[Patient participation in the assessment of alternatives to restraint and seclusion] (original) (raw)

JLD control of seclusion and restraint measures in psychiatry: a controversial reform

2024

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Patient participation in mental health: towards a framework for analysing practices

Santé publique, 2021

Introduction: This article aims to take stock of the ways in which the concept of participation is used in mental health, particularly in the literature relating to patient support. Based on the debates and issues identified, we propose a framework for analyzing participatory practices. Method: The methodology is based on a literature review to which a meta-synthesis has been applied. This method of secondary analysis of qualitative research initially made it possible to synthesise and structure knowledge on the subject studied. Secondly, an interpretative analysis has been carried out to identify a proposal for a framework for analyzing practices. Results: The search process, conducted from two databases, returned 28 articles after exclusion for full data extraction and analysis. Through the meta-synthesis of the data, three ideal models of participation in mental health emerged: the linear approach, the conditional approach and the unconditional approach. Conclusion: Our results show that the advantage of mobilizing conceptual variations of participation from the point of view of caregivers in health support does not lie in the opposition of concepts. Rather, it rests on the possibility ofshedding light on the different forms that this participation takes in the representation of professionals and their evolution in field practice.

Physical restraint in the emergency and intensive care units

2012

the context of agitation: delirium due to organic or toxic causes, psychiatric or mixed agitation. Physical restraint and sedation should be considered as merely symptomatic measures and should not delay the etiological treatment of agitation. Heterogeneity of views regarding physical restraint in medical settings, owing to the poor level of evidence supporting its benefit-risk ratio, warrants better studies and the development of a specific ethical framework.

Sortie du patient handicapé : de la fragmentation à la coopération

Journal de Réadaptation Médicale : Pratique et Formation en Médecine Physique et de Réadaptation

The standards of production in a hospital unit (based on homogeneous groups of patients) stands on triple criteria: rationalization of care process, evidence based medicine, and resource utilization groups. This all defines the sanitary model at hospital admission. The real discharge is social and medical. It faces the complexity of various cases based on biological, psychological and social criteria. The assessment of professional practices dedicated to the improvement of the discharge process of heavily disabled patients tested the ''Intermed''score. We studied how to stratify the needs inside and outside the hospital. The aim was double: improve the quality of care and decrease the vulnerablility of the hospital to the lack of solution. Over 13 patients who did need hopitalisation after four months: 11 where under 60 years old, 11 had a three points score at the Glasgow score, all of them had at least a 25 points score at the ''Intermed'' test at admission, one who had a two points GOS had a 23 points Intermed score. We suggest to pursue the study of the use of Intermed score for SSR short stays on the base of the graduated answers it allows as multidisciplinary teams or social and health networks.