Psychosocial Correlates of Patients Being Physically Restrained within the First 7 Days in an Acute Psychiatric Admission Ward: Retrospective Case Record Review

Abstract

Objective: Clinically, patients' characteristics may predict the use of physical restraint in a psychiatric ward. This study aimed to explore significant psychosocial variables in predicting the risk for application of physical restraint with intention of identifying patients at high risk for physical restraint at the time of admission to an acute psychiatric setting.

Methods: The case records of 335 adult patients aged > 18 years, who were treated in 4 acute psychiatric admission wards of a public hospital in Hong Kong from 1 November 2013 to 28 February 2014, were retrospectively reviewed.

Results: Results of statistical analysis indicated involuntary admission, current use of psychiatric medications, no history of violent behaviour, age, and depression as significant predictors of use of physical restraint. The model accounted for 28.5% to 38.5% of the variance in the use of physical restraint. Overall, this model had a success rate of 77.6%.

Conclusion: It was concluded that 39.7% of inpatients admitted to the acute psychiatric admission ward had been restrained at least once in the first 7 days. Significant predictors of restraint included involuntary admission, current use of psychiatric medications, no history of violent behaviour, age, and depression; all of which could be regarded as risk factors for restraint.

Keywords: Restraint, physical; Social environment.