title: Does experienced seclusion or restraint affect psychiatric patients' subjective quality of life at discharge?
abstract: BACKGROUND
  In Finland major effort has been invested in reducing the use of coercion in psychiatric treatment, and the goal is to diminish the use of coercion by 40% by 2015. Improving patients' quality of life (QoL) has gained prominence in psychiatric treatment during the past decade. Numerous studies have shown that most secluded or restrained patients (S/R patients) would prefer not to have had this experience. Experience of S/R could affect negatively patients' QoL, but empirical data on this issue are lacking.
  
  
  OBJECTIVE
  The study aimed to explore the effect of experienced S/R on the subjective QoL of psychiatric in-patients.
  
  
  METHODS
  This study explored subjective QoL of the S/R patients. At discharge, S/R patients completed the Short Form of the Quality of Life Enjoyment and Satisfaction Questionnaire (Q-LES-Q-SF).
  
  
  RESULTS
  We found that S/R patients' (n = 36) subjective QoL was significantly better than that of non-S/R patients' (n = 228). Most non-S/R patients were diagnosed with mood disorders (mostly depression). Most of S/R patients were diagnosed with schizophrenia, schizotypal and delusional disorders. The mean duration of S/R was 2.3 days, median was one day and mean length of the hospitalization after S/R episode was 2.5 months.
  
  
  CONCLUSIONS
  Our cross-sectional findings suggest that S/R does not considerably influence patients' QoL or that the influence is short-lived. Because baseline QoL was not measured this remains uncertain. There are also many other factors, such as negative mood, which decrease the patients' QoL ratings. These factors may either mask the influence of S/R on QoL or modify the experience of QoL to such an extent that no independent association can be found at the time of discharge.
authors.affiliation: Hospital District of Helsinki and Uusimaa, Hyvinkää Hospital Area, Tuusula, Finland. paivi.soininen@hus.fi.
authors.forename: Päivi
authors.initials: P
authors.lastname: Soininen
authors.forename: Hanna
authors.initials: H
authors.lastname: Putkonen
authors.forename: Grigori
authors.initials: G
authors.lastname: Joffe
authors.forename: Jyrki
authors.initials: J
authors.lastname: Korkeila
authors.forename: Pauli
authors.initials: P
authors.lastname: Puukka
authors.forename: Anneli
authors.initials: A
authors.lastname: Pitkänen
authors.forename: Maritta
authors.initials: M
authors.lastname: Välimäki