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Jornal Brasileiro de Psiquiatria

versão impressa ISSN 0047-2085versão On-line ISSN 1982-0208

Resumo

BRAGA, Isabela Pinto et al. Physical restraint in a Brazilian psychiatric hospital: cross-sectional study of practice and risk factors. J. bras. psiquiatr. [online]. 2016, vol.65, n.1, pp.53-59. ISSN 0047-2085.  http://dx.doi.org/10.1590/0047-2085000000103.

Objectives

To describe the use of physical restraint in a public psychiatric hospital and analyze the risk factors associated with its use in the context of the implementation of a clinical protocol.

Methods

In a public psychiatric hospital of Belo Horizonte-MG, registration forms for monitoring physical restraint (2011-2012) were analyzed and compared with the records of other admissions in the same period. In this cross-sectional study, the clinical and demographic characteristics of the restrained patients, the techniques used and the reported complications were described. Also, risk factors associated with the use of physical restraints were analyzed using multiple logistic regression.

Results

Physical restraint was used in 13.4% of admissions, was more common in young male patients, with a non-organic psychoses diagnosis, presenting agitation/aggressive behavior. Usually, a four-points restraint technique was performed, lasting between 61-240 minutes. The only significant risk factors for the use of restraints included age (OR = 0.98, p = 0.008) and length of stay (OR = 1.01, p < 0.001).

Conclusions

Physical restraint was used in the approach of the acutely agitated, aggressive, and non-responsive to verbal de-escalation patient, in the context of a psychotic disorder. The registration of vital signs and adverse effects were the items less frequently compliant to current protocols.

Palavras-chave : Physical restraint; psychomotor agitation; psychiatric hospital; risk factors.

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