found to be a multifactorial process which revealed significant associations with several patients variables (nosie-variables irritability and motor retardation) and one staff variable (subjective feeling of safety among nursing staff on the day of the patient's seclusion). We also found many more non-significant associations.
  
  
  CONCLUSIONS
  Interventions that might reduce the number of seclusions (in our institution) should perhaps be directed towards the irritability and motor retardation of the patient and towards feelings of safety among the nursing staff.
authors.affiliation: GGZ Centraal, locatie Veldwijk, Postbus 1000, 3850 BA Ermelo. m.vollema@ggzcentraal.nl
authors.forename: M G
authors.initials: MG
authors.lastname: Vollema
authors.forename: S J
authors.initials: SJ
authors.lastname: Hollants
authors.forename: C J
authors.initials: CJ
authors.lastname: Severs
authors.forename: A J K
authors.initials: AJ
authors.lastname: Hondius
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007297:Inpatients / Q000523:psychology*; D016015:Logistic Models; D008297:Male; D001523:Mental Disorders / Q000523:psychology* / Q000628:therapy; D015999:Multivariate Analysis; D010356:Patient Isolation / Q000523:psychology*; D011570:Psychiatry / Q000379:methods*; D012189:Retrospective Studies; D012934:Social Isolation / Q000523:psychology