Relationship of sociodemographic and clinical characteristics to mechanical restraint used in a psychiatric hospital in Spain.
Montserrat Cañabate Ros, Isabel Almodóvar Fernández, María Martínez Madrigal and 3 others
PMID 39046147WHAT IT FOUND
In psychiatric inpatients, mechanical restraint was associated with involuntary admission, prior restraint, positive psychotic symptoms and caffeine use.
These associations do not show cause, and should not be used alone to predict restraint.
Key findings
01Restraint was associated with younger age, living with parents or family, involuntary admission, previous psychiatric admissions and prior restraint.
02The logistic regression identified involuntary admission, previous restraint, positive psychotic symptoms and caffeine consumption as variables that predicted mechanical restraint.
03Restrained patients had more positive psychotic symptoms and less awareness of illness, while impulsivity and anxiety scores did not differ significantly.
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How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study was cross-sectional, so it can show association but not cause. Participants were recruited non-consecutively and non-randomly from only two acute psychiatric hospitals, so results may not apply to other settings or countries. The sample was 91 patients, and the regression confidence intervals were very wide, so the predictive estimates are uncertain. The study did not calculate the proportion of all hospitalized patients who were restrained, because sampling was not consecutive. Diagnoses came from clinical history and were not independently verified, which may affect clinical variables. Data were collected during the pandemic, which may have changed patient factors and hospital functioning.
Declared interests
Funding came from Cardenal Herrera University and CEU Universities (pre-competitive projects 2019-2020). The authors declared no commercial or financial relationships that could be construed as a conflict of interest.
The easy way to misread this
Do not conclude that caffeine, involuntary admission, previous restraint or positive psychotic symptoms cause mechanical restraint. This was a cross-sectional association study with non-random sampling and wide confidence intervals, so it cannot establish causality or reliable individual prediction.