Heterogeneity, equifinality and risk: Profiles of restrained patients presenting to a general medical hospital.
Physical restraints refer to the immobilization of patient movement to address safety concerns or manage treatment interference. Interventions to reduce restraints have been effective in long-term care and psychiatric facilities. In contrast, rates of restraint have increased in general medical hosp...
| Published in: | General Hospital Psychiatry Vol. 102; pp. 70 - 78 |
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| Main Authors: | , , , , , , , , |
| Format: | research Journal Article |
| Published: |
Elsevier B.V.
Sep2026
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| Online Access: | View this record in EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=196820647&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 196820647 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 01638343 JFH jtl: General Hospital Psychiatry issn: 01638343 maglogo: N pubinfo: dt: Sep2026 vid: 102 pid: 467 pub: Elsevier B.V. place: New York, New York artinfo: ui: 196820647 196820647 196820647 10.1016/j.genhosppsych.2026.07.006 196820647 ppf: 70 ppct: 8 formats: tig: atl: Heterogeneity, equifinality and risk: Profiles of restrained patients presenting to a general medical hospital. aug: au: Miele, Andrew S. Grigoryan, Zhanna Dial, Brandon Vargas, Matthew McDonough, Ryan Roth, Alan Basello, Gina Nienaber, Cameron Brondolo, Elizabeth affil: St. John's University Department of Psychology, Queens, NY, USA sug: subj: Psychiatric Patients Psychosocial Factors Hospitalization Restraint, Physical Sociodemographic Factors Human Male Female Structural Equation Modeling Sex Factors Age Factors Mental Disorders Comorbidity Substance Use Disorders Nervous System Diseases Race Factors Male Female ab: Physical restraints refer to the immobilization of patient movement to address safety concerns or manage treatment interference. Interventions to reduce restraints have been effective in long-term care and psychiatric facilities. In contrast, rates of restraint have increased in general medical hospitals, possibly because of high patient volume and heterogenous patient populations. This high level of heterogeneity makes it difficult to develop preventative interventions. The current study aims to address this heterogeneity by generating profiles of restrained patients. Latent class analysis (LCA) was conducted using hospital data incorporating demographic and clinical variables to identify restrained patient subgroups, then class membership was used to examine differences in contextual factors and characteristics of restraint episodes. Five classes were identified: (1) Men with high-risk alcohol use and traumatic head injuries; (2) men in acute physical and mental distress with psychiatric comorbidities; (3) middle-aged men with severe medical conditions and histories of substance use disorders; (4) older male and female patients with severe medical illness and comorbid neurological impairments; (5) relatively young, black patients with psychiatric conditions and comorbid substance use. Classes were found to differ in terms of the reasons for restraint and the settings in which restraints occurred. The current study extends previous findings and is the first to examine profiles of restrained patients across a general medical hospital. These profiles are recognizable to clinicians and readily derived from available data, facilitating more rapid classification of patients.These data could guide the development of tailored interventions to reduce restraint use. • Restrained patients are differentiated by demographic and clinical characteristics. • 5 distinct subgroups of restrained patients were found in general medical hospital. • Different risk factors present in different subgroups of restrained patients. • Relatively younger Black patients with psychiatric conditions are hospital-wide risk. pubtype: Academic Journal doctype: research Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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