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An Evaluation of the Use of Physical and Chemical Restraints in Geriatric Psychiatric Patients: A Retrospective Cohort Study

Published online by Cambridge University Press:  14 April 2025

Cindy Whitten Open the ORCID record for Cindy Whitten [Opens in a new window] ,
Hayley Baker ,
Brooklyn Sparkes ,
Marlise Ball  and
Julia Curtis
Cindy Whitten*
Affiliation:
Department of Research and Innovation, St. John’s, NL, Canada Faculty of Humanities and Social Sciences, St.John’s, NL, Canada
Hayley Baker
Affiliation:
Department of Research and Innovation, St. John’s, NL, Canada
Brooklyn Sparkes
Affiliation:
Department of Research and Innovation, St. John’s, NL, Canada
Marlise Ball
Affiliation:
Department of Research and Innovation, St. John’s, NL, Canada
Julia Curtis
Affiliation:
Department of Research and Innovation, St. John’s, NL, Canada
*
Corresponding author: La correspondance et les demandes de tirésàpart doivent être adressées à : / Correspondence and requests for offprints should be sent to: Dr Cindy Whittem, PhD, Senior Clinical Research Scientist, NL Health Services, Dept of Research and Innovation (cindy.whitten@easternhealth.ca).
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Abstract

Background

Restraints are used in various medical settings to control or restrict problematic patient behavior and can be physical, chemical, or environmental. Restraints can produce harmful psychological and physical effects.

Objectives

The prevalence of restraints in geriatric populations in psychiatric hospital settings in the province of Newfoundland and Labrador (NL) has not yet been documented.

Methods

This retrospective cohort study examined whether any form of restraint was used on patients admitted to the Geriatric Psychiatry Unit (GPU) at the Waterford Hospital in St. John’s, NL, from June 1, 2019, to June 1, 2021.

Findings

There were 277 admissions to the GPU during the period of observation, and of these, 189 (68.2%) had a chemical restraint administered, 135 (48.7%) had a physical restraint administered, and 123 patients (44.4%) had both a chemical and physical restraint administered.

Discussion

Restraints are used to control patient behavior for a number of reasons and in a variety of ways. While this practice is used to promote safer environments for patients, it is not without medical, ethical, and political concerns.

This study could promote alternatives to restraints for this geriatric psychiatric population in light of the construction of a new mental health and addictions facility in NL.

Résumé

RésuméContexte

Les contraintes sont utilisées dans divers milieux médicaux pour contrôler ou restreindre les comportements problématiques des patients et peuvent être physiques, chimiques ou environnementales. Les contraintes peuvent entraîner des effets psychologiques et physiques nuisibles.

Objectifs

La prévalence des contraintes chez les populations gériatriques dans les hôpitaux psychiatriques de la province de Terre-Neuve-et-Labrador (TNL) n’a pas encore été documentée.

Méthodes

Cette étude rétrospective de cohorte a examiné si une forme quelconque de contrainte a été utilisée sur les patients admis à l’Unité de Psychiatrie Gériatrique (UPG) de l’Hôpital Waterford à St. John’s, TNL, entre le 1er juin 2019 et le 1er juin 2021.

Résultats

Il y a eu 277 admissions à l’UPG pendant la période d’observation et, parmi celles-ci, 189 (68,2 %) ont reçu une contrainte chimique, 135 (48,7%) ont reçu une contrainte physique, et 123 patients (44,4 %) ont reçu à la fois une contrainte chimique et physique.

Discussion

Les contentions sont utilisées pour contrôler le comportement des patients pour diverses raisons et de différentes manières. Bien que cette pratique soit utilisée pour promouvoir des environnements plus sûrs pour les patients, elle n’est pas sans préoccupations médicales, éthiques et politiques

Cette étude pourrait promouvoir des alternatives aux contraintes pour cette population psychiatrique gériatrique à la lumière de la construction d’une nouvelle installation de santé mentale et de traitement des dépendances à Terre-Neuve-et-Labrador.

Keywords

geriatricpsychiatryrestraintschemical restraintphysical restraintNewfoundland and LabradorGériatriquePsychiatrieContrainte(s)Contrainte chimiqueContrainte physiqueTerre-Neuve-et-Labrador
Type
Article
Information
Canadian Journal on Aging / La Revue canadienne du vieillissement , First View , pp. 1 - 6
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Copyright
© Canadian Association on Gerontology 2025.

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