title: Risk Factors for Seclusion and Restraint in a Pediatric Psychiatry Day Hospital.
abstract: The use of seclusion and restraints (SR) in acute hospital settings remains a controversial practice. Despite the focus on SR in the psychiatric services literature, data on SR use in pediatric day hospital settings is lacking. A case-control retrospective analysis for children admitted into a pediatric psychiatry day hospital in a 2-year span examined predictors of SR use. Demographic and clinical descriptors were examined in relation to SR events using univariate and multivariate regression models. Significant univariate risk factors for SR use were psychiatric morbidity, history of physical abuse, post-traumatic stress disorder, having any anxiety disorder, and younger age. Knowledge of risk factors for SR use in pediatric psychiatric day hospitals can avert use of SR and lead to improved safety in a trauma-informed care model.
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, 1800 Orleans St., 12th Floor, Baltimore, MD, 21287, USA.
authors.forename: Wuroh
authors.initials: W
authors.lastname: Timbo
authors.affiliation: Johns Hopkins University, Baltimore, MD, USA.
authors.forename: Aishwarya
authors.initials: A
authors.lastname: Sriram
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, 1800 Orleans St., 12th Floor, Baltimore, MD, 21287, USA.
authors.forename: Elizabeth K
authors.initials: EK
authors.lastname: Reynolds
authors.affiliation: Johns Hopkins Hospital, Baltimore, MD, USA.
authors.forename: Renee
authors.initials: R
authors.lastname: DeBoard-Lucas
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, 1800 Orleans St., 12th Floor, Baltimore, MD, 21287, USA.
authors.forename: Matthew
authors.initials: M
authors.lastname: Specht
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, 1800 Orleans St., 12th Floor, Baltimore, MD, 21287, USA.
authors.forename: Carolyn
authors.initials: C
authors.lastname: Howell
authors.affiliation: Susquehanna University, Selinsgrove, PA, USA.
authors.forename: Colleen
authors.initials: C
authors.lastname: McSweeney
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, 1800 Orleans St., 12th Floor, Baltimore, MD, 21287, USA. mgrados1@jhmi.edu.
authors.forename: Marco A
authors.initials: MA
authors.lastname: Grados
mesh_terms: D002648:Child; D003631:Day Care, Medical / Q000379:methods / Q000706:statistics & numerical data; D005260:Female; D006776:Hospitals, Pediatric / Q000706:statistics & numerical data; D006778:Hospitals, Psychiatric / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology / Q000523:psychology / Q000628:therapy; D010356:Patient Isolation / Q000379:methods / Q000523:psychology; D011570:Psychiatry / Q000379:methods; D012149:Restraint, Physical / Q000009:adverse effects / Q000523:psychology; D012189:Retrospective Studies; D012307:Risk Factors; D014481:United States / Q000453:epidemiology
keywords: Abuse; Pediatric; Restraint; Seclusion; Trauma