Factors associated with the use of physical restraints for agitated patients in psychiatric emergency rooms
Abstract
Objective To examine factors associated with physical restraint in psychiatric emergency rooms.Method We extracted variables likely to predict use of physical restraints from a large randomised trial undertaken in three psychiatric emergency rooms in Rio de Janeiro. We fitted a Bayesian binary multivariate model using only variables clearly preceding the restraints.Results Of 301 agitated, aggressive people admitted to emergency rooms, 73 (24%) were restrained during the first 2 h of admission. In Rio, younger people (OR=1.03 for each year younger), exhibiting intense (OR=2.53) or extreme agitation (OR=7.71), thought to result from substance misuse (OR=1.75) or diagnoses other than psychosis (OR=1.88), arriving in the morning (OR=1.64) were at greater risk of physical restraints than older, less severely aggressive or agitated people, arriving at the hospital during the afternoon or night. Hospital, gender, first admission to hospital and medication were not associated with risk of being restrained.Conclusion Restraint practices in Rio are predictable and based on a limited clinical assessment. Predictive factors for physical restraint may vary worldwide, but should be monitored and studied to assist training, and to establish programs to evaluate and refine this controversial practice.
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Physical restraints could promote the occurrence of agitation, as described in psychiatric emergency departments.
“Physical restraints could promote, however, the occurrence of agitation, as described in psychiatric emergency departments [30].”
From Nicotine withdrawal and agitation in ventilated critically ill patients (2010) · cites this paper as [30]
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Nicotine withdrawal and agitation in ventilated critically ill patients
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- Authors
- Migon, M. N., Coutinho, E. S., Huf, G., Adams, C. E., Cunha, G. M., & Allen, M. H.
- Affiliations
- Escola Nacional de Saúde Pública Sergio Arouca (BR)
- Fundação Oswaldo Cruz (BR)
- University of Nottingham (GB)
- Corresponding author
- Allen, Michael H.
- Venue
- General Hospital Psychiatry
- Publisher
- Elsevier BV
- Published
- 2008-05
- Volume
- 30
- Issue
- 3
- Pages
- 263-268
- ISSN
- 0163-8343 (ISSN-L)
- OpenAlex
- W1978978302
- Cited by
- 63
- References
- 26
- Citations by year
- 2026: 3 · 2023: 4 · 2022: 1 · 2021: 2 · 2020: 1 · 2019: 5 · 2018: 5 · 2017: 6 · 2016: 5 · 2015: 5 · 2014: 5 · 2013: 3 · 2012: 5
- FWCI
- 4.82
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- General Hospital Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Conselho Nacional de Desenvolvimento Científico e Tecnológico
- Fundação Oswaldo Cruz
- Topics
- Social Sciences › Psychology › Clinical Psychology › Healthcare Decision-Making and Restraints
- Health Sciences › Medicine › Emergency Medicine › Restraint-Related Deaths
- Health Sciences › Medicine › Psychiatry and Mental health › Electroconvulsive Therapy Studies
- Keywords
- physical restraint, agitated patients, psychiatric emergency department, risk factors, aggression, substance abuse, psychosis, age, time of admission
- MeSH terms
- Adult, Aggression, Bayes Theorem, Brazil, Drug Therapy, Combination, Emergency Services, Psychiatric, Female, Haloperidol, Hospitals, Psychiatric, Humans, Male, Midazolam, Middle Aged, Patient Admission, Promethazine, Psychomotor Agitation, Psychotic Disorders, Restraint, Physical, Risk Factors, Tranquilizing Agents, Utilization Review, Substance-Related Disorders
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