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Associations between psychiatric symptoms and seclusion use: Clinical implications for care planning
Author(s) -
Sande Roland,
Noorthoorn Eric,
Nijman Henk,
Wierdsma Andre,
Staak Cees,
Hellendoorn Edwin,
Mulder Niels
Publication year - 2017
Publication title -
international journal of mental health nursing
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.911
H-Index - 54
eISSN - 1447-0349
pISSN - 1445-8330
DOI - 10.1111/inm.12381
Subject(s) - seclusion , brief psychiatric rating scale , psychiatry , medicine , psychiatric hospital , rating scale , aggression , substance abuse , clinical psychology , psychology , psychosis , developmental psychology
Findings from an increasing number of studies suggest that incorporating systematic short‐term risk assessments in treatment planning could lead to safer practice on psychiatric admissions wards. The aim of the present study was to investigate the associations between the scores of three structured observation tools – the Kennedy Axis V (K‐Axis‐V), the Brief Psychiatric Rating Scale ( BPRS ), and the Social Dysfunction and Aggression Scale ( SDAS ) – and seclusion. In total, 1840 weekly risk assessments with these observation scales were collected over 2342 admission weeks. These assessment scores related to 370 acutely‐admitted psychiatric patients and were subjected to a multilevel analysis. It was found that several dynamic and static factors were related to seclusion. Dynamic factors included violent behaviour, current substance abuse, suspiciousness, and negativism. Static factors included ethnicity and having been diagnosed with a substance abuse disorder. The findings suggest that the incorporation of the Kennedy‐Axis V, the BPRS , and the SDAS into standard practice might be helpful in identifying patients at high risk of seclusion, and could be supportive to treatment planning and clinical decision‐making in the prevention of seclusion use in acute psychiatric settings.