title: Effects of a Regulatory Protocol for Mechanical Restraint and Coercion in a Spanish Psychiatric Ward.
abstract: OBJECTIVE
  There is still limited information on what type of measures are most efficient to reduce coercion. The aim of this study was to determine if the introduction of a new regulatory protocol in a specific psychiatric ward in Andalusia (Spain) contributed to reducing the use of mechanical restraint.
  
  
  METHODS
  The study included a comparison of two time periods: 2005 (one year before the implementation of the new regulatory protocol) and 2012, in all hospitalized patients (N=1,094). The study also analyzes with logistic regression the variables related to a shorter duration of mechanical restraint.
  
  
  RESULTS
  Mechanical restraint rate per year was reduced, not significantly, from 18.2% to 15.1%. The average duration of each mechanical restraint episode was significantly reduced from 27.91 to 15.33 hr. The following variables have been associated with a shorter period of coercion: being female and the year of restraint (2012).
  
  
  CONCLUSIONS
  Specific plans are required, including different interventions, in order to achieve marked reduction in the use of coercive measures.
authors.affiliation: Department of Mental Health, University General Hospital of Malaga, Biomedical Research Institute of Malaga (IBIMA), Malaga, Spain.
authors.forename: Jose
authors.initials: J
authors.lastname: Guzman-Parra
authors.affiliation: Department of Mental Health, University General Hospital of Malaga, Biomedical Research Institute of Malaga (IBIMA), Malaga, Spain.
authors.forename: Juan A
authors.initials: JA
authors.lastname: Garcia-Sanchez
authors.affiliation: Department of Mental Health, University General Hospital of Malaga, Biomedical Research Institute of Malaga (IBIMA), Malaga, Spain.
authors.forename: Isabel
authors.initials: I
authors.lastname: Pino-Benitez
authors.affiliation: Department of Mental Health, University General Hospital of Malaga, Biomedical Research Institute of Malaga (IBIMA), Malaga, Spain.
authors.forename: Mercedes
authors.initials: M
authors.lastname: Alba-Vallejo
authors.affiliation: Department of Mental Health, University General Hospital of Malaga, Biomedical Research Institute of Malaga (IBIMA), Malaga, Spain.
authors.forename: Fermin
authors.initials: F
authors.lastname: Mayoral-Cleries
mesh_terms: D000328:Adult; D065187:Controlled Before-After Studies; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000628:therapy; D008875:Middle Aged; D011567:Psychiatric Department, Hospital / Q000592:standards* / Q000706:statistics & numerical data; D012149:Restraint, Physical / Q000592:standards* / Q000706:statistics & numerical data; D013030:Spain; D013997:Time Factors; D055815:Young Adult
keywords: Acute psychiatry; coercion; mechanical restraint; psychiatric inpatient