Patient Perception in Triggering Events and De-escalation in a Psychiatric Hospital: Implications for Seclusion/restraint

Abstract

This study investigated a self-report instrument at a psychiatric hospital as it did/did not apply to the events leading up to an incident of seclusion/restraint. This study also investigated the relationship between number of days spent in the hospital, and number of incidents of seclusion/restraint. Ninety patient charts were reviewed which included a total of 140 incidents of aggression that resulted in seclusion/restraint. The seclusion/restraint records were obtained and hard copies of the patient chart were utilized to review the Behavioral Assessment form (Appendix A). Within each chart exists a copy of the Behavioral Assessment form as well as a typed report that covers the events leading to the incident of seclusion/restraint. The report was read in an effort to identify any of the information that the patient reported on the Behavioral Assessment form. The results suggest that patients are accurate at identifying the factors leading to aggression, the additional triggers to aggression, and the successful interventions that decrease aggression. No relationship was observed between days spent in the hospital and number of incidents of aggression. The data suggests that patients are accurate at identifying what factors cause them to become aggressive as well as the triggers that increase the aggression.  Patients were also accurate at judging what interventions help to de-escalate them during an aggressive incident. The results suggest that psychiatric hospitals should utilize such forms as the Behavioral Assessment form to encourage patients to identify such factors related to aggression.