Objective. To examine psychiatric patients' experience of mechanical restraints and to describe the care the patients received. Background. All around the world, threats and violence perpetrated by patients in psychiatric emergency inpatient units are quite common and are a prevalent factor concerning the application of mechanical restraints, although psychiatric patients' experiences of mechanical restraints are still moderately unknown. Method. A qualitative design with an inductive approach were used, based on interviews with patients who once been in restraints. Results. This study resulted in an overbridging theme: Physical Presence, Instruction and Composed Behaviour Can Reduce Discontent and Trauma, including five categories. These findings implicated the following: information must be given in a calm and sensitive way, staff must be physically present during the whole procedure, and debriefing after the incident must be conducted. Conclusions. When mechanical restraints were unavoidable, the presence of committed staff during mechanical restraint was important, demonstrating the significance of training acute psychiatric nurses correctly so that their presence is meaningful. Nurses in acute psychiatric settings should be required to be genuinely committed, aware of their actions, and fully present in coercive situations where patients are vulnerable.
The Suicide Assessment Scale (SUAS) was constructed to be sensitive to change of suicidality. It was recently found to be predictive of suicide in a group of suicide attempters. The aim of the present study was to evaluate the reliability and validity of a modified interview version of SUAS with defined scores and also a new self-rating version (SUAS-S). The subjects consisted of former inpatients, 42 persons who had been admitted because of a suicide attempt about 12 years ago and 22 control patients. The subjects were rated according to the SUAS, the SUAS-S, as well as the Montgomery Asberg Depression Rating Scale (MADRS). The interrater reliability was found to be high. The SUAS correlated significantly with the MADRS, but the concordance was not consistent, which indicates that the SUAS measures something different from depression. The SUAS-S correlated significantly with the interview-rated SUAS, thus exhibiting good concurrent validity. In summary, both the modified interview version of SUAS and the SUAS-S seem to be valid, reliable and easily used suicide assessment instruments.
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