Reduction of adverse events in a psychiatric inpatient eating disorder unit during the COVID-19 pandemic.
aggressive behaviors
eating disorder
restraint and seclusion
Journal
Journal of child and adolescent psychiatric nursing : official publication of the Association of Child and Adolescent Psychiatric Nurses, Inc
ISSN: 1744-6171
Titre abrégé: J Child Adolesc Psychiatr Nurs
Pays: England
ID NLM: 9431738
Informations de publication
Date de publication:
Nov 2023
Nov 2023
Historique:
revised:
09
05
2023
received:
06
03
2023
accepted:
11
06
2023
pubmed:
23
6
2023
medline:
23
6
2023
entrez:
23
6
2023
Statut:
ppublish
Résumé
Globally, the COVID-19 pandemic had impacted the health care delivery including inpatient psychiatric facilities. Within psychiatric settings, life of inpatients was profoundly altered. This paper aimed to understand if pandemic-related changes within an inpatient Eating Disorder Unit in a specialized psychiatric hospital in Ontario, Canada impacted incidence of aggression and use of coercive methods among adolescents. An exploratory study design was used to examine incidence of aggression, self-harm, code whites, staff assist, restraints and seclusion, and nasogastric feeding (NGF) among adolescents with eating disorders before and after the modified service delivery within the inpatient unit. Descriptive analyses were conducted. Analyses revealed a complete reduction in episodes of self-harm, aggression, staff assists, use of restraint and seclusion as well as an 80.14% reduction on average use of NGF. Authors speculate that the change in environment and program delivery method, peer influence, and shift in power relations between patient and staff may have resulted in improved experiences. This report provides insights to adopt a recovery-oriented service delivery for adolescents with eating disorders in inpatient settings.
Types de publication
Journal Article
Langues
eng
Pagination
293-298Informations de copyright
© 2023 Wiley Periodicals LLC.
Références
Anthony, W. A. (1993). Recovery from mental illness: The guiding vision of the mental health service system in the 1990s. Psychosocial Rehabilitation Journal, 16(4), 11-23. https://doi.org/10.1037/h0095655
Brinchmann, B. S., & Krvavac, S. (2021). “Breaking down the wall” patients' and families' experience of multifamily therapy for young adult women with severe eating disorders. Journal of Eating Disorders, 9(1), 56. https://doi.org/10.1186/s40337-021-00412-w
Canadian Institute for Health Information. (2021, December 9). COVID-19's impact on hospital services. https://www.cihi.ca/en/covid-19-resources/impact-of-covid-19-on-canadas-health-care-systems/hospital-services#:~:text=Between%20March%202020%20and%20June,surge%20of%20COVID%2D19%20hospitalizations
Courtney, D., Watson, P., Battaglia, M., Mulsant, B. H., & Szatmari, P. (2020). COVID-19 impacts on child and youth anxiety and depression: Challenges and opportunities. The Canadian Journal of Psychiatry, 65(10), 688-691. https://doi.org/10.1177/0706743720935646
Eisler, I., Simic, M., Hodsoll, J., Asen, E., Berelowitz, M., Connan, F., Ellis, G., Hugo, P., Schmidt, U., Treasure, J., Yi, I., & Landau, S. (2016). A pragmatic randomised multi-centre trial of multifamily and single family therapy for adolescent anorexia nervosa. BMC Psychiatry, 16(1), 422. https://doi.org/10.1186/s12888-016-1129-6
Feeney, L., Bonner, N., & McAndrew, J. (2022). Restrictive interventions on a psychiatric admission ward before and after COVID-19. Irish Journal of Psychological Medicine, 1-7. https://doi.org/10.1017/ipm.2022.9
FitzGerald, G., Aitken, P., Shaban, R. Z., Patrick, J., Arbon, P., McCarthy, S., Clark, M., Considine, J., Finucane, J., Holzhauser, K., & Fielding, E. (2012). Pandemic (H1N1) influenza 2009 and Australian emergency departments: Implications for policy, practice and pandemic preparedness: Pandemic (H1N1) influenza 2009. Emergency Medicine Australasia, 24(2), 159-165. https://doi.org/10.1111/j.1742-6723.2011.01519.x
Flammer, E., Eisele, F., Hirsch, S., & Steinert, T. (2022). Increase in coercive measures in psychiatric hospitals in Germany during the COVID-19 pandemic. PLoS ONE, 17(8), e0264046. https://doi.org/10.1371/journal.pone.0264046
Hartley, S., Redmond, T., & Berry, K. (2022). Therapeutic relationships within child and adolescent mental health inpatient services: A qualitative exploration of the experiences of young people, family members and nursing staff. PLoS ONE, 17(1), e0262070. https://doi.org/10.1371/journal.pone.0262070
Huang, H. C.-H., & Ougrin, D. (2021). Impact of the COVID-19 pandemic on child and adolescent mental health services. BJPsych Open, 7(5), e145. https://doi.org/10.1192/bjo.2021.976
IBM SPSS Statistics. (2015). IBM SPSS statistics for Windows, version 23.0. IBM Corp.
King, G., Law, M., Hanna, S., King, S., Hurley, P., Rosenbaum, P., Kertoy, M., & Petrenchik, T. (2006). Predictors of the leisure and recreation participation of children with physical disabilities: A structural equation modeling analysis. Children's Health Care, 35(3), 209-234. https://doi.org/10.1207/s15326888chc3503_2
Kipping, S. M., De Souza, J. L., & Marshall, L. A. (2019). Co-creation of the safewards model in a forensic mental health care facility. Issues in Mental Health Nursing, 40(1), 2-7. https://doi.org/10.1080/01612840.2018.1481472
Leamy, M., Bird, V., Boutillier, C. L., Williams, J., & Slade, M. (2011). Conceptual framework for personal recovery in mental health: Systematic review and narrative synthesis. British Journal of Psychiatry, 199(6), 445-452. https://doi.org/10.1192/bjp.bp.110.083733
Majnemer, A. (2009). Promoting participation in leisure activities: Expanding role for pediatric therapists. Physical & Occupational Therapy in Pediatrics, 29(1), 1-5. https://doi.org/10.1080/01942630802625163
Martin, K., Arbour, S., McGregor, C., & Rice, M. (2022). Silver linings: Observed reductions in aggression and use of restraints and seclusion in psychiatric inpatient care during COVID-19. Journal of Psychiatric and Mental Health Nursing, 29(2), 381-385. https://doi.org/10.1111/jpm.12752
Mental Health Commission of Canada. (2015). Informing the future: Mental health indicators for Canada. Mental Health Commission of Canada.
Panchal, U., Salazar de Pablo, G., Franco, M., Moreno, C., Parellada, M., Arango, C., & Fusar-Poli, P. (2023). The impact of COVID-19 lockdown on child and adolescent mental health: Systematic review. European Child & Adolescent Psychiatry, 32(7), 1151-1177. https://doi.org/10.1007/s00787-021-01856-w
Payne-Gill, J., Whitfield, C., & Beck, A. (2021). The impact of the UK's first COVID-19 lockdown on rates of violence and aggression on psychiatric inpatient wards. MedRxiv. https://doi.org/10.1101/2021.03.10.21253244
Pedrosa, A. L., Bitencourt, L., Fróes, A. C. F., Cazumbá, M. L. B., Campos, R. G. B., de Brito, S. B. C. S., & Simões e Silva, A. C. (2020). Emotional, behavioral, and psychological impact of the COVID-19 pandemic. Frontiers in Psychology, 11, 566212. https://doi.org/10.3389/fpsyg.2020.566212
Puzzo, I., Aldridge-Waddon, L., Stokes, N., Rainbird, J., & Kumari, V. (2022). The impact of the COVID-19 pandemic on forensic mental health services and clinical outcomes: A longitudinal study. Frontiers in Psychiatry, 12, 780236. https://doi.org/10.3389/fpsyt.2021.780236
De Sousa, A., Mohandas, E., & Javed, A. (2020). Psychological interventions during COVID-19: Challenges for low and middle income countries. Asian Journal of Psychiatry, 51, 102128. https://doi.org/10.1016/j.ajp.2020.102128
Verschueren, M., Claes, L., Bogaerts, A., Palmeroni, N., Gandhi, A., Moons, P., & Luyckx, K. (2018). Eating disorder symptomatology and identity formation in adolescence: A cross-lagged longitudinal approach. Frontiers in Psychology, 9, 816. https://doi.org/10.3389/fpsyg.2018.00816
Wyder, M., Bland, R., & Crompton, D. (2013). Personal recovery and involuntary mental health admissions: The importance of control, relationships and hope. Health, 05, 574-581. https://doi.org/10.4236/health.2013.53A076