Related Experiment Video
Updated: Oct 14, 2025
Restraint to Induce Stress in Mice and Rats
Published on: December 6, 2024
Determinants of mechanical restraint in an acute psychiatric care unit
Khadija El-Abidi1, Antonio R Moreno-Poyato2, Alba Toll Privat1
1Department of Psychiatry, Institut de Neuropsiquiatria i Addiccions, Parc de Salut Mar, Barcelona 08003, Spain.
Background:
Despite numerous attempts to reduce the use of mechanical restraint (MR), this technique continues to be widely applied in many acute psychiatric care settings. In order to reduce MR, a better understanding of the variables associated with its use and duration in different clinical environments is essential.
Aim:
To determine the proportion of patients subjected to MR and the duration thereof in two acute care psychiatric units; and to identify the variables associated with the use and duration of MR.
Methods:
Descriptive study of all patients admitted to the acute psychiatric units at the Parc de Salut Mar (Barcelona, Spain) in the year 2018. The number and percentage of patients subjected to MR, as well as the duration of each episode were assessed. The following data were also registered: sociodemographic characteristics, psychiatric diagnosis, and presence of cultural and/or language barriers. Multivariate analyses were performed to assess determinants of MR and its duration.
Results:
Of the 464 patients, 119 (25.6%) required MR, with a median of 16.4 h per MR. Two factors - a diagnosis of psychotic disorder [Odds ratios (OR) = 0.22; 95%CI: 0.06-0.62; P = 0.005] and the presence of a language barrier (OR = 2.13; 95%CI: 1.2-3.7; P = 0.007) - were associated with a significantly higher risk of MR. Male sex was associated with a longer duration of MR (B = -19.03; 95%CI: -38.06-0.008; P = 0.05).
Conclusion:
The presence of a language barrier and a psychotic disorder diagnosis are associated with a significantly higher risk of MR. Furthermore, male sex is associated with a longer duration of MR. Individualized restraint protocols that include the required tools are necessary to ultimately limit the use of mechanical restraint.
Insights
Mechanical restraint (MR) is frequently used in psychiatric settings. A diagnosis of psychotic disorder and language barriers increase MR risk, while male sex is linked to longer restraint duration.
Area of Science:
- Psychiatry
- Clinical Psychology
- Healthcare Management
Background:
- Mechanical restraint (MR) remains prevalent in acute psychiatric care despite efforts to reduce its use.
- Understanding factors influencing MR application and duration is crucial for developing effective reduction strategies.
Purpose of the Study:
- To determine the incidence and duration of MR in two acute psychiatric units.
- To identify patient-specific variables associated with the use and length of MR episodes.
Main Methods:
- A descriptive study analyzed all admissions to acute psychiatric units in 2018.
- Data collected included MR episodes, duration, sociodemographics, psychiatric diagnosis, and language barriers.
- Multivariate analyses identified determinants of MR use and duration.
Main Results:
- Of 464 patients, 25.6% experienced MR, with a median duration of 16.4 hours.
- Psychotic disorder diagnosis (OR=0.22) and language barriers (OR=2.13) were significantly associated with higher MR risk.
- Male sex correlated with longer MR duration (B=-19.03).
Conclusions:
- Language barriers and psychotic disorder diagnoses significantly increase the risk of mechanical restraint.
- Male patients tend to experience longer durations of mechanical restraint.
- Developing individualized protocols is essential to minimize mechanical restraint use.
Related Concept Videos
01:29Mechanical Ventilation I: Indication and Settings
01:23Acute Respiratory Failure-IV
01:08Obedience
03:20The Stanford Prison Experiment
01:30Assessment of Airway, Skin Color, and Use of Accessory Muscles
Introduction
The initial evaluation of a patient's respiratory system...