Adverse Effects Associated with Physical Restraint

Mohr, Wanda K.; Petti, Theodore A.; Mohr, Brian D.

doi:10.1177/070674370304800509

Cited by 301 publications

(234 citation statements)

References 64 publications

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“…This includes "therapeutic holding," which has been repudiated as being harmful. 26 During the past 20 years, much research has demonstrated the effectiveness of alternative measures, commonly called "positive behavioral supports," to change behavior. 25 Pediatricians and others who could use additional information about the problems that occur from the use of aversive procedures or restraints can easily get this guidance from the Web sites of organizations such as the Association for the Severely Handicapped (www.tash.org/ IRR/resolutions/res02aversive.htm) and the Autism National Committee (www.Autcom.org/restraints.html).…”

Section: Causal Factorsmentioning

confidence: 99%

Maltreatment of Children With Disabilities

2007

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Widespread efforts are being made to increase awareness and provide education to pediatricians regarding risk factors of child abuse and neglect. The purpose of this clinical report is to ensure that children with disabilities are recognized as a population that is also at risk of maltreatment. Some conditions related to a disability can be confused with maltreatment. The need for early recognition and intervention of child abuse and neglect in this population, as well as the ways that a medical home can facilitate the prevention and early detection of child maltreatment, are the subject of this report.

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Section: Causal Factorsmentioning

confidence: 99%

Maltreatment of Children With Disabilities

2007

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“…Still, there are reports on unwanted effects such as prolonged admittance, pressure sores, psychological traumas, and even death [11,[13][14][15][16][17]. Executing coercion and restraint is also stressful for the health-care personal.…”

Section: Introductionmentioning

confidence: 99%

Use of mechanical and pharmacological restraint over an eight-year period and its relation to clinical factors

Reitan

Helvik

Iversen

2017

Nordic Journal of Psychiatry

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Background: Use of restraint and finding the balance between security and ethics is a continuous dilemma in clinical psychiatry. In daily clinic and in planning health-care service, knowledge on the characteristics of restraint situations is necessary to optimize its use and avoid abuse. Methods: We describe characteristics in the use of pharmacological and mechanical restraint in psychiatric acute wards in a hospital in Middle Norway over an eight-year period. Data on all cases of mechanical and pharmacological restraint from 2004 to 2011 were retrospectively collected from handwritten protocols. Complementary information on the patients was obtained from the hospital patient administrative system. Results: Restraint in acute wards was used on 13 persons per 100,000 inhabitants annually. The percentage of admitted patients exposed to restraint was 1.7%, with a mean of 4.5 cases per exposed patient. Frequency per 100 admitted patients varied from 3.7 (in 2007) to 10 (in 2009). The majority of restraint cases concerned male patients under 50 years and with substance-abuse, psychotic, or affective disorders. Significantly more coercive means were used during daytime compared to night and morning. There was a significant increase in pharmacological coercion during spring and mechanical coercion during summer. Conclusions: Restraint was used on 1.7% of admitted patients, representing 13 per 100,000 inhabitants per year. Use of restraint was higher during certain periods of the day and was associated with the patient's diagnosis, age, gender, and legal status of hospitalization. There was a marked variation over the years.

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“…This includes an increased chance of physical injury and death among patients as well as staff injury (Evans, Wood, & Lambert, 2003;Rakhmutaullina, Taub, & Jacob, 2013), and both patients and staff report trauma associated with the use of these containment measures (Frueh et al, 2005;Mohr, Petti, & Mohr, 2003;Robins, Sauvageot, Cusack, Suffoletta-Maierle, & Frueh, 2005;Sokol, 2010). Furthermore, the use of these measures raises ethical issues relating to patient rights and dignity, and runs contrary to recovery-oriented mental health care (Chang, Grant, Luther, & Beck, 2014;Mohr, 2010).…”

Section: Introductionmentioning

confidence: 99%