Correlation between levels of conflict and containment on acute psychiatric wards: the city-128 study

2.50
Hdl Handle:
http://hdl.handle.net/10547/558809
Title:
Correlation between levels of conflict and containment on acute psychiatric wards: the city-128 study
Authors:
Bowers, Len ( 0000-0002-1279-830X ) ; Stewart, Duncan; Papadopoulos, Chris; Iennaco, Joanne DeSanto
Abstract:
OBJECTIVE Attainment of safe, calm inpatient psychiatric wards that are conducive to positive therapeutic care is crucial. On such wards, rates of coerced medication, seclusion, manual restraint and other types of containment are comparatively low, and, usually, rates of conflict-for example, aggression, substance use, and absconding-are also low. Sometimes, however, wards maintain low rates of containment even when conflict rates are high. This study investigated wards with the counterintuitive combination of low containment and high conflict or high containment and low conflict. METHODS The authors conducted a secondary analysis of cross-sectional data collected from 136 acute psychiatric wards across England in 2004-2005. The wards were categorized into four groups on the basis of median splits of containment and conflict rates: high conflict and high containment, high conflict and low containment, low conflict and low containment, and low conflict and high containment. Features significantly associated with these ward types were identified. RESULTS Among the variables significantly associated with the various typologies, some-for example, environmental quality-were changeable, and others-such as social deprivation of the area served-were fixed. High-conflict, low-containment wards had higher rates of male staff and lower-quality environments than other wards. Low-conflict, high-containment wards had higher numbers of beds. High-conflict, high-containment wards utilized more temporary staff as well as more unqualified staff. No overall differences were associated with low-conflict, low-containment wards. CONCLUSIONS Wards can make positive changes to achieve a low-containment, nonpunitive culture, even when rates of patient conflict are high.
Affiliation:
King’s College London; University of Bedfordshire; Yale School of Nursing
Citation:
Bowers, L., Stewart, D., Papadopoulos, C., Iennaco, J.D. (2013) 'Correlation between levels of conflict and containment on acute psychiatric wards: the city-128 study' Psychiatric Services 64 (5):423-30
Publisher:
American Psychiatric Association
Journal:
Psychiatric services
Issue Date:
1-May-2013
URI:
http://hdl.handle.net/10547/558809
DOI:
10.1176/appi.ps.201200328
PubMed ID:
23370595
Additional Links:
http://dx.doi.org/10.1176/appi.ps.201200328
Type:
Article
Language:
en
ISSN:
1557-9700
Sponsors:
RP-PG-0707-10081/Department of Health/United Kingdom
Appears in Collections:
IHR Institute for Health Research

Full metadata record

DC FieldValue Language
dc.contributor.authorBowers, Lenen
dc.contributor.authorStewart, Duncanen
dc.contributor.authorPapadopoulos, Chrisen
dc.contributor.authorIennaco, Joanne DeSantoen
dc.date.accessioned2015-07-03T09:21:25Zen
dc.date.available2015-07-03T09:21:25Zen
dc.date.issued2013-05-01en
dc.identifier.citationBowers, L., Stewart, D., Papadopoulos, C., Iennaco, J.D. (2013) 'Correlation between levels of conflict and containment on acute psychiatric wards: the city-128 study' Psychiatric Services 64 (5):423-30en
dc.identifier.issn1557-9700en
dc.identifier.pmid23370595en
dc.identifier.doi10.1176/appi.ps.201200328en
dc.identifier.urihttp://hdl.handle.net/10547/558809en
dc.description.abstractOBJECTIVE Attainment of safe, calm inpatient psychiatric wards that are conducive to positive therapeutic care is crucial. On such wards, rates of coerced medication, seclusion, manual restraint and other types of containment are comparatively low, and, usually, rates of conflict-for example, aggression, substance use, and absconding-are also low. Sometimes, however, wards maintain low rates of containment even when conflict rates are high. This study investigated wards with the counterintuitive combination of low containment and high conflict or high containment and low conflict. METHODS The authors conducted a secondary analysis of cross-sectional data collected from 136 acute psychiatric wards across England in 2004-2005. The wards were categorized into four groups on the basis of median splits of containment and conflict rates: high conflict and high containment, high conflict and low containment, low conflict and low containment, and low conflict and high containment. Features significantly associated with these ward types were identified. RESULTS Among the variables significantly associated with the various typologies, some-for example, environmental quality-were changeable, and others-such as social deprivation of the area served-were fixed. High-conflict, low-containment wards had higher rates of male staff and lower-quality environments than other wards. Low-conflict, high-containment wards had higher numbers of beds. High-conflict, high-containment wards utilized more temporary staff as well as more unqualified staff. No overall differences were associated with low-conflict, low-containment wards. CONCLUSIONS Wards can make positive changes to achieve a low-containment, nonpunitive culture, even when rates of patient conflict are high.en
dc.description.sponsorshipRP-PG-0707-10081/Department of Health/United Kingdomen
dc.language.isoenen
dc.publisherAmerican Psychiatric Associationen
dc.relation.urlhttp://dx.doi.org/10.1176/appi.ps.201200328en
dc.rightsArchived with thanks to Psychiatric services (Washington, D.C.)en
dc.subjectB760 Mental Health Nursingen
dc.subjectpsychiatric nursingen
dc.subject.meshAggressionen
dc.subject.meshAttitude of Health Personnelen
dc.subject.meshCoercionen
dc.subject.meshConflict (Psychology)en
dc.subject.meshCross-Sectional Studiesen
dc.subject.meshEnglanden
dc.subject.meshHospital Unitsen
dc.subject.meshHumansen
dc.subject.meshMental Disordersen
dc.subject.meshNurse-Patient Relationsen
dc.subject.meshPatient Isolationen
dc.subject.meshPsychiatric Department, Hospitalen
dc.subject.meshRestraint, Physicalen
dc.subject.meshRetrospective Studiesen
dc.titleCorrelation between levels of conflict and containment on acute psychiatric wards: the city-128 studyen
dc.typeArticleen
dc.contributor.departmentKing’s College Londonen
dc.contributor.departmentUniversity of Bedfordshireen
dc.contributor.departmentYale School of Nursingen
dc.identifier.journalPsychiatric servicesen
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