[Compliance of patients admitted with consent to psychiatric hospital]. / Przestrzeganie zalecen lekarza przez pacjentów przyjetych za zgoda do szpitala psychiatrycznego.

AIM: The aim of the study is to assess the interrelation between three earlier described types of consent to inpatient treatment and compliance as well as some aspects of patients' autonomy. METHOD: 200 inpatients admitted to four psychiatric hospitals were examined by means of a structured questionnaire. Persons with severe dementia, distorted intellectual contact, incompetent, as well as the juvenile were excluded. RESULTS: The analyses of interrelation among the three groups of patients who gave their consent to treatment and compliance as well as other determinants of compliance indicated that: - All patients (100%) of the first group (informed consent) comply with the doctors' advice, in the second group (not capable to consent)--84 percent and in the third group (not asked about consent)--92 percent. - The patients of the 2nd and 3rd groups showed to have a lower level of compliance and other determinants of treatment such as need for treatment, confidence in doctor and other medical staff, satisfaction and others. - All groups of patients had a meaningless influence on choice of hospital, ward and kind of therapy. CONCLUSION: The study proved that: -The patients have a very high rate of therapeutic compliance not only in observing treatment regimens, but also in self-reporting their needs for treatment, confidence in doctor and other staff, efficiency of medication as well as treatment satisfaction. - Compliance rates in patients who confirmed their informed consent treatment were significantly higher than these who had not been asked to give their consent to treatment, and those who had not been capable of expressing their informed consent to treatment. - The high rates of therapeutic compliance are associated with very limited autonomy concerning the choice of hospital, in inpatient ward and method of therapy.

[Evaluation of following the regulations of informed consent for treatment in a psychiatric hospital]. / Ocena przestrzegania przepisów o zgodzie na leczenie w szpitalu psychiatrycznym.

AIM: The aim of this paper was to evaluate the frequency of following the regulations of informed consent for treatment in a psychiatric hospital. METHOD: 200 patients who were admitted to 4 psychiatric hospitals were studied with a structured questionnaire. In a random-purpose selection, patients with dementia, lower intellectual capability and those who were incapacitated were not taken into account. RESULTS AND CONCLUSIONS: Amongst the 200 patients admitted for a psychiatric hospital treatment 73 (36.5%) confirmed a conscious informed consent, 25 (12.5%) agreed but according to the researchers they were not capable to express conscious consent, but 102 (51%) did not agree to being treated. The first group was dominated by women (57.5%). 17.8% of the patients from this group were directed to hospital with no prior examination. 97.3% expressed conscious agreement to treatment, whilst 2.7% were hesitant. In the second group the ratio of women to men was similar. Only one patient was directed to the hospital with no prior examination. 68.0% patients expressed conscious agreement to treatment and 32.0% were hesitant. In the third group, there were more men--55.9%. 27.5% of the patients were sent to hospital with no examination prior to that. 76.5% of the patients had expressed a conscious agreement to being treated and 23.5% were hesitant. In the 1st group non-psychotic disorders dominated over the schizophrenic psychoses, amongst these there were affective disorders--37% and others. In the 2nd group the schizophrenic psychoses definitely were the most common--60% amongst the other disorders. The treatment of these individuals required formal consent--notification of the court--which was not done in any single case. In the 3rd, the schizophrenic psychoses also were those most frequently present--40.2% over other diagnoses amongst which there were affective disorders--23.5%, and others. The persons studied were not asked for consent, amongst these--63.7% were solely informed and treated, whilst 36.3% were not even informed and treated. The differences between the three groups in the distribution of the diagnoses are statistically significant.

[Physical restraint as a therapeutical procedure]. / Przymus bezposredni stosowany w niektórych czynnosciach leczniczych.

A study of 959 notices on physical restraint (Ph.R.) sent to the head of a mental hospital during 6 months showed that: imminent danger to the patient's own life or health or the life or health of others, violent destroying of ward equipment, grave psychomotor excitement prevail among the reasons for Ph.R. Therapeutic reasons are much less common. Every sixth (17%) episode of Ph.R. was used exclusively to perform therapeutic procedures, mainly intravenous drip. The Ph.R. was a therapeutic procedure is relatively seldom used without sufficient justification. As a rule a physician accepts nurses decision on Ph.R. with no further consideration. The same is true for director's acceptance of a physician's decision.

Pressure Sensitive Mats as Safety Devices in Danger Zones.

Developing prototypes of pressure sensitive mats and testing their practical application were the aims of this study. Two contact plate mats were designed and constructed: rubber-rubber (R) and metal-metal (M). A recipe for rubber mixes and the production technology were prepared. Two laboratory test stands for measuring the actuating force, response time, static pressure resistance, and the durability of the mats were constructed. Computer software was written to control the operation of those test stands. Methods of testing pressure sensitive mats were based on PrDIN 31 006 (Deutsches Institut fur Normung [DIN], 1990) and EN 1760-1 (Comite Europeen de Normalisation [CEN], 1997). Both prototypes of contact plate mats were tested under laboratory and industrial conditions. The test results proved that the design was correct, the setup requirements were fulfilled, and the mats were efficient and reliable in the industrial environment.