@article{ref1,
title="De-escalation techniques used, and reasons for seclusion and restraint, in a forensic psychiatric hospital",
journal="International journal of mental health nursing",
year="2017",
author="Kuivalainen, Satu and Vehviläinen-Julkunen, Katri and Louheranta, Olavi and Putkonen, Anu and Repo-Tiihonen, Eila and Tiihonen, Jari",
volume="26",
number="5",
pages="513-524",
abstract="In Finland, the Mental Health Act determines the legal basis for seclusion and restraint. Restrictive measures are implemented to manage challenging situations and should be used as a last resort in psychiatric inpatient care. In the present study, we examined the reasons for seclusion and restraint, as well as whether any de-escalation techniques were used to help patients calm down. Seclusion and restraint files from a 4-year period (1 June 2009-31 May 2013) were retrospectively investigated and analysed by content analysis. Descriptive statistics were calculated. A total of 144 episodes of seclusion and restraint were included to analyse the reasons for seclusion and restraint, and 113 episodes were analysed to examine unsuccessful de-escalation techniques. The most commonly-used techniques were one-to-one interaction with a patient (n = 74, 65.5% of n = 113) and administration of extra medication (n = 37, 32.7% of n = 113). The reasons for seclusion and restraint were threatening harmful behaviour (n = 51, 35.4% of n = 144), direct harmful behaviour (n = 43, 29.9%), indirect harmful behaviour (n = 42, 29.1%), and other behaviours (n = 8, 5.6%). In general, the same de-escalation techniques were used with most patients. Most episodes of seclusion or restraint were due to threats of violence or direct violence. Individual means of self-regulation and patient guidance on these techniques are needed. Additionally, staff should be educated on a diverse range of de-escalation techniques. Future studies should focus on examining de-escalation techniques for the prevention of seclusion.<br><br>© 2017 Australian College of Mental Health Nurses Inc.<p /> <p>Language: en</p>",
language="en",
issn="1445-8330",
doi="10.1111/inm.12389",
url="http://dx.doi.org/10.1111/inm.12389"
}