Techniki deeskalacyjne a agresja lub pobudzenie o podłożu psychotycznym
Referencias
References to studies excluded from this review
Additional references
References to other published versions of this review
Characteristics of studies
Characteristics of excluded studies [ordered by study ID]
| Study | Reason for exclusion |
| Allocation: not randomised. |
Study flow diagram.
| Methods | Allocation: cluster‐randomised, clearly described, with researched and recorded intra‐class correlation coefficient (ICC) reported. Blinding: none. Duration: 2 weeks. Setting: any psychiatric ward with high rate of aggression. |
| Participants | Diagnosis: any. History: people admitted or, or getting admitted to psychiatric ward. N =*. Age: adult. Sex: men or women. Exclude: those already randomised. |
| Interventions | 1. De‐escalation technique training. 2. Waiting list for training. The de‐escalation technique training could involve refining of: a. Verbal communication techniques; b. Use of body language; c. Prevention and recognition strategies (risk assessment tools); d. Staff attitudes, knowledge and skills; e. Setting of limits for patients to follow; f. Environmental controls (such as minimising light, noise, conversations and so on) used for the management of aggression ‐ or any combination of these. |
| Outcomes | Primarily routinely‐recorded binary outcomes. 1. Clinically important changes in global state (short‐term outcomes) 2. Aggression 2.1 Improved to an important extent 2.4 Recurrance of aggression 3. Adverse effects 3.1 Physical adverse effects 4. Service outcomes 4.1 Time in hospital 5. Acceptability 5.1 To staff 5.2 To patients 6. Cost |
| Notes | * We are unclear of power calculations at this point. It is likely that the sample of people will have to total at least 300 to gain sufficient power to find clear outcomes that are likely to effect clinical practice, but this figure would have to be modified depending on a well‐researched (not imputed) ICC. |
| Patient or population: people who are aggressive secondary to serious mental illness | ||||||
| Outcomes | Illustrative comparative risks* (95% CI) | Relative effect | No of Participants | Quality of the evidence | Comments | |
| Assumed risk | Corresponding risk | |||||
| Standard care control | De‐escalation technique | |||||
| Clinically important changes in global state | We identified no relevant studies. | |||||
| Aggression ‐ Improved to an important extent | ||||||
| Aggression ‐ deterioration: incidence of violence to self or others | ||||||
| Aggression ‐ changes in aggression as recorded by any other outcomes | ||||||
| Adverse effects ‐ physical adverse effects | ||||||
| Adverse effects ‐ death, suicide or natural causes | ||||||
| Adverse effects ‐ psychological adverse effects | ||||||
| *The basis for the assumed risk (e.g. the median control group risk across studies) is provided in footnotes. The corresponding risk (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). | ||||||
| GRADE Working Group grades of evidence | ||||||
| Focus of review | Reference |
| Completed and maintained reviews | |
| 'As required' medication regimens for seriously mentally ill people in hospital | |
| Benzodiazepines for psychosis‐induced aggression or agitation | |
| Chlorpromazine for psychosis‐induced aggression or agitation | |
| Clotiapine for acute psychotic illnesses | |
| Containment strategies for people with serious mental illness | |
| Droperidol for acute psychosis | |
| Haloperidol for psychosis‐induced aggression or agitation (rapid tranquillisation) | |
| Haloperidol plus promethazine for psychosis‐induced aggression | |
| Olanzapine IM or velotab for acutely disturbed/agitated people with suspected serious mental illnesses | |
| Seclusion and restraint for serious mental illnesses | |
| Zuclopenthixol acetate for acute schizophrenia and similar serious mental illnesses | |
| Reviews in the process of being completed | |
| Clozapine for people with schizophrenia and recurrent physical aggression | |
| De‐escalation techniques for managing aggression | |
| Haloperidol for long‐term aggression in psychosis | |
| Loxapine inhaler for psychosis‐induced aggression | |
| Quetiapine for psychosis‐induced aggression or agitation | |
| Risperidone for psychosis‐induced aggression or agitation | |
