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Pedersen ML. Enhancing comprehensive understanding: Advocating for grey literature searches in scoping reviews. Gen Hosp Psychiatry 2024; 89:93-94. [PMID: 38443219 DOI: 10.1016/j.genhosppsych.2024.02.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2024] [Revised: 02/27/2024] [Accepted: 02/28/2024] [Indexed: 03/07/2024]
Affiliation(s)
- Martin Locht Pedersen
- Forensic Mental Health Research Unit Middelfart, Department of Regional Health Research, Faculty of Health Science, University of Southern Denmark, Middelfart, Denmark; Psychiatric Department Middelfart, Mental Health Services in the Region of Southern Denmark, Middelfart, Denmark.
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Pedersen ML, Gildberg FA, Baker J, Tingleff EB. A systematic review of interventions to reduce mechanical restraint in adult mental health inpatient settings. Int J Ment Health Nurs 2024; 33:505-522. [PMID: 38017713 DOI: 10.1111/inm.13267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2023] [Revised: 10/25/2023] [Accepted: 11/13/2023] [Indexed: 11/30/2023]
Abstract
Mechanical restraint is a commonly used restrictive practice worldwide, although reducing its use is an international priority. Interventions to reduce mechanical restraint are needed if reducing mechanical restraint is to succeed. Therefore, this systematic review aimed to examine evaluated evidence-based interventions that seek to reduce the incidence of and/or time in mechanical restraint in adult mental health inpatient settings. The JBI framework was used to guide this systematic review. The search strategy included peer-reviewed primary research literature published between 1999 and 2023. Two authors independently conducted the systematic search, selection process and data extraction process. Forty-one studies were included in this review. Using content analysis, we grouped interventions into four categories: (I) calm-down methods, (II) staff resources, (III) legal and policy changes and (IV) changing staff culture. Interventions to reduce mechanical restraint in adult mental health inpatient settings have shown some promise. Evidence suggests that a range of interventions can reduce the incidence of and/or time in mechanical restraint. However, controlled trials were lacking and consensus was lacking across studies. Furthermore, specific findings varied widely, and reporting was inconsistent, hampering the development of interventions for this issue. Further research is needed to strengthen the evidence base for reducing mechanical restraint in mental health inpatient settings.
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Affiliation(s)
- Martin Locht Pedersen
- Forensic Mental Health Research Unit Middelfart, Department of Regional Health Research, University of Southern Denmark, Middelfart, Denmark
- Psychiatric Department Middelfart, Mental Health Services in the Region of Southern Denmark, Middelfart, Denmark
| | - Frederik Alkier Gildberg
- Forensic Mental Health Research Unit Middelfart, Department of Regional Health Research, University of Southern Denmark, Middelfart, Denmark
- Psychiatric Department Middelfart, Mental Health Services in the Region of Southern Denmark, Middelfart, Denmark
| | - John Baker
- School of Healthcare, University of Leeds, Leeds, UK
| | - Ellen Boldrup Tingleff
- Forensic Mental Health Research Unit Middelfart, Department of Regional Health Research, University of Southern Denmark, Middelfart, Denmark
- Psychiatric Department Middelfart, Mental Health Services in the Region of Southern Denmark, Middelfart, Denmark
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Pedersen ML, Gildberg FA, Baker JA. Culturally appropriate care and reduction of restrictive practices in mental health. Int J Ment Health Nurs 2024; 33:735-736. [PMID: 38356177 DOI: 10.1111/inm.13305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Revised: 01/30/2024] [Accepted: 02/01/2024] [Indexed: 02/16/2024]
Affiliation(s)
- Martin Locht Pedersen
- Forensic Mental Health Research Unit Middelfart, Department of Regional Health Research, University of Southern Denmark, Middelfart, Denmark
- Psychiatric Department Middelfart, Mental Health Services in the Region of Southern Denmark, Middelfart, Denmark
| | - Frederik Alkier Gildberg
- Forensic Mental Health Research Unit Middelfart, Department of Regional Health Research, University of Southern Denmark, Middelfart, Denmark
- Psychiatric Department Middelfart, Mental Health Services in the Region of Southern Denmark, Middelfart, Denmark
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Pedersen ML, Gildberg FA, Bogh SB, Birkeland S, Tingleff EB. Staff responses to interventions aiming to reduce mechanical restraint in adult mental health inpatient settings: a questionnaire-based survey. Nord J Psychiatry 2024; 78:328-338. [PMID: 38436663 DOI: 10.1080/08039488.2024.2323125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Accepted: 02/20/2024] [Indexed: 03/05/2024]
Abstract
PURPOSE To explore mental health staff's responses towards interventions designed to reduce the use of mechanical restraint (MR) in adult mental health inpatient settings. METHODS We conducted a cross-sectional, questionnaire-based survey. The questionnaire, made available online via REDCap, presented 20 interventions designed to reduce MR use. Participants were asked to rate and rank the interventions based on their viewpoints regarding the relevance and importance of each intervention. RESULTS A total of 128 mental health staff members from general and forensic mental health inpatient units across the Mental Health Services in the Region of Southern Denmark completed the questionnaire (response rate = 21.3%). A total of 90.8% of the ratings scored either 'agree' (45.2%) or 'strongly agree' (45.6%) concerning the relevance of the interventions in reducing MR use. Overall and in the divided analysis, interventions labelled as 'building relationship' and 'patient-related knowledge' claimed high scores in the staff's rankings of the interventions' importance concerning implementation. Conversely, interventions like 'carers' and 'standardised assessments' received low scores. CONCLUSIONS The staff generally considered that the interventions were relevant. Importance rankings were consistent across the divisions chosen, with a range of variance and dispersion being recorded among certain groups.
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Affiliation(s)
- Martin Locht Pedersen
- Forensic Mental Health Research Unit Middelfart, Department of Regional Health Research, University of Southern Denmark, Middelfart, Denmark
- Psychiatric Department Middelfart, Mental Health Services in the Region of Southern Denmark, Middelfart, Denmark
| | - Frederik Alkier Gildberg
- Forensic Mental Health Research Unit Middelfart, Department of Regional Health Research, University of Southern Denmark, Middelfart, Denmark
- Psychiatric Department Middelfart, Mental Health Services in the Region of Southern Denmark, Middelfart, Denmark
| | - Søren Bie Bogh
- OPEN, Odense Patient data Explorative Network, Odense University Hospital, /Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Søren Birkeland
- Forensic Mental Health Research Unit Middelfart, Department of Regional Health Research, University of Southern Denmark, Middelfart, Denmark
- Psychiatric Department Middelfart, Mental Health Services in the Region of Southern Denmark, Middelfart, Denmark
- OPEN, Odense Patient data Explorative Network, Odense University Hospital, /Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Ellen Boldrup Tingleff
- Forensic Mental Health Research Unit Middelfart, Department of Regional Health Research, University of Southern Denmark, Middelfart, Denmark
- Psychiatric Department Middelfart, Mental Health Services in the Region of Southern Denmark, Middelfart, Denmark
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Pedersen ML, Tingleff EB. Enhancing research inclusion: The importance of grey literature searches. Scand J Caring Sci 2024; 38:249-250. [PMID: 37392005 DOI: 10.1111/scs.13188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Accepted: 06/09/2023] [Indexed: 07/02/2023]
Affiliation(s)
- Martin Locht Pedersen
- Forensic Mental Health Research Unit Middelfart, Department of Regional Health Research, University of Southern Denmark, Middelfart, Denmark
- Psychiatric Department Middelfart, Mental Health Services in the Region of Southern Denmark, Middelfart, Denmark
| | - Ellen Boldrup Tingleff
- Forensic Mental Health Research Unit Middelfart, Department of Regional Health Research, University of Southern Denmark, Middelfart, Denmark
- Psychiatric Department Middelfart, Mental Health Services in the Region of Southern Denmark, Middelfart, Denmark
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Aguglia A, Corsini GP, Berardelli I, Berti A, Conio B, Garbarino N, Gnecco GB, Magni C, Venturini E, Costanza A, Amerio A, Amore M, Serafini G. Mechanical Restraint in Inpatient Psychiatric Unit: Prevalence and Associated Clinical Variables. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:1847. [PMID: 37893565 PMCID: PMC10607962 DOI: 10.3390/medicina59101847] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Revised: 10/09/2023] [Accepted: 10/11/2023] [Indexed: 10/29/2023]
Abstract
Background and Objectives: mechanical restraint (MR) is a controversial issue in emergency psychiatry and should be better studied to implement other alternative therapeutic interventions. The aim of this study was to estimate the prevalence of MR in an Italian psychiatric unit and identify the sociodemographic and clinical characteristics as well as the pharmacological pattern associated with MR. Materials and Methods: all subjects (N = 799) consecutively admitted to an Italian psychiatric inpatient unit were recruited. Several sociodemographic and clinical characteristics were recorded. Results: The prevalence of MR was 14.1%. Males, a younger age, and a single and migrant status were associated with the MR phenomenon. MR was more prevalent in patients affected by other diagnoses and comorbid illicit substance use, in patients with aggressive behaviors, and those that were involuntary admitted, leading significantly to hospitalization over 21 days. Furthermore, the patients that underwent MR were taking a lower number of psychiatric medications. Conclusions: Unfortunately, MR is still used in emergency psychiatry. Future research should focus on the dynamics of MR development in psychiatry, specifically considering ward- and staff-related factors that could help identify a more precise prevention and alternative intervention strategies.
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Affiliation(s)
- Andrea Aguglia
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Psychiatry, University of Genoa, 16132 Genoa, Italy; (A.A.); (A.B.); (N.G.); (G.B.G.); (C.M.); (E.V.); (A.A.); (M.A.); (G.S.)
- Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Ospedale Policlinico San Martino, 16132 Genoa, Italy; (G.P.C.); (B.C.)
| | - Giovanni Pietro Corsini
- Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Ospedale Policlinico San Martino, 16132 Genoa, Italy; (G.P.C.); (B.C.)
| | - Isabella Berardelli
- Department of Neurosciences, Mental Health and Sensory Organs, Faculty of Medicine and Psychology, Suicide Prevention Centre, Sant’Andrea Hospital, Sapienza University of Rome, 00189 Rome, Italy;
| | - Andrea Berti
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Psychiatry, University of Genoa, 16132 Genoa, Italy; (A.A.); (A.B.); (N.G.); (G.B.G.); (C.M.); (E.V.); (A.A.); (M.A.); (G.S.)
| | - Benedetta Conio
- Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Ospedale Policlinico San Martino, 16132 Genoa, Italy; (G.P.C.); (B.C.)
| | - Nicolò Garbarino
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Psychiatry, University of Genoa, 16132 Genoa, Italy; (A.A.); (A.B.); (N.G.); (G.B.G.); (C.M.); (E.V.); (A.A.); (M.A.); (G.S.)
| | - Giovanni Battista Gnecco
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Psychiatry, University of Genoa, 16132 Genoa, Italy; (A.A.); (A.B.); (N.G.); (G.B.G.); (C.M.); (E.V.); (A.A.); (M.A.); (G.S.)
| | - Caterina Magni
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Psychiatry, University of Genoa, 16132 Genoa, Italy; (A.A.); (A.B.); (N.G.); (G.B.G.); (C.M.); (E.V.); (A.A.); (M.A.); (G.S.)
| | - Enrico Venturini
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Psychiatry, University of Genoa, 16132 Genoa, Italy; (A.A.); (A.B.); (N.G.); (G.B.G.); (C.M.); (E.V.); (A.A.); (M.A.); (G.S.)
| | - Alessandra Costanza
- Department of Psychiatry, Adult Psychiatry Service, University Hospitals of Geneva (HUG), 1207 Geneva, Switzerland
- Department of Psychiatry, Faculty of Biomedical Sciences, University of Italian Switzerland (USI), 6900 Lugano, Switzerland
- Department of Psychiatry, Faculty of Medicine, University of Geneva (UNIGE), 1211 Geneva, Switzerland
| | - Andrea Amerio
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Psychiatry, University of Genoa, 16132 Genoa, Italy; (A.A.); (A.B.); (N.G.); (G.B.G.); (C.M.); (E.V.); (A.A.); (M.A.); (G.S.)
- Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Ospedale Policlinico San Martino, 16132 Genoa, Italy; (G.P.C.); (B.C.)
| | - Mario Amore
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Psychiatry, University of Genoa, 16132 Genoa, Italy; (A.A.); (A.B.); (N.G.); (G.B.G.); (C.M.); (E.V.); (A.A.); (M.A.); (G.S.)
| | - Gianluca Serafini
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Psychiatry, University of Genoa, 16132 Genoa, Italy; (A.A.); (A.B.); (N.G.); (G.B.G.); (C.M.); (E.V.); (A.A.); (M.A.); (G.S.)
- Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Ospedale Policlinico San Martino, 16132 Genoa, Italy; (G.P.C.); (B.C.)
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Pedersen ML, Gildberg FA, Laulund R, Jørgensen K, Tingleff EB. Nurses' clinical decision-making in the use of rapid tranquillization in adult mental health inpatient settings: An integrative review. Int J Ment Health Nurs 2023; 32:1274-1288. [PMID: 37341210 DOI: 10.1111/inm.13181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Revised: 04/28/2023] [Accepted: 05/26/2023] [Indexed: 06/22/2023]
Abstract
Rapid tranquillization is a restrictive practice that remains widely used in mental health inpatient settings worldwide. Nurses are the professionals most likely to administer rapid tranquillization in mental health settings. To improve mental health practices, an enhanced understanding of their clinical decision-making when using rapid tranquillization is, therefore, important. The aim was to synthesize and analyse the research literature on nurses' clinical decision-making in the use of rapid tranquillization in adult mental health inpatient settings. An integrative review was conducted using the methodological framework described by Whittemore and Knafl. A systematic search was conducted independently by two authors in APA PsycINFO, CINAHL Complete, Embase, PubMed and Scopus. Additional searches for grey literature were conducted in Google, OpenGrey and selected websites, and in the reference lists of included studies. Papers were critically appraised using the Mixed Methods Appraisal Tool, and the analysis was guided by manifest content analysis. Eleven studies were included in this review, of which nine were qualitative and two were quantitative. Based on the analysis, four categories were generated: (I) becoming aware of situational changes and considering alternatives, (II) negotiating voluntary medication, (III) administering rapid tranquillization and (IV) being on the other side. Evidence suggests that nurses' clinical decision-making in the use of rapid tranquillization involved a complex timeline with various impact points and embedded factors that continuously influenced and/or were associated with nurses' clinical decision-making. However, the topic has received scant scholarly attention, and further research may help to characterize the complexities involved and improve mental health practice.
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Affiliation(s)
- Martin Locht Pedersen
- Department of Public Health, Aarhus University, Aarhus, Denmark
- Department of Regional Health Research, Forensic Mental Health Research Unit Middelfart, University of Southern Denmark, Middelfart, Denmark
- Psychiatric Department Middelfart, Mental Health Services in the Region of Southern Denmark, Middelfart, Denmark
| | - Frederik Alkier Gildberg
- Department of Regional Health Research, Forensic Mental Health Research Unit Middelfart, University of Southern Denmark, Middelfart, Denmark
- Psychiatric Department Middelfart, Mental Health Services in the Region of Southern Denmark, Middelfart, Denmark
| | | | - Kim Jørgensen
- Department of Public Health, Aarhus University, Aarhus, Denmark
- Department of People and Technology, Roskilde University, Roskilde, Denmark
| | - Ellen Boldrup Tingleff
- Department of Regional Health Research, Forensic Mental Health Research Unit Middelfart, University of Southern Denmark, Middelfart, Denmark
- Psychiatric Department Middelfart, Mental Health Services in the Region of Southern Denmark, Middelfart, Denmark
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