AI Article Synopsis

  • The study aimed to analyze recent literature on how restrictive care practices are measured in adult mental health inpatient units, focusing on their prevalence and the reliability and validity of these measurement methods.
  • A systematic review of 128 studies published from 2010 to 2023 was conducted across various databases, revealing significant variations in measurement approaches and unclear reliability and validity for most studies.
  • The lack of standardized measurement methods could lead to biases, making it difficult to accurately assess these practices and their reduction strategies, highlighting the need for reliable and standardized measures in future research.

Article Abstract

Aims: To identify and characterise the approaches and instruments used in recent literature to measure the prevalence of restrictive care practices in adult mental health inpatient units. Additionally, it sought to summarise the reported psychometric properties, including reliability and validity of these measures.

Methods: A systematic review of recent litratures was conducted using Scopus, MEDLINE, CINAHL, PsycINFO, Web of Science and Embase databases to identify studies published from 1 January 2010 to 11 October 2023. A total of 128 studies measuring the use of restrictive care practices were included. Data on measurement methods were extracted from each study and summarised to compare how consistently these practices have been measured across studies and how authors consistently reported the reliability and validity of these measurment approaches. All findings were reported following the PRISMA 2020 checklist.

Results: There were significant variations in how the prevalence of restrictive care practices was measured, and the reliability and validity of these measurements were unclear for most studies. Only 11 studies reported inter/intra-rater reliability. Key variations were observed in data sources utilised, how and by whom the data were collected, the timing and total duration of data collection during patient admission, how and by whom data were extracted from secondary sources, measurement instruments and the reported reliability and validity of measures.

Conclusions: Methodological inconsistencies about the measurements approaches of restricitve care practices would introduduce potential random and/or systematic biases on the reported data which may obscure the the true prevalance these practices. This hinder the ability to acurately assess the effectiveness of reduction strategies and understand the naturally occuring practices. Establishing a standardised set of reliable measures is crucial for enabling valid comparisons for the rates of restricitve car epractice use across settings and countries, which could enhance the ongoing monitoring and reduction of these practices.

Relevance To The Clinical Practice: The absence of standardised defintions and measurement approaches for restrictive care practices challenges the global effort to reduce their use. Without reliable and common measures, clinicians and researchers often face challenges in documening RCP incidents accurately, compromising efforts to improve care quality and support a recovery-oriented approach. Such measurment errors would mislead decission-maker which would furhter contribute to the inconsistency the the implementation of these practices.

Patient Or Public Contribution: No patient or public contribution.

Trial Registration: PROSPERO: CRD:42022335167; https://www.crd.york.ac.uk/prospero/export_details_pdf.php.

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Source
http://dx.doi.org/10.1111/jocn.17588DOI Listing

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