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The relationship between ethnic background and the use of restrictive practices to manage incidents of violence or aggression in psychiatric inpatient settings

Restrictive practices raise considerable concern in mental health inpatient care. Previous studies suggest there are disparities in the use of restrictive practices to manage service users of different ethnic groups. The present study analyses the relationship between ethnicity and the use of restri...

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Autores principales: Payne‐Gill, James, Whitfield, Corin, Beck, Alison
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9292244/
https://www.ncbi.nlm.nih.gov/pubmed/34180128
http://dx.doi.org/10.1111/inm.12873
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author Payne‐Gill, James
Whitfield, Corin
Beck, Alison
author_facet Payne‐Gill, James
Whitfield, Corin
Beck, Alison
author_sort Payne‐Gill, James
collection PubMed
description Restrictive practices raise considerable concern in mental health inpatient care. Previous studies suggest there are disparities in the use of restrictive practices to manage service users of different ethnic groups. The present study analyses the relationship between ethnicity and the use of restrictive practices to manage incidents of violence or aggression in inpatient settings across an NHS Mental Health Trust. Three years’ worth of routinely collected incident data were analysed using multilevel multiple logistic regression to assess the relationship between ethnic group and four types of restrictive practices: physical restraint (without prone), physical restraint (with prone), seclusion, and rapid tranquilization. We controlled for a range of demographic variables and the type and severity of the incident. Adjusted analyses showed that service users with a Black African [Odds Ratio = 1.96, 95% CI: 1.36–2.83, P < 0.001], Black Caribbean [Odds Ratio = 1.76, 95% CI: 1.08–2.85, P = 0.022], Black Other [Odds Ratio = 1.76, 95% CI: 1.27–2.44, P = 0.001], and Mixed [Odds Ratio = 1.88, 95% CI: 1.11–3.18, P = 0.019] ethnic background were more likely to be secluded, and Black Caribbean [Odds Ratio = 1.45, 95% CI: 1.02–2.07, P = 0.040] service users were more likely to be restrained in prone position. We did not detect differences in the use of physical restraints without prone or in the use of rapid tranquilization. Our findings illustrate the need to focus on outcomes for different ethnic groups when implementing restraint reduction programmes.
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spelling pubmed-92922442022-07-20 The relationship between ethnic background and the use of restrictive practices to manage incidents of violence or aggression in psychiatric inpatient settings Payne‐Gill, James Whitfield, Corin Beck, Alison Int J Ment Health Nurs Original Articles Restrictive practices raise considerable concern in mental health inpatient care. Previous studies suggest there are disparities in the use of restrictive practices to manage service users of different ethnic groups. The present study analyses the relationship between ethnicity and the use of restrictive practices to manage incidents of violence or aggression in inpatient settings across an NHS Mental Health Trust. Three years’ worth of routinely collected incident data were analysed using multilevel multiple logistic regression to assess the relationship between ethnic group and four types of restrictive practices: physical restraint (without prone), physical restraint (with prone), seclusion, and rapid tranquilization. We controlled for a range of demographic variables and the type and severity of the incident. Adjusted analyses showed that service users with a Black African [Odds Ratio = 1.96, 95% CI: 1.36–2.83, P < 0.001], Black Caribbean [Odds Ratio = 1.76, 95% CI: 1.08–2.85, P = 0.022], Black Other [Odds Ratio = 1.76, 95% CI: 1.27–2.44, P = 0.001], and Mixed [Odds Ratio = 1.88, 95% CI: 1.11–3.18, P = 0.019] ethnic background were more likely to be secluded, and Black Caribbean [Odds Ratio = 1.45, 95% CI: 1.02–2.07, P = 0.040] service users were more likely to be restrained in prone position. We did not detect differences in the use of physical restraints without prone or in the use of rapid tranquilization. Our findings illustrate the need to focus on outcomes for different ethnic groups when implementing restraint reduction programmes. John Wiley and Sons Inc. 2021-06-27 2021-10 /pmc/articles/PMC9292244/ /pubmed/34180128 http://dx.doi.org/10.1111/inm.12873 Text en © 2021 The Authors. International Journal of Mental Health Nursing published by John Wiley & Sons Australia, Ltd. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ (https://creativecommons.org/licenses/by-nc-nd/4.0/) License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.
spellingShingle Original Articles
Payne‐Gill, James
Whitfield, Corin
Beck, Alison
The relationship between ethnic background and the use of restrictive practices to manage incidents of violence or aggression in psychiatric inpatient settings
title The relationship between ethnic background and the use of restrictive practices to manage incidents of violence or aggression in psychiatric inpatient settings
title_full The relationship between ethnic background and the use of restrictive practices to manage incidents of violence or aggression in psychiatric inpatient settings
title_fullStr The relationship between ethnic background and the use of restrictive practices to manage incidents of violence or aggression in psychiatric inpatient settings
title_full_unstemmed The relationship between ethnic background and the use of restrictive practices to manage incidents of violence or aggression in psychiatric inpatient settings
title_short The relationship between ethnic background and the use of restrictive practices to manage incidents of violence or aggression in psychiatric inpatient settings
title_sort relationship between ethnic background and the use of restrictive practices to manage incidents of violence or aggression in psychiatric inpatient settings
topic Original Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9292244/
https://www.ncbi.nlm.nih.gov/pubmed/34180128
http://dx.doi.org/10.1111/inm.12873
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