Retrospective Study on the Use of Restraints in an Acute Psychiatric Inpatient Unit

Abstract

Background: This retrospective observational study investigates the utilization of restraints in the psychiatric inpatient unit of King Salman Armed Forces Hospital, Tabuk, KSA, over a 12-month period from October 1, 2022, to September 30, 2023. The study aims to discern patterns and factors associated with the use of restraints, shedding light on the demographics and circumstances surrounding restraining episodes. Methods: Data for analysis were collected from medical records, incident reports, and electronic databases. A total of 17 patients who experienced 54 restraining episodes were included in the study. The analysis focused on patient characteristics, including age, gender, substance-related conditions, psychiatric diagnoses, seasonal variations, and the length of stay during admission.

Results: The majority of restrained patients were male (76.5%), aged 17 to 29 years (58.8%), and diagnosed with Bipolar Mood Disorder (41.2%). Notably, a significant association was found between substance-related conditions and the use of restraints (X^2 = 26.724, p = 0.000). Patients without substance-related conditions exhibited more diverse lengths of stay. A substantial relationship was identified between specific psychiatric diagnoses and the use of restraints (X^2 = 65.718, p = 0.000), particularly Bipolar Mood Disorder. Seasonal variations significantly influenced restraining episodes (X^2 = 32.554, p = 0.000), with higher occurrences during Autumn and Winter. The length of stay during admission was significantly associated with the occurrence of restraining episodes (X^2 = 26.724, p = 0.000), indicating a higher likelihood of restraints in patients with substance-related conditions and shorter lengths of stay.

Conclusion: This study provides comprehensive insights into the intricate dynamics of patient demographics, diagnoses, and environmental factors influencing the use of restraints in a psychiatric inpatient setting. The findings underscore the importance of tailored interventions for specific patient populations, with implications for improving patient care and fostering ethical practices within psychiatric inpatient units. Future research should explore the impact of targeted interventions and assess the effectiveness of strategies aimed at reducing restraint use in this population.