The use of mechanical restraint in a psychiatric setting: an observational study

Nicola Poloni, Marta Ielmini, Ivano Caselli, Giulia Lucca, Celeste Isella, Aldo Emanuele Buzzi, Lucia Rosa Maria Rizzo, Alessandra Gasparini, Giacomo Introini, Camilla Callegari

Department of Medicine and Surgery, Division of Psychiatry, University of Insubria, Varese, Italy

Objectives

The use of mechanical restraints is a practice used both in hospital and extra-hospital settings. This paper aims to outline the socio-demographic and clinical variables related to physical containment. 

Methods

This observational study evaluates data from 65 adult psychiatric inpatients hospitalized at General Hospital Psychiatric Ward in Varese, Northern Italy, from January 2016 to August 2017. 

Results

Patients were found to be mainly males (61.5%), with an average age of 43 years (Tab. I). The main reasons for restraints resulted to be “confusion” (81.5%), followed by “aggression” (61.5%) and “opposition to treatments” (20%). A positive correlation between length of hospitalization and numbers of episodes of restraint was found (Tab. II). Furthermore, a statistically significant correlation between female gender and number of restraints for single hospitalization emerged (p = 0.039) (Tab. III). Schizophrenia spectrum disorder was the most represented diagnosis, accounting for 44.60% of the sample (Tab. IV). 

Conclusions

The study provides an overview on patients’ characteristics and variables related to mechanical restraints. An early identification of these factors can be useful in the management of confused and agitated patients in order to reduce the episodes of restraint.

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