Les pratiques de la mise en isolement et sous contention en psychiatrie : étude descriptive au regard de la nouvelle réglementation

Abstract : The article 72 of January 26th 2016 has set a necessary legal framework in order to constrain the medico-administrative community to put in place everything possible to limit the use of seclusion. Our aims at describing the practices of seclusion, and their comparison between units to confront them to the requirements of the new law and the new recommendations from « High Authority of Health ». This descriptive study has been conducted at the “Centre Hospitalier Alpes Isère” and focused on the measures of seclusion in general adult psychiatry units from 19 September to 31 December 2016. 182 measures for 105 patients were collected. There were men rather young suffering from psychotic spectrum troubles and hospitalized under constraint. 55% of the measures were in seclusion room and 41% in standard locked room with restraints. The average duration of stay in seclusion was of 5 days and under restraints of 10 hours. The most often mentioned reason has been agitation-violence-dangerousness. 17% of measures were issued from reasons “no compliant” to the regulations. For 39.5% of measures, alternative strategies prior to seclusion have been monitored. A significant difference between units has been shown to: the frequency of the use of the seclusion room and the standard locked room (Khi2 45,559 p<0,05), the duration of stay in seclusion (ANOVA 3,600 p<0,05) and of the restraint measure (ANOVA 3,363 p<0.05). Some of the practices were out of recommendations or legal framework, these points require to be improved by an assertive will from the Institution to initiate and accompany the politics aiming at promoting the factors limiting the resort to these practices.
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Master Thesis
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Charlène Bekhdadi. Les pratiques de la mise en isolement et sous contention en psychiatrie : étude descriptive au regard de la nouvelle réglementation. Médecine humaine et pathologie. 2017. ⟨dumas-01958187⟩

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