Variations in definitions used for describing restrictive care practices (seclusion and restraint) in adult mental health inpatient units: a systematic review and content analysis

Factors involving in healthcare professionals' decision-making process regarding the use of restrictive care practices in adult mental health inpatient units: A protocol for an umbrella review

INTRODUCTION

The use of restrictive care practices, such as physical restraint, seclusion, and chemical restraint, remains common practices, yet controversial aspect of mental health care, particularly in inpatient settings. Variations in legal definitions and protocols guiding the implementation of these practices often create legal and ethical dilemmas for professionals when deciding whether to implement such practices in certain circumstances. This leads them to rely on subjective decision-making, which is further shaped by epistemic disparities stemming from differences in knowledge, perspectives, and experiences that impact professionals' understanding and implementation of restrictive practices.

AIMS

This is a study protocol for an upcoming umbrella review aiming to identify and analyse the thematic elements that affect healthcare professionals' decision-making regarding the uimplementations of restrictive care practices in adult mental health inpatient settings.

METHODS

This protocol outlines the approach for an umbrella review. The review will conduct a systematic literature search of electronic databases (Scopus, CINAHL, Embase, OVID, PsycINFO, Cochrane Reviews, and Web of Science) using comprehensive search strings, as well as a manual review of reference lists from included reviews. Only review studies will be considered. Textual data discussing issues related to professionals' decision-making regarding the use of restrictive care practices will be extracted from each study, coded, and analysed using inductive content analysis. This protocol has been reported according to the PRISMA-P Checklist.

DISCUSSION

The findings from this review will provide valuable insights into the key factors influencing the implementation of restrictive practices in adult mental health inpatient settings. The factors identified in this umbrella review will be applied in clinical practices to guide healthcare practitioners in considering and navigating various contexts when deciding how and in which situations restrictive care practices should be implemented. This contributes to the current global effort in promoting more patient-centered, transparent, evidence-based and accountable practices, while minimizing restrictive interventions. It will also inform future training, practice, and policy interventions aiming at reducing the use of restrictive measures in adult mental health settings. Protocol registration: This protocol has been registered in PROSPERO (CRD-42024581848).

Diminishing restrictive practices in psychiatric wards via virtual reality training: Old wine in a new bottle?

This editorial examines the application of virtual reality (VR) training to mitigate restrictive practices (RPs) within psychiatric facilities. RPs include physical restraints, seclusion, and chemical restraints, used to ensure patient safety but with varying usage rates across regions. In recent years, there has been a growing focus on the adverse effects of RPs on both healthcare workers and patients, leading to calls for its reduction. Previous research has shown the efficiency of VR training in RP reduction. This editorial will analyze the limitations of VR training in prior research aimed at reducing RP, emphasizing that the essence of RPs is a medical safety issue, calling for careful differentiation of the causes of RPs, and avoiding the use of AR technology as a "new bottle" for "old wine" to improve the quality and reproducibility of future research in this field.

Diminishing restrictive practices in psychiatric wards via virtual reality training: Old wine in a new bottle?

This editorial examines the application of virtual reality (VR) training to mitigate restrictive practices (RPs) within psychiatric facilities. RPs include physical restraints, seclusion, and chemical restraints, used to ensure patient safety but with varying usage rates across regions. In recent years, there has been a growing focus on the adverse effects of RPs on both healthcare workers and patients, leading to calls for its reduction. Previous research has shown the efficiency of VR training in RP reduction. This editorial will analyze the limitations of VR training in prior research aimed at reducing RP, emphasizing that the essence of RPs is a medical safety issue, calling for careful differentiation of the causes of RPs, and avoiding the use of AR technology as a "new bottle" for "old wine" to improve the quality and reproducibility of future research in this field.