Volume 4, Issue 5, September 2016, Page: 71-75
Managing Aggressive Behaviors among Psychiatric Inpatients Through the Use of Restrictive Methods
Anas Husam Khalifeh, Department of Nursing, Prince Hamzah Hospital, Ministry of Health of the Hashemite Kingdom of Jordan, Amman, Jordan
Received: Jul. 22, 2016;       Accepted: Aug. 10, 2016;       Published: Aug. 25, 2016
DOI: 10.11648/j.ajpn.20160405.11      View  3593      Downloads  123
The most aggressive behaviors were common in patients who diagnosed with schizophrenia, major depressive disorder, bipolar disorder, and substance use disorders. The prevalence in Jordan 23.6% of psychiatric inpatients occurred with them aggressive behavior. There are interventions and ways to control the aggressive behaviors include seclusion, physical restraints, time out, and chemical restraints. The aim of this paper is to highlight on the concepts about aggressive behaviors, seclusion, physical restraints and factors that consider using seclusion and physical restraints and the effective methods were used with aggressive behaviors among psychiatric inpatients. Searching strategies used an online database that searched include PubMed, Wiley, EBSCO host, Ovid database, and Google Scholar from 2006 to January 2016. The most articles of physical restraints and seclusion that use among psychiatric inpatients setting work on to reduce it and to know factors of aggressive behaviors to move away from using it. Recommendation train staff nurse to managing with aggressive behaviors, work as multidisciplinary staff, and creating a therapeutic environment.
Restraints, Psychiatric Inpatients, Chemical Restraints, Physical Restraints, Seclusion, Aggressive Behaviors
To cite this article
Anas Husam Khalifeh, Managing Aggressive Behaviors among Psychiatric Inpatients Through the Use of Restrictive Methods, American Journal of Psychiatry and Neuroscience. Vol. 4, No. 5, 2016, pp. 71-75. doi: 10.11648/j.ajpn.20160405.11
Copyright © 2016 Authors retain the copyright of this article.
This article is an open access article distributed under the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Gabbey, A. (2013). Aggressive Behavior. Healthline. Retrieved 13 May 2016, from http://www.healthline.com/health/aggressive-behavior#Overview1
Huf, G., Coutinho, E., Ferreira, M., Ferreira, S., Mello, F., & Adams, C. (2011). TREC-SAVE: a randomised trial comparing mechanical restraints with use of seclusion for aggressive or violent seriously mentally ill people: study protocol for a randomised controlled trial. Trials, 12 (1). doi: 10.1186/1745-6215-12-180
Ketelsen, R., Zechert, C., Driessen, M., & Schulz, M. (2007). Characteristics of aggression in a German psychiatric hospital and predictors of patients at risk. J Psychiatr Ment Health Nurs, 14 (1). doi: 10.1111/j.1365-2850.2007.01049.x
Dean, K., Walsh, E., Morgan, C., Demjaha, A., Dazzan, P., & Morgan, K. et al. (2006). Aggressive behaviour at first contact with services: findings from the AESOP First Episode Psychosis Study. Psychological Medicine, 37 (04), 547-557. doi: 10.1017/s0033291706008920
Al-Sagarat, A., Hamdan-Mansour, A., Al-Sarayreh, F., Nawafleh, H., & Moxham, L. (2015). Prevalence of aggressive behaviours among inpatients with psychiatric disorders: A case study analysis from Jordan. Nursing & Health Sciences, 18 (2), 172-179. doi: 10.1111/nhs.12239
Kim, Y. O. (2010). Analysis of nursing intervention according to type of aggressive behavior in psychiatric inpatients. Unpublished master's thesis, Ewha Womans University, Seoul
Amoo, G., & Fatoye, F. O. (2010). Aggressive behaviour and mental illness: a study of in-patients at Aro Neuropsychiatric Hospital, Abeokuta. Nigerian journal of clinical practice, 13 (3), 351-355
Friedman, R. (2006). Violence and Mental Illness — How Strong is the Link? New England Journal of Medicine, 355(20), 2064-2066. doi: 10.1056/nejmp068229
Migon, M., Coutinho, E., Huf, G., Adams, C., Cunha, G., & Allen, M. (2008). Factors associated with the use of physical restraints for agitated patients in psychiatric emergency rooms. General Hospital Psychiatry, 30 (3), 263-268. doi: 10.1016/j.genhosppsych.2007.12.005
Carr, P. (2012). The use of mechanical restraint in mental health: a catalyst for change?.Journal of Psychiatric and Mental Health Nursing, 19 (7), 657-664. doi: 10.1111/j.1365-2850.2012.01912.x
Husum, T., Bjørngaard, J., Finset, A., & Ruud, T. (2010). A cross-sectional prospective study of seclusion, restraint and involuntary medication in acute psychiatric wards: patient, staff and ward characteristics. BMC Health Services Research, 10 (1). doi: 10.1186/1472-6963-10-89
Bowers, L., Van Der Merwe, M., Nijman, H., Hamilton, B., Noorthorn, E., Stewart, D., & Muir-Cochrane, E. (2010). The Practice of Seclusion and Time-out on English Acute Psychiatric Wards: The City-128 Study. Archives of Psychiatric Nursing, 24 (4), 275-286. doi: 10.1016/j.apnu.2009.09.003
Bowers, L., Ross, J., Nijman, H., Muir-Cochrane, E., Noorthoorn, E., & Stewart, D. (2011). The scope for replacing seclusion with time out in acute inpatient psychiatry in England. Journal of Advanced Nursing, 68 (4), 826-835. doi: 10.1111/j.1365-2648.2011.05784.x
Mayers, P., Keet, N., Winkler, G., & Flisher, A. (2010). Mental Health Service Users' Perceptions and Experiences of Sedation, Seclusion and Restraint. International Journal of Social Psychiatry, 56 (1), 60-73. doi: 10.1177/0020764008098293
Stewart, D., Van der Merwe, M., Bowers, L., Simpson, A., & Jones, J. (2010). A Review of Interventions to Reduce Mechanical Restraint and Seclusion among Adult Psychiatric Inpatients. Issues in Mental Health Nursing, 31 (6), 413-424. doi: 10.3109/01612840903484113
Janssen, W., Noorthoorn, E., de Vries, W., Hutschemeakers, G., Lendemeijer, H., & Widdershoven, G. (2008). The use of seclusion in the Netherlands compared to countries in and outside Europe. International Journal of Law And Psychiatry, 31 (6), 463-470. doi: 10.1016/j.ijlp.2008.09.002
Khalifeh, A. (2015). Position Statement: The Use of Seclusion in Psychiatric Settings. Middle East Journal of Nursing, 9 (3), 31-36. doi: 10.5742/mejn.2015.92662
American Psychiatric Association (APA). (2006). The Use of Restraint and Seclusion in Correctional Mental Health Care. http://www.psychiatry.org/File%20Library/Learn/Archives /rd2006_Seclusion.pdf: American Psychiatric Association
Dumais, A., Larue, C., Drapeau, A., Ménard, G., & Giguére Allard, M. (2011). Prevalence and correlates of seclusion with or without restraint in a Canadian psychiatric hospital: a 2-year retrospective audit. Journal of Psychiatric and Mental Health Nursing, 18 (5), 394-402. doi: 10.1111/j.1365-2850.2010.01679.x
Choe, J., Teplin, L., & Abram, K. (2008). Perpetration of Violence, Violent Victimization, and Severe Mental Illness: Balancing Public Health Concerns. PS, 59 (2), 153-164. doi: 10.1176/ps.2008.59.2.153
Knutzen, M., Bjørkly, S., Eidhammer, G., Lorentzen, S., Helen Mjøsund, N., & Opjordsmoen, S. et al. (2013). Mechanical and pharmacological restraints in acute psychiatric wards—Why and how are they used? Psychiatry Research, 209 (1), 91-97. doi: 10.1016/j.psychres.2012.11.017
Whittington, R., Bowers, L., Nolan, P., Simpson, A., & Neil, L. (2009). Approval Ratings of Inpatient Coercive Interventions in a National Sample of Mental Health Service Users and Staff in England. Psychiatric Services, 60 (6). doi: 10.1176/appi.ps.60.6.792
Bowers, L., Allan, T., Simpson, A., Jones, J., Van Der Merwe, M., & Jeffery, D. (2009). Identifying Key Factors Associated with Aggression on Acute Inpatient Psychiatric Wards. Issues in Mental Health Nursing, 30 (4), 260-271. doi: 10.1080/01612840802710829
Baker, J., Bowers, L., & Owiti, J. (2009). Wards features associated with high rates of medication refusal by patients: a large multi-centred survey. General Hospital Psychiatry, 31 (1), 80-89. doi: 10.1016/j.genhosppsych.2008.09.005
Khudhur, I. (2013). Nurses’ knowledge about psychiatric patient seclusion in Jordan. Kufa Journal for Nursing Sciences, 3 (3)
National Center for Mental Health. (2011). Policies and Procedures for Psychiatric Nursing. Jordan: Jordanian nursing council, 1-165
Hendryx, M., Trusevich, Y., Coyle, F., Short, R., & Roll, J. (2009). The Distribution and Frequency of Seclusion and/or Restraint among Psychiatric Inpatients. The Journal of Behavioral Health Services & Research, 37 (2), 272-281. doi: 10.1007/s11414-009-9191-1
Knutzen, M. (2011). Characteristics of Psychiatric Inpatients Who Experienced Restraint and Those Who Did Not: A Case-Control Study. Psychiatric Services, 62 (5), 492. doi: 10.1176/appi.ps.62.5.492
Larue, C., Dumais, A., Ahern, E., Bernheim, E., & Mailhot, M. (2009). Factors influencing decisions on seclusion and restraint. Journal of Psychiatric and Mental Health Nursing, 16 (5), 440-446. doi: 10.1111/j.1365-2850.2009.01396.x
Hammer, J., Springer, J., Beck, N., Menditto, A., & Coleman, J. (2010). The Relationship Between Seclusion and Restraint Use and Childhood Abuse Among Psychiatric Inpatients. Journal of Interpersonal Violence, 26 (3), 567-579. doi: 10.1177/0886260510363419
Downey, L., Zun, L., & Gonzales, S. (2007). Frequency of alternative to restraints and seclusion and uses of agitation reduction techniques in the emergency department. General Hospital Psychiatry, 29 (6), 470-474. doi: 10.1016/j.genhosppsych.2007.07.006
Vruwink, F., Noorthoorn, E., Nijman, H., VanDerNagel, J., Hox, J., & Mulder, C. (2012). Determinants of Seclusion After Aggression in Psychiatric Inpatients. Archives of Psychiatric Nursing, 26 (4), 307-315. doi:10.1016/j.apnu.2011.10.004
Khalifeh, A. (2015). Arguments of Legal and Ethical Use of Seclusion among Psychiatric Inpatients. Middle East Journal of Psychiatry and Alzheimers, 6 (2), 12-20. doi: 10.5742/mepa.2015.92730
Lewis, M., Taylor, K., & Parks, J. (2009). Crisis Prevention Management: A Program to Reduce the Use of Seclusion and Restraint in an Inpatient Mental Health Setting. Issues in Mental Health Nursing, 30 (3), 159-164. doi: 10.1080/01612840802694171
Sclafani, M., Humphrey II, F., Repko, S., Ko, H., Wallen, M., & DiGiacomo, A. (2007). Reducing Patient Restraints: A Pilot Approach Using Clinical Case Review. Perspectives in Psychiatric Care, 44 (1), 32-39. doi: 10.1111/j.1744-6163.2008.00145.x
Zhang, J., Harvey, C., & Andrew, C. (2011). Factors associated with length of stay and the risk of readmission in an acute psychiatric inpatient facility: a retrospective study. Aust NZ J Psychiatry, 45 (7), 578-585. doi: 10.3109/00048674.2011.585452
Vaaler, A., Iversen, V., Morken, G., Fløvig, J., Palmstierna, T., & Linaker, O. (2011). Short-term prediction of threatening and violent behaviour in an Acute Psychiatric Intensive Care Unit based on patient and environment characteristics. BMC Psychiatry, 11(1). doi: 10.1186/1471-244x-11-44
Gelkopf, M., Roffe, Z., Behrbalk, P., Melamed, Y., Werbloff, N., & Bleich, A. (2009). Attitudes, Opinions, Behaviors, and Emotions of the Nursing Staff Toward Patient Restraint. Issues in Mental Health Nursing, 30 (12), 758-763. doi: 10.3109/01612840903159777
Mohr, W. (2010). Restraints and the code of ethics: An uneasy fit. Archives of Psychiatric Nursing, 24 (1), 3-14. doi: 10.1016/j.apnu.2009.03.003
Paterson, B. & Duxbury, J. (2007). Restraint and the Question of Validity. Nursing Ethics, 14 (4), 535-545. doi: 10.1177/0969733007077888
Ishida, T., Katagiri, T., Uchida, H., Takeuchi, H., Sakurai, H., Watanabe, K., & Mimura, M. (2014). Incidence of Deep Vein Thrombosis in Restrained Psychiatric Patients. Psychosomatics, 55 (1), 69-75. doi: 10.1016/j.psym.2013.04.001
Lavelle, M., Stewart, D., James, K., Richardson, M., Renwick, L., Brennan, G., & Bowers, L. (2016). Predictors of effective de-escalation in acute inpatient psychiatric settings. J Clin Nurs, 25 (15-16), 2180-2188. doi: 10.1111/jocn.13239
Price, O., Baker, J., Bee, P., & Lovell, K. (2015). Learning and performance outcomes of mental health staff training in de-escalation techniques for the management of violence and aggression. The British Journal of Psychiatry, 206 (6), 447-455. doi: 10.1192/bjp.bp.114.144576
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