Scholarlink

Background <p>Seclusion and physical restraint (PR) are sometimes required in psychiatric emergency wards for safety, but reducing their use is a key clinical and ethical objective. Although ward features such as private rooms are believed to affect coercive practices, empirical evidence remains limited.</p> Methods <p>In April 2020, Hospital A’s psychiatric emergency ward relocated to Hospital B, with a slightly reduced bed capacity (46 to 42 beds), increased private rooms, expanded closed-circuit television (CCTV) monitoring, and a centralised staff station. We retrospectively analysed 816 admissions (Hospital A: <i>n</i> = 372; Hospital B: <i>n</i> = 444) before and after relocation. Primary outcomes were seclusion and PR use; secondary outcomes included event count, duration, and days from open observation to termination. Analyses used logistic regression and generalized linear mixed models (GLMMs).</p> Results <p>Hospital B had fewer patients subjected to seclusion (<i>n</i> = 155) and PR (<i>n</i> = 94). Multivariable analyses showed lower odds of seclusion (odds ratio [OR] = 0.70, 95% confidence interval [CI]: 0.50–0.99) and PR (OR = 0.65, 95% CI: 0.46–0.92). GLMMs showed shorter seclusion duration (β = − 0.281, <i>p</i> &lt; 0.05) and faster transition from observation to termination (β = − 0.386, <i>p</i> &lt; 0.01). PR duration did not differ significantly.</p> Conclusions <p>Ward structural changes may reduce coercive interventions.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Association between ward structural changes and coercive interventions in psychiatric emergency wards in Japan: a retrospective study

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2026年5月7日

查看全文
  • Takaaki Hirooka,
  • Satoru Oishi,
  • Shoko Miura,
  • Ken Inada

摘要

Background

Seclusion and physical restraint (PR) are sometimes required in psychiatric emergency wards for safety, but reducing their use is a key clinical and ethical objective. Although ward features such as private rooms are believed to affect coercive practices, empirical evidence remains limited.

Methods

In April 2020, Hospital A’s psychiatric emergency ward relocated to Hospital B, with a slightly reduced bed capacity (46 to 42 beds), increased private rooms, expanded closed-circuit television (CCTV) monitoring, and a centralised staff station. We retrospectively analysed 816 admissions (Hospital A: n = 372; Hospital B: n = 444) before and after relocation. Primary outcomes were seclusion and PR use; secondary outcomes included event count, duration, and days from open observation to termination. Analyses used logistic regression and generalized linear mixed models (GLMMs).

Results

Hospital B had fewer patients subjected to seclusion (n = 155) and PR (n = 94). Multivariable analyses showed lower odds of seclusion (odds ratio [OR] = 0.70, 95% confidence interval [CI]: 0.50–0.99) and PR (OR = 0.65, 95% CI: 0.46–0.92). GLMMs showed shorter seclusion duration (β = − 0.281, p < 0.05) and faster transition from observation to termination (β = − 0.386, p < 0.01). PR duration did not differ significantly.

Conclusions

Ward structural changes may reduce coercive interventions.