The impact of modified mania assessment scale (MAS-M) implementation on the use of mechanical restraint in psychiatric units

TY - CHAP

T1 - The impact of modified mania assessment scale (MAS-M) implementation on the use of mechanical restraint in psychiatric units

AU - Odgaard, Anne Sofie

AU - Kragh, Mette

AU - Roj Larsen, Erik

PY - 2018/11

Y1 - 2018/11

N2 - BACKGROUND AND AIM: During recent years, there has been an increased focus on reducing use of mechanical restraint in psychiatric care. Studies show that implementing an assessment tool could potentially prevent or decrease the number of episodes of mechanical restraint. This study aims to examine the association between use of the Danish assessment tool for psychiatric inpatients diagnosed with mania (MAS-M) and mechanical restraint to highlight if number, type, and duration of restraint could be prevented or reduced by this procedure.MATERIALS AND METHOD: This historical cohort study included psychiatric inpatients diagnosed with bipolar disorder and hospitalized with symptoms of mania at the departments of affective disorders during the years 2012-2015. Logistic regression was used in the statistical analyses.RESULT: A total of 218 patients were included, 74 of whom were scored with MAS-M. Thirty-five episodes of mechanical restraint were recorded. A crude OR of 1.58 (95% CI: 0.75-3.30) of the association was estimated. The study showed a tendency toward patients scored with MAS-M being more frequently restrained with both belt and straps, however, in shorter duration, compared to the control group.CONCLUSION: This study reported relevant clinical information concerning staff's use of MAS-M, however, did not show a significant association between the use of MAS-M and mechanical restraint. Nevertheless, conflicting results about the impact of MAS-M on preventing and reducing these coercive measures have been highlighted, suggesting that more complex factors influence the use of mechanical restraint. No causal effect was examined thus further studies are needed.

AB - BACKGROUND AND AIM: During recent years, there has been an increased focus on reducing use of mechanical restraint in psychiatric care. Studies show that implementing an assessment tool could potentially prevent or decrease the number of episodes of mechanical restraint. This study aims to examine the association between use of the Danish assessment tool for psychiatric inpatients diagnosed with mania (MAS-M) and mechanical restraint to highlight if number, type, and duration of restraint could be prevented or reduced by this procedure.MATERIALS AND METHOD: This historical cohort study included psychiatric inpatients diagnosed with bipolar disorder and hospitalized with symptoms of mania at the departments of affective disorders during the years 2012-2015. Logistic regression was used in the statistical analyses.RESULT: A total of 218 patients were included, 74 of whom were scored with MAS-M. Thirty-five episodes of mechanical restraint were recorded. A crude OR of 1.58 (95% CI: 0.75-3.30) of the association was estimated. The study showed a tendency toward patients scored with MAS-M being more frequently restrained with both belt and straps, however, in shorter duration, compared to the control group.CONCLUSION: This study reported relevant clinical information concerning staff's use of MAS-M, however, did not show a significant association between the use of MAS-M and mechanical restraint. Nevertheless, conflicting results about the impact of MAS-M on preventing and reducing these coercive measures have been highlighted, suggesting that more complex factors influence the use of mechanical restraint. No causal effect was examined thus further studies are needed.

KW - Adult

KW - Bipolar Disorder/diagnosis

KW - Coercion

KW - Female

KW - Humans

KW - Male

KW - Middle Aged

KW - Psychiatric Status Rating Scales

KW - Restraint, Physical

KW - Time Factors

U2 - 10.1080/08039488.2018.1490816

DO - 10.1080/08039488.2018.1490816

M3 - Book chapter

C2 - 30348037

VL - 72

T3 - Nordic Journal of Psychiatry

SP - 549

EP - 555

BT - The impact of modified mania assessment scale (MAS-M) implementation on the use of mechanical restraint in psychiatric units

ER -