Mental Disorders
Conditions
Keywords
Joint Crisis Plan, Internalized Stigma of Mental Illness (ISMI), Isolation, physical restraint, Psychiatry
Brief summary
For some patients in department psychiatric, isolation measures are put in place. But the measures is not pleasant for the patient or for the care team. That's why care team are trying to find ways to improve patient care, including asking them how they would like to be treated. One of the solutions is called the Joint Crisis Plan. A Joint Crisis Plan is a personalized procedure for a patient. It describes the attitude, the care, the measures in case of crisis with the patient and his family. Patients indicate their wishes regarding their care. However, there is no real scientific proof of the effectiveness of this Joint Crisis Plan, especially to reduce isolation measures.
Detailed description
The primary objective of this study is to evaluate efficacy of the Joint Crisis Plan.
Interventions
PROCEDUREJoint Crisis Plan
A Joint Crisis Plan will be drafted with the patient and a nurse
Sponsors
Ministry of Health, France
Centre Hospitalier Universitaire de Saint Etienne
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
OTHER
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Patients \>18 years * Patients having had at least one isolation, restraint or forced hospitalization measure in the 24 months before inclusion * Followed by nurses of a mobile team of psychiatry sector Saint Etienne * Social security affiliation * Signed informed consent
Exclusion criteria
* Patient having already had a Joint Crisis Plan for less than 6 months. * Patient does not speak French * Pregnant and lactating women
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Duration of isolation | Months: 12 | Measured in hours. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Number of hospitalizations | Months: 12 | — |
| Number of isolation | Months: 12 | — |
| Number of physical restraints | Months: 12 | — |
| Duration of physical restraint | Months: 12 | Measured in hours |
| Perception of constraint | Months: 12 | Measured by the MacArthur Coercion Scale. Each True = 0, and each False = 1, perceived cohesion scale score is between 0 and 5, Negative pressures scale score is between 0 and 6, Voice scale score is between 0 and 3, Affective Reactions to Hospitalization score is between 0 and 6. |
| Number of violent events | Months: 12 | — |
| Number of emergency room visits for psychiatric opinion | Months: 12 | — |
| Adhesion and feeling of nurses in relation to Joint Crisis Plan | Months: 12 | Measured by focus-groups and individual interviews of nurses |
| Experience of discrimination and stigmatization | Months: 12 | Measured by the Internalized Stigma of Mental Illness. This scale is a 29 items scale with stigma graded on a 4 point scale (Strongly disagree-1, Disagree-2, Agree-3 and strongly agree-4) which are divided into fivecomponents/domains (alienation, stereotype endorsement, perceived discrimination, social withdrawal and stigma resistance). Higher scores indicate higher level of self stigma. |
Countries
France
Outcome results
None listed