Assessing behavioral coping preferences of psychiatric inpatients: a pilot study

Area of Science:

• Psychiatric Nursing
• Inpatient Psychiatry
• Patient Safety

Background:

• Growing concerns exist regarding the overuse of restraint and seclusion in psychiatric settings.
• These practices have been linked to patient injuries and fatalities.
• Individualized crisis management, including behavioral coping plans, may offer alternatives.

Purpose of the Study:

• To explore patient preferences for managing agitation and preventing loss of control.
• To assess the utility of the Coping Agreement Questionnaire (CAQ) in developing alternatives to restraint and seclusion.
• To identify how patient characteristics influence coping strategy preferences.

Main Methods:

• Developed and administered a 5-question Coping Agreement Questionnaire (CAQ) to inpatients.
• Nurses completed the CAQ with 264 patients across various diagnoses (mood, schizophrenia, substance use disorders).
• Analyzed CAQ responses based on diagnosis, sex, age, and ethnicity.

Main Results:

• Patient preferences for coping strategies varied significantly by diagnosis, sex, age, and ethnicity.
• "Talk with me" was a highly preferred intervention across groups.
• Substance use disorder patients preferred solitude, while adolescents and elderly patients had differing views on visitors.

Conclusions:

• Patient preferences offer insights into optimizing the inpatient milieu.
• Tailoring case management strategies to specific population characteristics is crucial.
• Engaging patients as active partners in managing their behavior enhances hospitalization outcomes.