目的:这篇综述的主要目的是(1)确定最近发表的文献用于描述物理/机械约束构造的定义中的主题元素,成人精神健康住院部的隔离和化学约束。
方法:我们对六个数据库进行了全面的文献检索(Scopus,MEDLINE,PsycINFO,WebofScience,Embase,和CINAHL-Plus)。在这次审查中,我们进行了内容分析,以综合证据来理解和比较不同形式限制性护理实践定义中包含的概念要素的共性和差异.
结果:总共95项研究为不同形式的限制性护理实践提供了定义[物理/机械约束(n=72),隔离(n=65)和化学限制(n=19)]包括在这篇综述中。在物理/机械约束的应用定义中提出的概念域中存在重大变化,隐居,和化学约束。这篇综述中确定的概念主题是限制性护理实践的方法,原因和预期结果,限制性护理实践期间患者限制的程度,定时(持续时间,频率,和一天中的时间),患者自主性的水平,以及实施这些做法的人员。
结论:用于描述不同形式的限制性护理实践结构的术语和概念边界的不一致强调了在认可反映不同观点的共识定义方面向前迈进的必要性,确保实践和研究的清晰度和一致性。这将有助于有效地衡量和比较不同医疗机构和司法管辖区限制性护理实践使用的实际趋势。
OBJECTIVE: The main purpose of this review was to (1) identify thematic elements within definitions used by recently published literature to describe the constructs of physical/mechanical
restraint, seclusion and chemical
restraint in adult mental health inpatient units.
METHODS: We conducted a comprehensive literature search of six databases (Scopus, MEDLINE, PsycINFO, Web of Science, Embase, and CINAHL-Plus). In this review, we conducted content analysis to synthesize evidence to understand and compare the commonalities and discrepancies in conceptual elements that were incorporated within the definitions of different forms of restrictive care practices.
RESULTS: A total of 95 studies that provided definitions for different forms of restrictive care practices [physical/mechanical
restraint (n = 72), seclusion (n = 65) and chemical
restraint (n = 19)] were included in this review. Significant variations existed in the conceptual domains presented within the applied definitions of physical/mechanical restraint, seclusion, and chemical
restraint. Conceptual themes identified in this review were methods of restrictive care practice, reasons and desired outcomes, the extent of patient restriction during restrictive care practice episodes, timing (duration, frequency, and time of the day), the level of patient autonomy, and the personnel implementing these practices.
CONCLUSIONS: Inconsistencies in the terminologies and conceptual boundaries used to describe the constructs of different forms of restrictive care practices underscore the need to move forward in endorsing consensus definitions that reflect the diverse perspectives, ensuring clarity and consistency in practice and research. This will assist in validly measuring and comparing the actual trends of restrictive care practice use across different healthcare institutions and jurisdictions.