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The disruption of a patient : a longitudinal study about the association between global functioning and disruptive behaviour of patients in the acute psychiatric care.

Boer, T.A. de (2020) The disruption of a patient : a longitudinal study about the association between global functioning and disruptive behaviour of patients in the acute psychiatric care.

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Abstract:Coercion is a frequently applied method in the acute psychiatric care to manage disruptive behaviour. To improve the health, safety and wellbeing of both patients and staff, coercion need to be reduced to a minimum by the prevention of disruptive behaviour. Disruptive behaviour arises from different patient related risk factors. The internal signs of impending disruption of a patient has to be understood. For this, the global functioning of a patient could be helpful. The global functioning of a patients is a multidimensional look on a patients functioning. It captures psychological symptoms, social skills, symptoms of violence and activities of daily living of a patient. A deeper understanding of a patient’s global functioning within the acute psychiatric care can be helpful to predict disruptive behaviour at an early stage and thereby prevent this behaviour from being aggravated. While there are previous studies investigating the association of global functioning and disruptive behaviour resulting in seclusion, there is a dearth of research investigating the association between global functioning and disruptive behaviour. The aim of the present study was to investigate this association over time. To intervene at an early stage, we wanted to know if and which subscales of global functioning had an association with disruptive behaviour over time. Also, the global functioning could be a better predictor of disruptive behaviour in some subgroups of patients. In longitudinal retrospective study we used the daily measurements with the Brøset Violence Checklist (BVC) and the Kennedy Axis V (K-As) of each patient admitted over a period of three years in two different acute psychiatric care units. The data of the first 28 days of hospitalisation of 483 patients were used for a series of linear mixed models for repeated measurements. Patient-related static factors such as sex, age, type of unit and type of diagnosis were investigated as moderators. In the cross-sectional analyses, global functioning was moderately negatively associated with disruptive behaviour over time. In the multivariate cross-sectional analysis the subscales psychological functioning, social functioning and violence (to self/others) showed an independent but weak negative association with disruptive behaviour over time. Patients at an age < 35 or diagnosed with a psychotic disorder appeared to have a stronger association between global functioning and disruptive behaviour. Patients diagnosed with a neurobiological development disorder had a weaker association. The within-patients analyses indicated that a change in a patients global functioning influenced their disruptive behaviour, or vice versa. Monitoring a patients global functioning could be useful in the prediction and prevention of disruptive behaviour of a patient in the acute psychiatric care.
Item Type:Essay (Master)
Faculty:BMS: Behavioural, Management and Social Sciences
Subject:77 psychology
Programme:Psychology MSc (66604)
Link to this item:http://purl.utwente.nl/essays/80469
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