RT Generic
T1 Alternatives to the Use of Mechanical Restraints in the Management of Agitation or Aggressions of Psychiatric Patients: A Scoping Review
A1 Fernandez-Costa, Damian
A1 Gomez-Salgado, Juan
A1 Fagundo-Rivera, Javier
A1 Martin-Pereira, Jorge
A1 Prieto-Callejero, Blanca
A1 Garcia-Iglesias, Juan Jesus
K1 agitation
K1 aggressive behaviors
K1 mental disorders
K1 psychiatry
K1 mechanical restraint
K1 Mental-health
K1 Coercive measures
K1 Risk-assessment
K1 Seclusion
K1 Violence
K1 Wards
K1 Interventions
K1 Program
K1 Reduce
K1 Units
AB Coercive measures are a highly controversial issue in mental health. Although scientific evidence on their impact is limited, they are frequently used. Furthermore, they lead to a high number of ethical, legal, and clinical repercussions on both patients, and professionals and institutions. This review aims to assess the impact of the main alternative measures to prevent or limit the use of coercive measures with restraints in the management of agitated psychiatric patients. The research was conducted following the guidelines recommended by PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) in Medline, Cochrane Library, CINAHL, Web of Science, PsycInfo, LILACS, and Health Database of records between 2015 and 2020. After a critical reading, 21 valid articles were included. Both simple interventions and complex restraint programs were evaluated. Training in de-escalation techniques, risk assessment, and implementation of the "six core strategies" or "Safewards" program were the most assessed and effective interventions to reduce aggressive behaviors and the use of coercive measures. According to the revised literature, it is possible to reduce the use of restraints and coercive measures and not increase the number of incidents and violent behaviors among the patients through a non-invasive and non-pharmacological approach. However, further research and further randomized clinical trials are needed to compare the different alternatives and provide higher quality evidence.
PB Mdpi
YR 2020
FD 2020-09-01
LK http://hdl.handle.net/10668/19288
UL http://hdl.handle.net/10668/19288
LA en
DS RISalud
RD Apr 6, 2025