Associations between psychiatric symptoms and seclusion use: Clinical implications for care planning

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...

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Bibliographic Details
Published in:International journal of mental health nursing 2017-10, Vol.26 (5), p.423-436
Main Authors: Sande, Roland, Noorthoorn, Eric, Nijman, Henk, Wierdsma, Andre, Staak, Cees, Hellendoorn, Edwin, Mulder, Niels
Format: Article
Language:English
Subjects:
Adult
Aggression - psychology
Aggressiveness
Brief Psychiatric Rating Scale
Care plans
Clinical decision making
daily assessment
Drug abuse
Ethnicity
Female
Health risk assessment
High risk
Humans
Male
Mental disorders
Mental Disorders - psychology
Mental Disorders - therapy
Middle Aged
Multilevel analysis
Netherlands
Nursing
Patient admissions
Patient Isolation - methods
Patient Isolation - psychology
Psychiatric hospitals
Psychiatric symptoms
Risk Assessment
seclusion
Social isolation
Substance use disorder
symptoms
treatment planning
Trust
Young Adult
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Summary: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.
ISSN:1445-8330
1447-0349
DOI:10.1111/inm.12381