芬兰精神科护理中的隔离、约束和非自愿药物治疗：具有根级数据的登记研究,Nordic Journal of Psychiatry

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芬兰精神科护理中的隔离、约束和非自愿药物治疗：具有根级数据的登记研究
Nordic Journal of Psychiatry ( IF 1.5 ) Pub Date : 2020-03-03 , DOI: 10.1080/08039488.2020.1733658
Emilia Laukkanen _{1,

2} , Lauri Kuosmanen ₁ , Tuomas Selander ₃ , Katri Vehviläinen-Julkunen _{1,

4}

Affiliation

摘要目的：尽管存在潜在的有害影响，隔离、约束和非自愿药物治疗仍然经常用于精神科护理。这些限制性措施通常通过登记册进行检查，但似乎缺少衡量和描述中的同类做法。这项全国性的登记研究旨在检查芬兰使用隔离、机械和身体约束以及非自愿药物治疗的情况。材料和方法：直接从 21 个组织的 140 个住院精神病病房收集 2017 年的根级登记数据。对数据进行统计学分析。结果：2017年，芬兰精神病房使用最多的限制措施是隔离（4006次），其次是非自愿药物（2187次），机械约束（2113 集）和身体约束（1064 事件）。同样，隔离事件的持续时间长于约束事件的持续时间。可以观察到病房之间在使用隔离、约束和非自愿药物方面的显着差异。使用负二项回归模型 (NB2) 来分析限制性措施的使用与有关人口、健康、药物滥用和社会经济地位的区域变量之间的关联，但无法产生可靠的解释。结论：这项研究提供了有关芬兰使用隔离、约束和非自愿药物治疗的详细而独特的数据。与之前的国家级数据相比，本研究强调了收集根级数据的重要性。

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Seclusion, restraint, and involuntary medication in Finnish psychiatric care: a register study with root-level data

Abstract Purpose: Despite potentially harmful effects, seclusion, restraint, and involuntary medication continue to be frequently applied in psychiatric care. These restrictive measures are often examined by means of registers, but homogeneous practices in the measurement and description seem to be missing. This nationwide register study aimed to examine the use of seclusion, mechanical and physical restraint, and involuntary medication in Finland. Material and methods: Root-level register data concerning the year 2017 were collected directly from 140 inpatient psychiatric wards within 21 organizations. The data were analyzed statistically. Results: In 2017, the most used restrictive measure in Finnish psychiatric wards was seclusion (4006 episodes), followed by involuntary medication (2187 episodes), mechanical restraint (2113 episodes) and physical restraint (1064 events). Similarly, the duration of seclusion episodes was longer than the duration of restraint episodes. Remarkable variation between wards in the use of seclusion, restraint and involuntary medication was observable. A negative binomial regression model (NB2) was used to analyze the associations between the use of restrictive measures and regional variables concerning demography, health, substance abuse, and socio-economic status, but reliable interpretations were impossible to generate. Conclusion: This study provides detailed and unique data on the use of seclusion, restraint and involuntary medication in Finland. Compared to previous national-level data, this study highlights the importance of collecting root-level data. Future research should use registries and describe the associations between the use of restrictive measures and ward-level factors, patient-level characteristics, and societal factors.

更新日期：2020-03-03

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