BACKGROUND Despite numerous attempts to reduce the use of mechanical restraint(MR),this technique continues to be widely applied in many acute psychiatric care settings.In order to reduce MR,a better understanding of ...BACKGROUND Despite numerous attempts to reduce the use of mechanical restraint(MR),this technique continues to be widely applied in many acute psychiatric care settings.In order to reduce MR,a better understanding of the variables associated with its use and duration in different clinical environments is essential.AIM To determine the proportion of patients subjected to MR and the duration thereof in two acute care psychiatric units;and to identify the variables associated with the use and duration of MR.METHODS Descriptive study of all patients admitted to the acute psychiatric units at the Parc de Salut Mar(Barcelona,Spain)in the year 2018.The number and percentage of patients subjected to MR,as well as the duration of each episode were assessed.The following data were also registered:sociodemographic characteristics,psychiatric diagnosis,and presence of cultural and/or language barriers.Multivariate analyses were performed to assess determinants of MR and its duration.RESULTS Of the 464 patients,119(25.6%)required MR,with a median of 16.4 h per MR.Two factors-a diagnosis of psychotic disorder[Odds ratios(OR)=0.22;95%CI:0.06-0.62;P=0.005]and the presence of a language barrier(OR=2.13;95%CI:1.2-3.7;P=0.007)-were associated with a significantly higher risk of MR.Male sex was associated with a longer duration of MR(B=-19.03;95%CI:-38.06-0.008;P=0.05).CONCLUSION The presence of a language barrier and a psychotic disorder diagnosis are associated with a significantly higher risk of MR.Furthermore,male sex is associated with a longer duration of MR.Individualized restraint protocols that include the required tools are necessary to ultimately limit the use of mechanical restraint.展开更多
The Shenzhen Fair Competition Review System has experienced internal review and cross-examination since its inception.However,it is still dominated by the self-review of policy-making organs,with a lack of effective c...The Shenzhen Fair Competition Review System has experienced internal review and cross-examination since its inception.However,it is still dominated by the self-review of policy-making organs,with a lack of effective control and restraint mechanisms.In addition,insufficient compensatory effect of the external review has led to weak effectiveness of social supervision.Shenzhen is currently the pilot of an independent fair competition review system.The Fair Competition Commission can be set up as an independent review body.Then,the operational mechanism should be improved and the constraints and incentives should be set up scientifically.Last but not the least,by strengthening the social supervision network for fair competition review,the legality and rationality of a wide range of local regulations,rules,and normative documents will be reviewed,thereby regulating the behavior of policy-making organs.展开更多
文摘BACKGROUND Despite numerous attempts to reduce the use of mechanical restraint(MR),this technique continues to be widely applied in many acute psychiatric care settings.In order to reduce MR,a better understanding of the variables associated with its use and duration in different clinical environments is essential.AIM To determine the proportion of patients subjected to MR and the duration thereof in two acute care psychiatric units;and to identify the variables associated with the use and duration of MR.METHODS Descriptive study of all patients admitted to the acute psychiatric units at the Parc de Salut Mar(Barcelona,Spain)in the year 2018.The number and percentage of patients subjected to MR,as well as the duration of each episode were assessed.The following data were also registered:sociodemographic characteristics,psychiatric diagnosis,and presence of cultural and/or language barriers.Multivariate analyses were performed to assess determinants of MR and its duration.RESULTS Of the 464 patients,119(25.6%)required MR,with a median of 16.4 h per MR.Two factors-a diagnosis of psychotic disorder[Odds ratios(OR)=0.22;95%CI:0.06-0.62;P=0.005]and the presence of a language barrier(OR=2.13;95%CI:1.2-3.7;P=0.007)-were associated with a significantly higher risk of MR.Male sex was associated with a longer duration of MR(B=-19.03;95%CI:-38.06-0.008;P=0.05).CONCLUSION The presence of a language barrier and a psychotic disorder diagnosis are associated with a significantly higher risk of MR.Furthermore,male sex is associated with a longer duration of MR.Individualized restraint protocols that include the required tools are necessary to ultimately limit the use of mechanical restraint.
基金a phase research result of the 2022 Shenzhen Philosophy and Social Planning Project“Research on the Innovation of Shenzhen Fair Competition Review System”(SZ2022D014).
文摘The Shenzhen Fair Competition Review System has experienced internal review and cross-examination since its inception.However,it is still dominated by the self-review of policy-making organs,with a lack of effective control and restraint mechanisms.In addition,insufficient compensatory effect of the external review has led to weak effectiveness of social supervision.Shenzhen is currently the pilot of an independent fair competition review system.The Fair Competition Commission can be set up as an independent review body.Then,the operational mechanism should be improved and the constraints and incentives should be set up scientifically.Last but not the least,by strengthening the social supervision network for fair competition review,the legality and rationality of a wide range of local regulations,rules,and normative documents will be reviewed,thereby regulating the behavior of policy-making organs.
