Reactions of patients and psychiatric hospital staff about physical restraint

The use of physical restraint in a variety of health care settings, has received increased attention in recent years. Restraint when used properly, can be a lift saving and an injury sparing measure. However, it has a potential for abuse if used improperly. The responsibility of ordering restraint is that of the physician, and his opinion and experience toward restraint is one of the significant factors affecting the frequency with which this intervention is used. Nurses are often on the front line, interacting with patients who may be violent or who display disruptive behavior, and they may choose to use restraint as an intervention. Front the patients' perspective, restraint can be understood as a form of assault, humiliation and detention. The controversy over how helpful physical restraint is to the patients continues to be an issue in psychiatric settings. This highlights the need and importance of systematic and comprehensive research of patients and staff experience about restraint. The main results yielded by the study proved that, concerning the patients' feelings during restraint, humiliation and worthlessness are the most common feelings experienced by 38.75% of the patients, followed by rage and resentment [25.00%], sadness and despair as well as injustice were experienced equally by the patients [18.75%], feeling guilty was mentioned by 11.25% of the studied subjects; and 3.75% said that they calmed down

Psychotic patients' awareness of their illness and its correlates

Awareness about illness is defined in terms of a patient's psychological attitude toward the psychiatric situation, and is to be evaluated from the standpoint of the person's sick-role concept, by assessing the recognition of the need for treatment and acceptance of the treatment situation. Previous researches have suggested that lack of psychiatric patients' awareness of their illness may have considerable power in predicting the long-term course of chronic mental disorders, and have an impact on patients compliance with treatment plans and relapses of psychosis. The aim of this study was to find out the psychotic patients' awareness of their illness and its correlates. The results suggest that self-awareness deficits are a prevalent feature in mentally ill patients, perhaps stemming from the neuropsychological dysfunction associated with the disorders, and deficits in illness awareness are associated with greater number and longer duration of hospitalizations, and is considered one of the most important reasons for non-compliance

Impact of a psycho-education intervention on insight of hospitalized schizophrenic patients

Severely impaired insight is one of the main characteristics of psychotic disorders that present a major obstacle for treatment. Traditionally, insight has often been viewed as a simple or unitary construct. Recently, it is considered as a complex phenomenon with multiple components. A general lack of insight is widespread and very common in many patients with schizophrenia. Psycho-education is a form of mental health intervention which focuses on educating patients about their disorders, emotional responses, and treatments, as well as supporting positive coping mechanisms. The main purpose of this study was to determine the impact of psycho-education intervention on insight development among hospitalized schizophrenic patients. A structured frame of psycho-education intervention was developed by the researchers. The intervention aimed at increasing patients' awareness about their mental disorder, their symptoms as well as its attribution, the social consequences of mental disorder and the achieved effects of medication. Before the implementation of psycho-education intervention, the total Scale to Assess Unawareness of Mental Disorder [SUMD] mean scores for current awareness and attribution were 13.78 +/- 2.95 for the intervention group and 15.04 +/- 2.73 for the control group [mild to moderate degree lack of insight]. These results changed after the implementation of the psycho-education intervention to 7.96 +/- 2.81 and 15.67 +/- 2.39 respectively, with a statistical significant improvement [t=14.731, P=0.00] on the part of the intervention group. This was also true when comparing the two groups' SUMD subscale mean scores