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Kandlur NR, Fernandes AC, Gerard SR, Rajiv S, Quadros S. Sensory modulation interventions for adults with mental illness: A scoping review. Hong Kong J Occup Ther 2023; 36:57-68. [PMID: 38027047 PMCID: PMC10680857 DOI: 10.1177/15691861231204896] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Accepted: 09/15/2023] [Indexed: 12/01/2023] Open
Abstract
Introduction Sensory Modulation Interventions (SMI) assist people with mental illnesses to regulate emotional and physiological arousal. We aimed to conduct a scoping review to identify the study designs, geographical distribution, modality/regimen, barriers and facilitators in using SMI for individuals with mental illnesses. Methods A systematic search was conducted using Arksey and O'Malley's framework with studies published on SMI from January 2010 to November 2020. Results 17 articles were found to be relevant. One was a case-control study, qualitative (N = 3), mixed-method (N = 3), and case studies (N = 3), and the rest were pilot interventional studies (N = 8). The duration of sessions ranged from 2 to 30 minutes for 2 days to 3 years. The facilitators in using SMI were of being cost-effective and easily adaptable. Barriers were in terms of maintenance of sensory items. Sensory modulation based items related to proprioception, vestibular and tactile were the frequently used in the SMI based interventions used in the included studies. Conclusions SMI as an occupational therapy intervention for individuals with mental illnesses is evolving and more robust studies in the future are recommended.
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Wright L, Bennett S, Meredith P. Using the Theoretical Domain Framework to understand what helps and hinders the use of different sensory approaches in Australian psychiatric units: A survey of mental health clinicians. Aust Occup Ther J 2023; 70:599-616. [PMID: 37259982 DOI: 10.1111/1440-1630.12889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2022] [Revised: 04/17/2023] [Accepted: 05/16/2023] [Indexed: 06/02/2023]
Abstract
BACKGROUND/AIM Although sensory approaches are recommended to relieve distress and agitation and reduce the use of seclusion and restraint, many Australian psychiatric units have struggled to sustain their practice. The aim of this study was to investigate the barriers and enablers influencing the use of different sensory approaches across one health region in Australia and to obtain recommendations for strategies to improve their use. METHOD This cross-sectional survey was informed by the Theoretical Domain Framework. Likert scale questions considered barriers and enablers to the use of non-weighted sensory interventions, weighted modalities, sensory rooms, and sensory assessments/plans. Open-ended questions explored participant concerns and recommendations to improve the use of sensory approaches. RESULTS Participants (n = 211) were from nursing, allied health, medical, and peer support staff across inpatient psychiatric units. Factors most frequently identified as enablers for using sensory approaches were beliefs of positive benefits to consumers (e.g. decreasing distress and agitation); belief it was within the staff's role; and knowledge of the approaches. Limited time was the most common identified barrier. Factors statistically associated with more frequent use were knowledge, skills, confidence, availability, and easy access to sensory tools/equipment. Only 30% of participants were concerned about potential risks of sensory approaches, with this risk mitigated through adequate supervision and thorough risk assessment. Recommendations to improve practice included improved access to, and maintenance of, equipment, more training, and increased staffing. CONCLUSION This study revealed how barriers and enablers vary for different sensory approaches and how these factors impact their frequency of use in psychiatric units. It provides insights into staff recommendations to improve the use of sensory approaches in one health region in Australia. This knowledge will lead to the development of implementation strategies to address identified barriers and improve the use of sensory approaches in psychiatric units.
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Affiliation(s)
- Lisa Wright
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
- Metro North Mental Health - The Prince Charles Hospital, Metro North Hospital and Health Service, Brisbane, Australia
| | - Sally Bennett
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| | - Pamela Meredith
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
- School of Health and Behavioural Sciences, University of Sunshine Coast, Sunshine Coast, Australia
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3
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Hudon A, Rosca MA, La Charité-Harbec O, Allard JM, Borduas Pagé S. The Use of Alternative Rooms in Forensic and Regular Psychiatric Units: A Scoping Review. Healthcare (Basel) 2023; 11:2432. [PMID: 37685466 PMCID: PMC10487261 DOI: 10.3390/healthcare11172432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 07/31/2023] [Accepted: 08/29/2023] [Indexed: 09/10/2023] Open
Abstract
(1) Background: Emotional regulation, distress and relational conflicts often occur during hospitalization and rehabilitation on psychiatric units, especially in patients suffering from severe and persistent mental disorders. While widely used in children and geriatric patients, little literature exists on the use and outcomes of alternative rooms in the context of forensic and regular psychiatric units for adult patients. Considering the scarcity of the literature on alternative use, this study is motivated by the following research question: what are the main uses and outcomes of alternative rooms in the context of forensic and regular psychiatric units? The main objective of this study is to conduct a scoping review of the use and outcomes of alternative rooms for the context of psychiatric inpatients. (2) Methods: A systematic search was performed in the electronic databases of MedLine, Web of Science, PsycNet (PsycINFO) and Google Scholar from their inception dates until 2022. (3) Results: A total of nine studies were analyzed. Sensory, multisensory rooms, Snoezelen, and comfort rooms are the types of alternative rooms discussed in these studies. Distress and anxiety reduction, increase in self-esteem, impact on seclusion rates, patient-staff communication and alliances, heart and respiration rate reduction, and improvement of alexithymia were identified among the main uses and outcomes of these rooms. (4) Conclusions: The scarcity of literature available to draw information from for this review and possible impact on improving patient outcomes and quality of treatment in psychiatric units opens the door to future studies to better understand the efficacy of such rooms. Research into the ideal implementation tactics of such rooms, long-term outcomes, and the influence on diverse patient demographics could be areas of improvement in the use of alternative rooms.
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Affiliation(s)
- Alexandre Hudon
- Centre de Recherche de l’Institut Universitaire en Santé Mentale de Montréal, Montreal, QC H1N 3V2, Canada
| | - Maria Alexandra Rosca
- Department of Psychiatry and Addictology, Faculty of Medicine, Université de Montréal, Montreal, QC H3T 1J4, Canada;
| | - Olivier La Charité-Harbec
- Institut Universitaire en Santé Mentale de Montréal, Montreal, QC H1N 3M5, Canada; (O.L.C.-H.); (J.-M.A.)
| | - Jeanne-Marie Allard
- Institut Universitaire en Santé Mentale de Montréal, Montreal, QC H1N 3M5, Canada; (O.L.C.-H.); (J.-M.A.)
| | - Stéphanie Borduas Pagé
- Institut Universitaire en Santé Mentale de Montréal, Montreal, QC H1N 3M5, Canada; (O.L.C.-H.); (J.-M.A.)
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4
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Jurdana MA, Lacambre M, Fovet T. [Soothing spaces and techniques in psychiatry]. REVUE DE L'INFIRMIERE 2023; 72:29-31. [PMID: 37364973 DOI: 10.1016/j.revinf.2023.05.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/28/2023]
Abstract
The development of alternatives to seclusion and restraint is a priority for psychiatric care services. Among them, the implementation of soothing spaces is currently experiencing considerable growth.
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Affiliation(s)
| | - Mathieu Lacambre
- Université de Lille, Inserm, U1172 - Lille Neuroscience & Cognition, 59000 Lille, France; Filière de psychiatrie légale, Unité de soins intensifs de psychiatrie, CHU Montpellier, 191 avenue du Doyen Giraud, 34295 Montpellier cedex 5, France
| | - Thomas Fovet
- CHU Lille, Service de Psychiatrie adulte, F-59000 Lille, France; Université de Lille, Inserm, U1172 - Lille Neuroscience & Cognition, 59000 Lille, France; Section psychiatrie légale, Association française de psychiatrie biologique et de neuropsychopharmacologie (AFPBN), BP 60222, 78102 Saint-Germain-en-Laye, France.
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5
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Haig S, Hallett N. Use of sensory rooms in adult psychiatric inpatient settings: A systematic review and narrative synthesis. Int J Ment Health Nurs 2023; 32:54-75. [PMID: 36082841 DOI: 10.1111/inm.13065] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/09/2022] [Indexed: 01/14/2023]
Abstract
Reducing the use of restrictive interventions within psychiatric inpatient settings is a global priority. There are many strategies which may support the prevention of violence before escalation into more severe incidences. Sensory rooms have been identified as one such intervention, aiding patients to emotionally regulate and reduce distress, with a growing body of academic literature interested in whether sensory rooms can ultimately impact incidences of patient violence and the use of restraint, seclusion, and other restrictive practices. A systematic literature review was conducted to identify how effective sensory rooms are at reducing patient violence and restrictive interventions within adult psychiatric inpatient settings. Eighteen studies met the eligibility criteria and were included in the review. There is a lack of evidence as to whether sensory rooms are effective at reducing seclusion, restraint, or violence. They are, however, likely to support a reduction in patient distress. Patient and staff experiences suggest sensory rooms support emotional regulation, promote self-management, and positively impact the overall patient admission experience and ward environment. Further research is needed to identify what works, for who and in what circumstances in relation to the design of sensory rooms.
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Affiliation(s)
| | - Nutmeg Hallett
- School of Nursing, University of Birmingham, Birmingham, UK
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6
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Wright L, Meredith P, Bennett S. Sensory approaches in psychiatric units: Patterns and influences of use in one Australian health region. Aust Occup Ther J 2022; 69:559-573. [PMID: 35706333 PMCID: PMC9796746 DOI: 10.1111/1440-1630.12813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Revised: 04/10/2022] [Accepted: 05/05/2022] [Indexed: 01/07/2023]
Abstract
BACKGROUND/AIM Australian guidelines and policies recommend the use of sensory approaches in mental health care. Nevertheless, many Australian psychiatric units report difficulty sustaining these approaches. To inform efforts to close the gap between recommendations and practice, the aim of this study was to understand the patterns of use of sensory approaches and what demographic and clinical factors influence their use, across one health region in Queensland, Australia. METHODS Using a cross-sectional survey design, a custom-designed questionnaire was distributed via email and in paper form to health professionals and peer support workers working in acute, secure, and community care psychiatric units across one health region. Information on demographics and the use of various sensory interventions was gathered utilising both open-ended and Likert scale questions. RESULTS Useable questionnaires were collected from 183 participants from various disciplines (77% nursing). The majority reported using sensory approaches with a limited number of consumers, and almost 9% never used the approach. Activity-based sensory interventions and sensory equipment were most often used, whereas sensory assessments, sensory plans, and sensory groups were least used. Sensory interventions were mainly used to reduce consumer anxiety and agitation and to assist with emotional regulation. Factors positively correlated with frequency of use for all interventions were discipline (occupational therapy); working in an acute inpatient unit; and training in sensory approaches. Age was negatively correlated with frequency of use only for weighted modalities. CONCLUSIONS This study revealed that sensory approaches were used by most staff though with a limited proportion of consumers in psychiatric units in one large metropolitan health service. It provides insights into the factors influencing frequency of use, highlighting the importance of training in sensory approaches and access to occupational therapists. With this knowledge, we can work towards closing the gap between recommendations and the practice of sensory approaches.
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Affiliation(s)
- Lisa Wright
- School of Health and Rehabilitation SciencesThe University of QueenslandBrisbaneQueenslandAustralia,The Prince Charles HospitalMetro North Mental Health Hospital and Health ServicesBrisbaneQueenslandAustralia
| | - Pamela Meredith
- School of Health and Rehabilitation SciencesThe University of QueenslandBrisbaneQueenslandAustralia,School of Health and Behavioural SciencesUniversity of Sunshine CoastSunshine CoastQueenslandAustralia
| | - Sally Bennett
- School of Health and Rehabilitation SciencesThe University of QueenslandBrisbaneQueenslandAustralia
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7
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Ma D, Su J, Wang H, Zhao Y, Li H, Li Y, Zhang X, Qi Y, Sun J. Sensory-based approaches in psychiatric care: A systematic mixed-methods review. J Adv Nurs 2021; 77:3991-4004. [PMID: 33951221 DOI: 10.1111/jan.14884] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Revised: 02/18/2021] [Accepted: 04/18/2021] [Indexed: 11/28/2022]
Abstract
AIMS Sensory-based approaches, including sensory room, sensory cart and specific sensory integration programs, feature various sensory stimulations to focus on a particular space or program. This systematic mixed-methods review describes the impact of sensory-based approaches in psychiatric care and summarizes the important components of sensory interventions. DESIGN Systematic mixed-methods review was based on the guidelines by Pluye and Hong for comprehensively searching, appraising and synthesizing research evidence. DATA SOURCES Data were collected from five databases: CINAHL, Embase, Pubmed, Web of Science and Cochrane before March 9, 2020. REVIEW METHODS Qualitative, quantitative, mixed-methods and original studies published in English on sensory-based approaches in psychiatric care were included. The studies were selected by screening titles, abstracts and full texts, and the quality of each study was assessed by two researchers independently. The data were analysed using thematic analysis. RESULTS Sixteen studies were chosen for review. Through data integration, four subthemes with positive effects were formed: (1) calming of the patient's mood; (2) calming of the patient's body; (3) improvement of self-care ability; and (4) improvement of the nurse-patient relationship. The sensory-based approach may also lead to negative effects. CONCLUSIONS Several important components play important roles in the sensory-based approaches: (1) rich, culture-based, personalized sensory stimulation; (2) a quiet, safe, home-based physical environment; (3) a good one-to-one nurse-patient relationship; (4) and the cultivation of patient autonomy and self-management. Sensory-based approaches in a multicultural environment and home environment will be important topics of psychiatric care in the future. IMPACT There is a lack of synthesis of studies on results of sensory-based approaches in psychiatric care. Four components are important to sensory interventions. It is necessary for mental health service centres and home care for the patients with psychotic disorders to use sensory-based approaches for reference.
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Affiliation(s)
- Dongfei Ma
- School of Nursing, Jilin University, Jilin, People's Republic of China
| | - Jianping Su
- School of Nursing, Jilin University, Jilin, People's Republic of China.,School of Nursing, Xinjiang Medical University, Urumqi, People's Republic of China
| | - Hong Wang
- The First Bethune Hospital of Jilin University, Jilin, People's Republic of China
| | - Yingnan Zhao
- School of Nursing, Jilin University, Jilin, People's Republic of China
| | - Huanhuan Li
- School of Nursing, Jilin University, Jilin, People's Republic of China
| | - Yijing Li
- School of Nursing, Jilin University, Jilin, People's Republic of China
| | - Xu Zhang
- School of Nursing, Jilin University, Jilin, People's Republic of China
| | - Yicheng Qi
- School of Nursing, Jilin University, Jilin, People's Republic of China
| | - Jiao Sun
- School of Nursing, Jilin University, Jilin, People's Republic of China
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8
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Wright L, Bennett S, Meredith P. 'Why didn't you just give them PRN?': A qualitative study investigating the factors influencing implementation of sensory modulation approaches in inpatient mental health units. Int J Ment Health Nurs 2020; 29:608-621. [PMID: 32061046 DOI: 10.1111/inm.12693] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/05/2020] [Indexed: 11/28/2022]
Abstract
Clinical guidelines and policies worldwide call for sensory modulation approaches to be incorporated into inpatient mental health care to assist in eliminating the use of restrictive practices. Although increasing evidence shows that these approaches reduce patient distress and the need for seclusion and restraint, sensory modulation approaches have been challenging to implement in many psychiatric units. Implementation strategies can effectively support inclusion of new approaches by addressing potential barriers to change and supporting likely enabling factors. This study aimed to gain a better understanding of the barriers and enablers influencing implementation of sensory modulation approaches in psychiatric inpatient units in one health region in Australia. A qualitative descriptive study design was used, with three focus groups and a total of 15 participants from nursing and allied health disciplines answering questions about the use of sensory modulation approaches. Framework analysis using the Theoretical Domains Framework and thematic analysis was used to analyse data. Overall, participants were positive about the use of sensory modulation approaches, particularly for reducing distress. Four domains (Social Influences; Belief about Consequences; Professional Role and Identify; and Environmental Context and Resources) were identified as the most salient. The key influencing factors were support from peers; beliefs about risks; belief it was part of their role; and availability of resources and materials. Numerous challenges and opportunities related to implementing sensory modulation approaches in mental health inpatient units, identified in this study, provide insights to support effective implementation of these approaches, underpinning more person-centred, trauma-informed, and recovery-orientated care.
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Affiliation(s)
- Lisa Wright
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Queensland, Australia.,The Prince Charles Hospital, Metro North Mental Health Hospital and Health Services, Brisbane, Queensland, Australia
| | - Sally Bennett
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Queensland, Australia
| | - Pamela Meredith
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Queensland, Australia.,School of Health, Medical and Applied Sciences, Central Queensland University, Rockhampton, Queensland, Australia
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9
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Williamson P, Ennals P. Making sense of it together: Youth & families co-create sensory modulation assessment and intervention in community mental health settings to optimise daily life. Aust Occup Ther J 2020; 67:458-469. [PMID: 32648269 DOI: 10.1111/1440-1630.12681] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2019] [Revised: 05/03/2020] [Accepted: 05/31/2020] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Occupational therapists work collaboratively with young people experiencing mental ill-health to enable meaningful occupational participation in daily life. Sensory modulation is used as a means of developing self-regulation and enabling occupational participation. Published literature on sensory modulation in mental health settings is primarily located within acute inpatient settings and focuses on self-regulation. Little is known about the use of sensory modulation within community settings to enhance occupational participation in daily lives of people with mental-ill health. This study investigated the experiences of young people and their families who engaged in sensory modulation assessment (Adolescent/Adult Sensory Profile) and intervention (between one and twelve sessions) as part of community mental health care at a large area mental health service in Melbourne, Australia. METHODS The qualitative study used naturalistic inquiry methodology involving semi-structured interviews with six young people and three families. Nine interview transcripts were thematically analysed to elicit the experiences of sensory modulation assessment and intervention, and how this may influence daily life. RESULTS Thematic analysis revealed that young people and their families' positive experiences of sensory modulation were underpinned by processes of co-creation: (a) knowing yourself; (b) understanding 'the why': developing shared reasons for engaging in sensory modulation; (c) creating comfort; (d) creating connection; and (e) constantly learning. Sensory modulation supported occupational participation in young peoples' daily lives in the areas of sleep, study, relationships, self-care, independent living, being in the world, and doing new things. CONCLUSION Young people and their families valued the process of co-creating sensory modulation assessment and intervention to enhance occupational participation. Results revealed that sensory modulation assessment and intervention was optimised when it was a process of co-creation. Future research should investigate the effectiveness of sensory modulation in enhancing occupational participation in these domains that influence daily life.
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Affiliation(s)
| | - Priscilla Ennals
- School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Vic, Australia.,Neami National, Preston, Vic, Australia
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10
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Andersson H, Sutton D, Bejerholm U, Argentzell E. Experiences of sensory input in daily occupations for people with serious mental illness. Scand J Occup Ther 2020; 28:446-456. [DOI: 10.1080/11038128.2020.1778784] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
| | - Daniel Sutton
- School of Clinical Sciences, Auckland University of Technology, Auckland, New Zealand
| | - Ulrika Bejerholm
- Department of Health Sciences, Mental Health, Activity and Participation (MAP), Lund University, Lund, Sweden
| | - Elisabeth Argentzell
- Department of Health Sciences, Mental Health, Activity and Participation (MAP), Lund University, Lund, Sweden
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11
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Hedlund Lindberg M, Samuelsson M, Perseius KI, Björkdahl A. The experiences of patients in using sensory rooms in psychiatric inpatient care. Int J Ment Health Nurs 2019; 28:930-939. [PMID: 30931543 DOI: 10.1111/inm.12593] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/11/2019] [Indexed: 11/30/2022]
Abstract
The use of sensory rooms and similar sensory approaches in psychiatric inpatient settings is becoming increasingly common. In sensory rooms, patients can choose different sensory stimulating items that may help regulate distress and enhance well-being. Outcomes are often measured as effects on patients' self-rated distress and rates of seclusion and restraint. The subjective experiences of patients using sensory rooms have been less explored. This paper presents a qualitative study of the experiences of 28 patients who chose to use sensory rooms on seven different types of psychiatric inpatient wards. Data were collected by individual patient interviews and by texts written by patients. A qualitative content analysis resulted in four categories: emotional calm, bodily calm, empowerment, and unexpected effects. A majority of the participants described several positive experiences, such as enhanced well-being, reduced anxiety, increased self-management, and enhanced self-esteem. Our findings align with previous research that has shown similar positive patient experiences, and support the use of sensory rooms as part of person-centred care.
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Affiliation(s)
- Mathilde Hedlund Lindberg
- Division of Nursing, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden
| | - Mats Samuelsson
- Division of Nursing, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden
| | | | - Anna Björkdahl
- Department of Clinical Neuroscience, Centre for Psychiatry Research, Karolinska Institutet, Huddinge, Sweden.,Stockholm Health Care Services, Stockholm County Council, Psykiatri Södra Stockholm, Stockholm, Sweden
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12
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Forsyth AS, Trevarrow R. Sensory strategies in adult mental health: A qualitative exploration of staff perspectives following the introduction of a sensory room on a male adult acute ward. Int J Ment Health Nurs 2018; 27:1689-1697. [PMID: 29663648 DOI: 10.1111/inm.12466] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/21/2018] [Indexed: 12/01/2022]
Abstract
In recent years, there has been growing interest in the use of sensory techniques to help with emotional regulation in adult mental health populations. This is against a backdrop of international policies aimed at reducing restrictive interventions and improving the effectiveness of de-escalation techniques. A sensory room was designed and implemented on a male adult acute psychiatric ward. Staff perspectives were sought to evaluate the effectiveness of the room in managing emotional distress by exploring staff awareness of a broader range of de-escalation strategies and by exploring what effect the room had on staff behaviours with respect to sensory interventions. A series of semi-structured interviews were carried out, analysed, and grouped into themes. Three themes emerged as follows: enhancing de-escalation, sensory interventions, and impact on staff. Findings showed that increased awareness of sensory processing and use of sensory strategies such as the sensory room were perceived by staff to have a positive impact on reducing distress with male service users. Staff use of the room was also discovered to have benefits that included staff attending to their own emotional needs and the use of the room supporting reflective learning during critical incident debriefing.
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Affiliation(s)
- Angus S Forsyth
- University of Sunderland, Sunderland, UK.,Northumberland, Tyne and Wear NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Rebecca Trevarrow
- University of Sunderland, Sunderland, UK.,Northumberland, Tyne and Wear NHS Foundation Trust, Newcastle upon Tyne, UK
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13
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Brown A, Tse T, Fortune T. Defining sensory modulation: A review of the concept and a contemporary definition for application by occupational therapists. Scand J Occup Ther 2018; 26:515-523. [DOI: 10.1080/11038128.2018.1509370] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Anahita Brown
- College of Science, Health and Engineering, School of Allied Health, La Trobe University, Bundoora, Victoria, Australia
| | - Tamara Tse
- College of Science, Health and Engineering, School of Allied Health, La Trobe University, Bundoora, Victoria, Australia
| | - Tracy Fortune
- College of Science, Health and Engineering, School of Allied Health, La Trobe University, Bundoora, Victoria, Australia
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14
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Holmes D, Perron A, Jacob JD, Paradis-Gagné É, Gratton SM. Pratique en milieu de psychiatrie légale : proposition d’un modèle interdisciplinaire. Rech Soins Infirm 2018:33-43. [DOI: 10.3917/rsi.134.0033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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15
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Yakov S, Birur B, Bearden MF, Aguilar B, Ghelani KJ, Fargason RE. Sensory Reduction on the General Milieu of a High-Acuity Inpatient Psychiatric Unit to Prevent Use of Physical Restraints: A Successful Open Quality Improvement Trial. J Am Psychiatr Nurses Assoc 2018; 24:133-144. [PMID: 29039238 DOI: 10.1177/1078390317736136] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Impaired sensory gating in patients with acute mental illness predisposes to overstimulation and behavioral dyscontrol. OBJECTIVE Explore use of sensory reduction interventions on a high-acuity inpatient milieu to reduce high assault/restraint rates. DESIGN A multidisciplinary team using failure mode and effect analysis to explore high restraint use between 4:00 p.m. and 7:00 p.m. observed patient/staff overstimulation contributed to behavioral escalations. The team implemented sensory reduction/integration improvements over a 5-month period to prevent excessive restraint use. RESULTS Restraint rates dropped immediately following light and sound reduction interventions and by 72% at 11 months postimplementation. Mann-Whitney statistics for unpaired 6-month comparisons, 1-year pre- and postintervention showed significant reductions: Assault rates (median pre = 1.37, post = 0.18, U = 4, p = .02); Restraint rates (median pre = 0.50, post = 0.06, U = 0, p = .002). CONCLUSION Sensory reduction during a high-stress time period on a high-acuity psychiatric unit was associated with a reduction in assaults and restraints.
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Affiliation(s)
- Svetlana Yakov
- 1 Svetlana Yakov, MD, University of Alabama at Birmingham, AL, USA
| | - Badari Birur
- 2 Badari Birur, MD, University of Alabama at Birmingham, AL, USA
| | - Melissa F Bearden
- 3 Melissa F. Bearden, MACN, OT/L, University of Alabama at Birmingham, AL, USA
| | - Barbara Aguilar
- 4 Barbara Aguilar, BSN-BC, RN, University of Alabama at Birmingham, AL, USA
| | - Kinjal J Ghelani
- 5 Kinjal J. Ghelani, MD, University of Alabama at Birmingham, AL, USA
| | - Rachel E Fargason
- 6 Rachel E. Fargason, MD, University of Alabama at Birmingham, AL, USA
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16
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Seckman A, Paun O, Heipp B, Van Stee M, Keels-Lowe V, Beel F, Spoon C, Fogg L, Delaney KR. Evaluation of the use of a sensory room on an adolescent inpatient unit and its impact on restraint and seclusion prevention. JOURNAL OF CHILD AND ADOLESCENT PSYCHIATRIC NURSING 2017; 30:90-97. [DOI: 10.1111/jcap.12174] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2016] [Revised: 05/15/2017] [Accepted: 06/08/2017] [Indexed: 10/19/2022]
Affiliation(s)
- Angela Seckman
- Wexner Medical Center, Harding Hospital; The Ohio State University; Columbus OH USA
| | - Olimpia Paun
- Rush University College of Nursing; Chicago IL USA
| | - Biljana Heipp
- Wexner Medical Center, Harding Hospital; The Ohio State University; Columbus OH USA
| | - Marie Van Stee
- Wexner Medical Center, Harding Hospital; The Ohio State University; Columbus OH USA
| | | | - Frank Beel
- Wexner Medical Center, Harding Hospital; The Ohio State University; Columbus OH USA
| | - Cari Spoon
- Wexner Medical Center, Harding Hospital; The Ohio State University; Columbus OH USA
| | - Louis Fogg
- Rush University College of Nursing; Chicago IL USA
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