Consideraciones éticas en la restricción de pacientes con trastorno mental
23 páginas
- Autores:
-
Ardila Salamanca, Kelly Geraldine
- Tipo de recurso:
- Trabajo de grado de pregrado
- Fecha de publicación:
- 2018
- Institución:
- Universidad de Ciencias Aplicadas y Ambientales U.D.C.A
- Repositorio:
- Repositorio Institucional UDCA
- Idioma:
- spa
- OAI Identifier:
- oai:repository.udca.edu.co:11158/924
- Acceso en línea:
- https://repository.udca.edu.co/handle/11158/924
- Palabra clave:
- Trastornos mentales
Enfermería - Etica profesional
Enfermería
Enfermería
Etica
Trastorno mental
- Rights
- openAccess
- License
- Derechos Reservados - Universidad de Ciencias Aplicadas y Ambientales
| id |
RepoUDCA2_f43a0b18433343936619a421a4d33293 |
|---|---|
| oai_identifier_str |
oai:repository.udca.edu.co:11158/924 |
| network_acronym_str |
RepoUDCA2 |
| network_name_str |
Repositorio Institucional UDCA |
| repository_id_str |
|
| dc.title.spa.fl_str_mv |
Consideraciones éticas en la restricción de pacientes con trastorno mental |
| title |
Consideraciones éticas en la restricción de pacientes con trastorno mental |
| spellingShingle |
Consideraciones éticas en la restricción de pacientes con trastorno mental Trastornos mentales Enfermería - Etica profesional Enfermería Enfermería Etica Trastorno mental |
| title_short |
Consideraciones éticas en la restricción de pacientes con trastorno mental |
| title_full |
Consideraciones éticas en la restricción de pacientes con trastorno mental |
| title_fullStr |
Consideraciones éticas en la restricción de pacientes con trastorno mental |
| title_full_unstemmed |
Consideraciones éticas en la restricción de pacientes con trastorno mental |
| title_sort |
Consideraciones éticas en la restricción de pacientes con trastorno mental |
| dc.creator.fl_str_mv |
Ardila Salamanca, Kelly Geraldine |
| dc.contributor.advisor.spa.fl_str_mv |
Coral Ibarra, Rosa del Carmen, dir. |
| dc.contributor.author.spa.fl_str_mv |
Ardila Salamanca, Kelly Geraldine |
| dc.subject.lemb.spa.fl_str_mv |
Trastornos mentales Enfermería - Etica profesional Enfermería |
| topic |
Trastornos mentales Enfermería - Etica profesional Enfermería Enfermería Etica Trastorno mental |
| dc.subject.proposal.spa.fl_str_mv |
Enfermería Etica Trastorno mental |
| description |
23 páginas |
| publishDate |
2018 |
| dc.date.accessioned.spa.fl_str_mv |
2018-08-29T14:02:30Z |
| dc.date.available.spa.fl_str_mv |
2018-08-29T14:02:30Z |
| dc.date.issued.spa.fl_str_mv |
2018 |
| dc.type.spa.fl_str_mv |
Trabajo de grado - Pregrado |
| dc.type.coarversion.fl_str_mv |
http://purl.org/coar/version/c_970fb48d4fbd8a85 |
| dc.type.coar.spa.fl_str_mv |
http://purl.org/coar/resource_type/c_7a1f |
| dc.type.driver.spa.fl_str_mv |
info:eu-repo/semantics/bachelorThesis |
| dc.type.version.spa.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
| dc.type.content.spa.fl_str_mv |
Text |
| dc.type.redcol.spa.fl_str_mv |
http://purl.org/redcol/resource_type/TP |
| format |
http://purl.org/coar/resource_type/c_7a1f |
| status_str |
publishedVersion |
| dc.identifier.uri.spa.fl_str_mv |
https://repository.udca.edu.co/handle/11158/924 |
| dc.identifier.local.spa.fl_str_mv |
ENF006 A72c 2018 |
| url |
https://repository.udca.edu.co/handle/11158/924 |
| identifier_str_mv |
ENF006 A72c 2018 |
| dc.language.iso.spa.fl_str_mv |
spa |
| language |
spa |
| dc.relation.references.spa.fl_str_mv |
Alvarado García A. La ética del cuidado. Rev Aquichán, [Internet]. 2004 [consultado 09 de octubre de 2017]; 4(1), 30-39. Disponible en: http://www.scielo.org.co/scielo.php?script=sci_arttext&pid=S1657- 59972004000100005&lng=en&tlng=es. Garzón. N. Toma de decisiones Éticas. En Peña, B Ética y bioética: memorias cátedra Manuel Ancízar. División Académica y Cultural. Bogotá. Editorial 2001. p. 171-190 Piñón Gaytán F. El problema ético en la filosofía de Kant. (Spanish). Política y Cult [Internet]. 2013;(39):99–112. Available from: http://search.ebscohost.com/login.aspx?direct=true&db=fua&AN=88269613&lang=es&site=ehost-live Organización Panamericana S, Protección Social M. Regulación de la Enfermería en América Latina [Internet]. 56. 2011. 61-76 p. Available from: http://www.paho.org/hq/index.php?option=com_docman&task=doc_view&gid=16768&Itemid=721&lang =en Jiménez- Garrote J. Fundamentación Ética en el Paciente Psiquiátrico. Rev Bioética [Internet]. 2007 [consultado 09 de octubre de 2017] 7 (2), 16-19 Disponible en: http://www.cbioetica.org/revista/72/721619.pdf Tamyres-Araújo AD, Rocha-Pires L, Pedrería-Silva L, Caje Mora LV, C. M. Physical restraint in patients in intensive care units: Exploratory. Rev Online Brazilian Journal of Nursing [Internet]. 2017 [consultado 16 de noviembre de 2017] Disponible en: https://bibliobd.udca.edu.co:2118/docview/1958788754/9C28A615DDFC46E6PQ/1?accountid=47900 Fernández Rodríguez Á, Zabala Blanco J. Restricción física: Revisión y reflexión ética. Gerokomos. 2014;25(2):63–7. Guevara-Narváez C., Escobar-Córdoba FE, Fontecha J. Restricción en pacientes agitados atendidos en unidades de cuidado médico primario. Rev de La Facultad De Medicina [Internet]. 2004 [consultado 02 de diciembre de 2017]; 52(3), 199-211. Disponible en: https://search.proquest.com/docview/1677568895?accountid=47900 Luengas-Ramírez LM. Medidas de Sujeción en Pacientes Hospitalizados. Rev Actualizaciones en enfermería [Internet]. 2007 [consultado 02 de diciembre de 2017]; 10(2):28-30. Disponible en: https://encolombia.com/medicina/revistas-medicas/enfermeria/ve-102/medidasdesujecion/ Sastre-Rus M, Campaña-Castillo F. Contención mecánica: definición conceptual. Rev [Internet]. 2014 [consultado 02 de diciembre de 2017]; 8( 1 ). Disponible en: http://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S1988-348X2014000100007&lng=es. http://dx.doi.org/10.4321/S1988-348X2014000100007. Martínez A. ¿ Contención Física O Castigo? Un Recorte Histórico De Sus Antecedentes. V Congr Int Investig y Práctica Prof en Psicol XX Jornadas Investiación Noveno Encuentro Investig en Psicol del MERCOSUR Fac Psicol - Univ Buenos Aires [Internet]. 2013;95–7. Available from: http://www.aacademica.com/000-054/295%5CnActa Korkeila H, Koivisto AM, Paavilainen E, Kylmä J. Psychiatric Nurses’ Emotional and Ethical Experiences Regarding Seclusion and Restraint. Issues Ment Health Nurs. 2016;37(7):464–75. Pettit SA, Bowers L, Tulloch A, Cullen AE, Moylan LB, Sethi F, et al. Acceptability and use of coercive methods across differing service configurations with and without seclusion and/or psychiatric intensive care units. J Adv Nurs. 2017; Korkeila H, Koivisto AM, Paavilainen E, Kylmä J. Psychiatric Nurses’ Emotional and Ethical Experiences Regarding Seclusion and Restraint. Issues Ment Health Nurs. 2016;37(7):464–75. McCann T V., Baird J, Muir-Cochrane E. Attitudes of clinical staff toward the causes and management of aggression in acute old age psychiatry inpatient units. BMC Psychiatry. 2014;14(1). Nenadović M, Katanić M, Tocilovac-Nina M, Kostić V, Peruncić M, Simonović P, et al. Most common diagnoses requiring physical restriction of psychiatric patients: humanity at the test. Srp Arh Celok Lek. 2011; Carr PG. The use of mechanical restraint in mental health: A catalyst for change? J Psychiatr Ment Health Nurs. 2012; Landeweer EGM, Abma TA, Widdershoven GAM. The essence of psychiatric nursing: Redefining nurses’ identity through moral dialogue about reducing the use of coercion and restraint. Adv Nurs Sci. 2010; Sacks MH, Walton MF. Seclusion and Restraint as Measures of the Quality of Hospital Care: Any Exceptions? Psychiatr Serv. 2014; Steinert T, Lepping P, Bernhardsgrütter R, Conca A, Hatling T, Janssen W, et al. Incidence of seclusion and restraint in psychiatric hospitals: a literature review and survey of international trends. Social psychiatry and psychiatric epidemiology. 2010 Vítolo F. Inmovilización física y contención racional de pacientes. Biblio Virtu NOBLE. 2013;(4):1– 15. Hernández Figaredo Pablo. Psychiatry and Medical Ethics. Rev Hum Med [Internet]. 2007 Ago [citado 2018 Mar 27] ; 7( 2 ): . Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S1727- 81202007000200001&lng=es. Strout TD. Perspectives on the experience of being physically restrained: An integrative review of the qualitative literature. Int J Ment Health Nurs 2010;19(6):416-427. Jalil R, Huber JW, Sixsmith J, Dickens GL. Mental health nurses’ emotions, exposure to patient aggression, attitudes to and use of coercive measures: Cross sectional questionnaire survey. Int J Nurs Stud. 2017 Lam K, Kwan JSK, Wai Kwan C, Chong AML, Lai CKY, Lou VWQ, et al. Factors Associated With the Trend of Physical and Chemical Restraint Use Among Long-Term Care Facility Residents in Hong Kong: Data From an 11-Year Observational Study. J Am Med Dir Assoc. 2017; Kuivalainen S, Vehviläinen-Julkunen K, Louheranta O, Putkonen A, Repo-Tiihonen E, Tiihonen J. Seasonal variation of hospital violence, seclusion and restraint in a forensic psychiatric hospital. Int J Law Psychiatry. 2017; Simpson SA, Joesch JM, West II, Pasic J. Risk for physical restraint or seclusion in the psychiatric emergency service (PES). Gen Hosp Psychiatry. 2014; Graziani K, Vedana G, Maria Da Silva D, Aparecida C, Ventura A, Cristina B, et al. Physical and mechanical restraint in psychiatric units: Perceptions and experiences of nursing staff. Arch Psychiatr Nurs [Internet]. 2017;1–0. Available from: https://doi.org/10.1016/j.apnu.2017.11.027 Organización de las Naciones Unidas. La Declaración Universal de Derechos Humanos 1998 http://www.un.org/es/universal-declaration-human-rights/ Republica de Colombia. Congreso de Colombia. Ley 911 de 2004, octubre 4, por la cual se dictan disposiciones en materia de responsabilidad deontológica para el ejercicio de la profesión de Enfermería en Colombia; se establece el régimen disciplinario correspondiente y se dictan otras disposiciones. [Internet]. [Consultado 25 de abril de 2018]. Disponible en: https://www.mineducacion.gov.co/1621/articles-105034_archivo_pdf.pdf Republica de Colombia. Congreso de Colombia. Ley 1616 de 2013, enero 21, por medio de la cual se expide la ley de salud mental y se dictan otras disposiciones". [Internet]. [Consultado 25 de abril de 2018]. Disponible en: http://wsp.presidencia.gov.co/Normativa/Leyes/Documents/2013/LEY%201616%20DEL%2021%20DE% 20ENERO%20DE%202013.pdf Guzman-Parra J, Aguilera Serrano C, García-Sánchez JA, Pino-Benítez I, Alba-Vallejo M, MorenoKüstner B, et al. Effectiveness of a Multimodal Intervention Program for Restraint Prevention in an Acute Spanish Psychiatric Ward. J Am Psychiatr Nurses Assoc. 2016; Perkins E, Prosser H, Riley D, Whittington R. Physical restraint in a therapeutic setting; a necessary evil? Int J Law Psychiatry. 2012 D. Winkler, A. Naderi-Heiden, A. Strnad, E. Pjrek, J. Scharfetter, S. Kasper, R. Frey, Intensive care in psychiatry, In European Psychiatry, Volume 26, Issue 4, 2011, Pages 260-264, ISSN 0924-9338, https://doi.org/10.1016/j.eurpsy.2010.10.008. (http://www.sciencedirect.com/science/article/pii/S0924933810002245) Xiang YT, Sha S, Zhang QE, Wu PP, Jin X. Physical restraint for psychiatric patients and its associations with clinical characteristics and the National Mental Health Law in China. Psychiatry Res. 2016 Choe K, Song EJ, Jung CH. Ethical Problems Experienced by Psychiatric Nurses in Korea. Arch Psychiatr Nurs. 2012; Reitan SK, Helvik AS, Iversen V. Use of mechanical and pharmacological restraint over an eight-year period and its relation to clinical factors. Nord J Psychiatry. 2018 Lejman E, Westerbotn M, Pöder U, Wadensten B. The ethics of coercive treatment of people with dementia. Nursing Ethics. 2013 Tranvåg O, Petersen KA, Nåden D. Dignity-preserving dementia care: A metasynthesis. Nurs Ethics. 2013; Van Doeselaar M, Sleegers P, Hutschemaekers G. Professionals’ attitudes toward reducing restraint: The case of seclusion in The Netherlands. Psychiatr Q. 2008; Yamamoto M, Aso Y. Placing physical restraints on older people with dementia. Nurs Ethics. 2009; Gaskin CJ1, Elsom SJ, Happell B. (2007) Interventions for reducing the use of seclusion in psychiatric facilities: review of the literature. Br J Psychiatry. 2007 Oct;191:298-303. 10.1192/bjp.bp.106.034538 Husum, T. L., Bjørngaard, J. H., Finset, A., & Ruud, T. (2010). A cross-sectional prospective study of seclusion, restraint and involuntary medication in acute psychiatric wards: Patient, staff and ward characteristics. BMC Health Services Research, 10, 89. doi:http://dx.doi.org/10.1186/1472-6963-10-89 De Benedictis, L., Dumais, A., Sieu, N., Mailhot, M., Létourneau, G., Tran, M. M., . . . Lesage, A. D. (2011). Staff perceptions and organizational factors as predictors of seclusion and restraint on psychiatric wards. Psychiatric Services, 62(5), 484-91. Retrieved from https://search.proquest.com/docview/865201819?accountid=47900 Goulet M-H, Larue C, Stafford M-C, Dumais A. Profiles of Patients Admitted to a Psychiatric Intensive Care Unit: Secluded with or without Restraint. Can J Psychiatry. 2013; Zwijsen SA, Smalbrugge M, Zuidema SU, Koopmans RT, Bosmans JE, Van Tulder MW, et al. Grip on challenging behaviour: A multidisciplinary care programme for managing behavioural problems in nursing home residents with dementia. Study protocol. BMC Health Serv Res. 2011; Bowers L, Nijman H, Simpson A, Jones J. The relationship between leadership, teamworking, structure, burnout and attitude to patients on acute psychiatric wards. Soc Psychiatry Psychiatr Epidemiol. 2011; Fariña-López E, Estévez-Guerra GJ, Gandoy-Crego M, Polo-Luque LM, Gómez-Cantorna C, Capezuti EA. Perception of Spanish nursing staff on the use of physical restraints. J Nurs Scholarsh. 2014; Molewijk B, Kok A, Husum T, Pedersen R, Aasland O. Staff’s normative attitudes towards coercion: The role of moral doubt and professional context - A cross-sectional survey study. BMC Med Ethics. 2017; Huf G, Coutinho ESF, Adams CE. Physical restraints versus seclusion room for management of people with acute aggression or agitation due to psychotic illness (TREC-SAVE): A randomized trial. Psychol Med. 2012; Cleary M, Hunt GE, Walter G. Seclusion and its context in acute inpatient psychiatric care. J Med Ethics. 2010;36(8):459–62. Vuckovich PK, Artinian BM. Ustifying oercion. 2005;12(4). Bowers L, Nijman H, Simpson A, Jones J. The relationship between leadership, teamworking, structure, burnout and attitude to patients on acute psychiatric wards. Soc Psychiatry Psychiatr Epidemiol. 2011; Carr PG. The use of mechanical restraint in mental health: A catalyst for change? J Psychiatr Ment Health Nurs. 2012; Choe K, Song EJ, Jung CH. Ethical Problems Experienced by Psychiatric Nurses in Korea. Arch Psychiatr Nurs. 2012; Cleary M, Hunt GE, Walter G. Seclusion and its context in acute inpatient psychiatric care. J Med Ethics. 2010;36(8):459–62. D. Winkler, A. Naderi-Heiden, A. Strnad, E. Pjrek, J. Scharfetter, S. Kasper, R. Frey, Intensive care in psychiatry, In European Psychiatry, Volume 26, Issue 4, 2011, Pages 260-264, ISSN 0924-9338, https://doi.org/10.1016/j.eurpsy.2010.10.008. (http://www.sciencedirect.com/science/article/pii/S0924933810002245) De Benedictis, L., Dumais, A., Sieu, N., Mailhot, M., Létourneau, G., Tran, M. M., . . . Lesage, A. D. (2011). Staff perceptions and organizational factors as predictors of seclusion and restraint on psychiatric wards. Psychiatric Services, 62(5), 484-91. Retrieved from https://search.proquest.com/docview/865201819?accountid=47900 Fariña-López E, Estévez-Guerra GJ, Gandoy-Crego M, Polo-Luque LM, Gómez-Cantorna C, Capezuti EA. Perception of Spanish nursing staff on the use of physical restraints. J Nurs Scholarsh. 2014; Fernández Rodríguez Á, Zabala Blanco J. Restricción física: Revisión y reflexión ética. Gerokomos. 2014;25(2):63–7. Garzón. N. Toma de decisiones Éticas. En Peña, B Ética y bioética: memorias cátedra Manuel Ancízar. División Académica y Cultural. Bogotá. Editorial 2001. p. 171-190 Gaskin CJ1, Elsom SJ, Happell B. (2007) Interventions for reducing the use of seclusion in psychiatric facilities: review of the literature. Br J Psychiatry. 2007 Oct;191:298-303. 10.1192/bjp.bp.106.034538 Goulet M-H, Larue C, Stafford M-C, Dumais A. Profiles of Patients Admitted to a Psychiatric Intensive Care Unit: Secluded with or without Restraint. Can J Psychiatry. 2013; Graziani K, Vedana G, Maria Da Silva D, Aparecida C, Ventura A, Cristina B, et al. Physical and mechanical restraint in psychiatric units: Perceptions and experiences of nursing staff. Arch Psychiatr Nurs [Internet]. 2017;1–0. Available from: https://doi.org/10.1016/j.apnu.2017.11.027 Guevara-Narváez C., Escobar-Córdoba FE, Fontecha J. Restricción en pacientes agitados atendidos en unidades de cuidado médico primario. Rev de La Facultad De Medicina [Internet]. 2004 [consultado 02 de diciembre de 2017]; 52(3), 199-211. Disponible en: https://search.proquest.com/docview/1677568895?accountid=47900 Guzman-Parra J, Aguilera Serrano C, García-Sánchez JA, Pino-Benítez I, Alba-Vallejo M, Moreno-Küstner B, et al. Effectiveness of a Multimodal Intervention Program for Restraint Prevention in an Acute Spanish Psychiatric Ward. J Am Psychiatr Nurses Assoc. 2016; Hernández Figaredo Pablo. Psychiatry and Medical Ethics. Rev Hum Med [Internet]. 2007 Ago [citado 2018 Mar 27] ; 7( 2 ): . Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S1727- 81202007000200001&lng=es. Huf G, Coutinho ESF, Adams CE. Physical restraints versus seclusion room for management of people with acute aggression or agitation due to psychotic illness (TREC-SAVE): A randomized trial. Psychol Med. 2012; Husum, T. L., Bjørngaard, J. H., Finset, A., & Ruud, T. (2010). A cross-sectional prospective study of seclusion, restraint and involuntary medication in acute psychiatric wards: Patient, staff and ward characteristics. BMC Health Services Research, 10, 89. doi:http://dx.doi.org/10.1186/1472-6963-10-89 Jalil R, Huber JW, Sixsmith J, Dickens GL. Mental health nurses’ emotions, exposure to patient aggression, attitudes to and use of coercive measures: Cross sectional questionnaire survey. Int J Nurs Stud. 2017 Jiménez- Garrote J. Fundamentación Ética en el Paciente Psiquiátrico. Rev Bioética [Internet]. 2007 [consultado 09 de octubre de 2017] 7 (2), 16-19 Disponible en: http://www.cbioetica.org/revista/72/721619.pdf Korkeila H, Koivisto AM, Paavilainen E, Kylmä J. Psychiatric Nurses’ Emotional and Ethical Experiences Regarding Seclusion and Restraint. Issues Ment Health Nurs. 2016;37(7):464–75. Kuivalainen S, Vehviläinen-Julkunen K, Louheranta O, Putkonen A, Repo-Tiihonen E, Tiihonen J. Seasonal variation of hospital violence, seclusion and restraint in a forensic psychiatric hospital. Int J Law Psychiatry. 2017; Lam K, Kwan JSK, Wai Kwan C, Chong AML, Lai CKY, Lou VWQ, et al. Factors Associated With the Trend of Physical and Chemical Restraint Use Among Long-Term Care Facility Residents in Hong Kong: Data From an 11-Year Observational Study. J Am Med Dir Assoc. 2017; Landeweer EGM, Abma TA, Widdershoven GAM. The essence of psychiatric nursing: Redefining nurses’ identity through moral dialogue about reducing the use of coercion and restraint. Adv Nurs Sci. 2010; Lejman E, Westerbotn M, Pöder U, Wadensten B. The ethics of coercive treatment of people with dementia. Nursing Ethics. 2013 Luengas-Ramírez LM. Medidas de Sujeción en Pacientes Hospitalizados. Rev Actualizaciones en enfermería [Internet]. 2007 [consultado 02 de diciembre de 2017]; 10(2):28-30. Disponible en: https://encolombia.com/medicina/revistas-medicas/enfermeria/ve-102/medidasdesujecion/ Martínez A. ¿ Contención Física O Castigo? Un Recorte Histórico De Sus Antecedentes. V Congr Int Investig y Práctica Prof en Psicol XX Jornadas Investiación Noveno Encuentro Investig en Psicol del MERCOSUR Fac Psicol - Univ Buenos Aires [Internet]. 2013;95–7. Available from: http://www.aacademica.com/000-054/295%5CnActa McCann T V., Baird J, Muir-Cochrane E. Attitudes of clinical staff toward the causes and management of aggression in acute old age psychiatry inpatient units. BMC Psychiatry. 2014;14(1). Molewijk B, Kok A, Husum T, Pedersen R, Aasland O. Staff’s normative attitudes towards coercion: The role of moral doubt and professional context - A cross-sectional survey study. BMC Med Ethics. 2017; Nenadović M, Katanić M, Tocilovac-Nina M, Kostić V, Peruncić M, Simonović P, et al. Most common diagnoses requiring physical restriction of psychiatric patients: humanity at the test. Srp Arh Celok Lek. 2011; Organización de las Naciones Unidas. La Declaración Universal de Derechos Humanos 1998 http://www.un.org/es/universal-declaration-human-rights/ Organización Panamericana S, Protección Social M. Regulación de la Enfermería en América Latina [Internet]. 56. 2011. 61-76 p. Available from: http://www.paho.org/hq/index.php?option=com_docman&task=doc_view&gid=16768&Itemid=721&lang =en Perkins E, Prosser H, Riley D, Whittington R. Physical restraint in a therapeutic setting; a necessary evil? Int J Law Psychiatry. 2012 Pettit SA, Bowers L, Tulloch A, Cullen AE, Moylan LB, Sethi F, et al. Acceptability and use of coercive methods across differing service configurations with and without seclusion and/or psychiatric intensive care units. J Adv Nurs. 2017; Piñón Gaytán F. El problema ético en la filosofía de Kant. (Spanish). Política y Cult [Internet]. 2013;(39):99–112. Available from: http://search.ebscohost.com/login.aspx?direct=true&db=fua&AN=88269613&lang=es&site=ehost-live Reitan SK, Helvik AS, Iversen V. Use of mechanical and pharmacological restraint over an eight-year period and its relation to clinical factors. Nord J Psychiatry. 2018 República de Colombia. Congreso de Colombia. Ley 1616 de 2013, enero 21, por medio de la cual se expide la ley de salud mental y se dictan otras disposiciones". [Internet]. [Consultado 25 de abril de 2018]. Disponible en: http://wsp.presidencia.gov.co/Normativa/Leyes/Documents/2013/LEY%201616%20DEL%2021%20DE% 20ENERO%20DE%202013.pdf República de Colombia. Congreso de Colombia. Ley 911 de 2004, octubre 4, por la cual se dictan disposiciones en materia de responsabilidad deontológica para el ejercicio de la profesión de Enfermería en Colombia; se establece el régimen disciplinario correspondiente y se dictan otras disposiciones. [Internet]. [Consultado 25 de abril de 2018]. Disponible en: https://www.mineducacion.gov.co/1621/articles-105034_archivo_pdf.pdf Sacks MH, Walton MF. Seclusion and Restraint as Measures of the Quality of Hospital Care: Any Exceptions? Psychiatr Serv. 2014; Sastre-Rus M, Campaña-Castillo F. Contención mecánica: definición conceptual. Rev [Internet]. 2014 [consultado 02 de diciembre de 2017]; 8( 1 ). Disponible en: http://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S1988-348X2014000100007&lng=es. http://dx.doi.org/10.4321/S1988-348X2014000100007. Simpson SA, Joesch JM, West II, Pasic J. Risk for physical restraint or seclusion in the psychiatric emergency service (PES). Gen Hosp Psychiatry. 2014; Steinert T, Lepping P, Bernhardsgrütter R, Conca A, Hatling T, Janssen W, et al. Incidence of seclusion and restraint in psychiatric hospitals: a literature review and survey of international trends. Social psychiatry and psychiatric epidemiology. 2010 Strout TD. Perspectives on the experience of being physically restrained: An integrative review of the qualitative literature. Int J Ment Health Nurs 2010;19(6):416-427. Tamyres-Araújo AD, Rocha-Pires L, Pedrería-Silva L, Caje Mora LV, C. M. Physical restraint in patients in intensive care units: Exploratory. Rev Online Brazilian Journal of Nursing [Internet]. 2017 [consultado 16 de noviembre de 2017] Disponible en: https://bibliobd.udca.edu.co:2118/docview/1958788754/9C28A615DDFC46E6PQ/1?accountid=47900 Tranvåg O, Petersen KA, Nåden D. Dignity-preserving dementia care: A metasynthesis. Nurs Ethics. 2013; Van Doeselaar M, Sleegers P, Hutschemaekers G. Professionals’ attitudes toward reducing restraint: The case of seclusion in The Netherlands. Psychiatr Q. 2008; Vítolo F. Inmovilización física y contención racional de pacientes. Biblio Virtu NOBLE. 2013;(4):1–15. Vuckovich PK, Artinian BM. Ustifying oercion. 2005;12(4). Xiang YT, Sha S, Zhang QE, Wu PP, Jin X. Physical restraint for psychiatric patients and its associations with clinical characteristics and the National Mental Health Law in China. Psychiatry Res. 2016 Yamamoto M, Aso Y. Placing physical restraints on older people with dementia. Nurs Ethics. 2009; Zwijsen SA, Smalbrugge M, Zuidema SU, Koopmans RT, Bosmans JE, Van Tulder MW, et al. Grip on challenging behaviour: A multidisciplinary care programme for managing behavioural problems in nursing home residents with dementia. Study protocol. BMC Health Serv Res. 2011; |
| dc.rights.spa.fl_str_mv |
Derechos Reservados - Universidad de Ciencias Aplicadas y Ambientales |
| dc.rights.coar.fl_str_mv |
http://purl.org/coar/access_right/c_abf2 |
| dc.rights.uri.spa.fl_str_mv |
https://creativecommons.org/licenses/by-nc-sa/4.0/ |
| dc.rights.accessrights.spa.fl_str_mv |
info:eu-repo/semantics/openAccess |
| dc.rights.creativecommons.spa.fl_str_mv |
Atribución-NoComercial-CompartirIgual 4.0 Internacional (CC BY-NC-SA 4.0) |
| rights_invalid_str_mv |
Derechos Reservados - Universidad de Ciencias Aplicadas y Ambientales https://creativecommons.org/licenses/by-nc-sa/4.0/ Atribución-NoComercial-CompartirIgual 4.0 Internacional (CC BY-NC-SA 4.0) http://purl.org/coar/access_right/c_abf2 |
| eu_rights_str_mv |
openAccess |
| dc.format.mimetype.spa.fl_str_mv |
application/pdf |
| dc.publisher.faculty.spa.fl_str_mv |
Facultad de Ciencias de la Salud |
| dc.publisher.program.spa.fl_str_mv |
Enfermería |
| institution |
Universidad de Ciencias Aplicadas y Ambientales U.D.C.A |
| bitstream.url.fl_str_mv |
https://repository.udca.edu.co/bitstreams/621d15de-4412-4171-a0fe-cd0a98531d70/download https://repository.udca.edu.co/bitstreams/30ef38ac-79e8-4d76-90f4-525947c90e8d/download https://repository.udca.edu.co/bitstreams/52b0f9c4-bf93-41aa-a0d4-6ebb42eaded2/download https://repository.udca.edu.co/bitstreams/475a2dcf-800f-45a7-a275-1c9636fc5f54/download |
| bitstream.checksum.fl_str_mv |
41293f0350dbfe696bba95a9aacaa536 f661acf14bedbf9f5d13897a0387e751 ab73266d953c65e188c9fb805493f3df 46a81b2e699357234b1e047f5a32072c |
| bitstream.checksumAlgorithm.fl_str_mv |
MD5 MD5 MD5 MD5 |
| repository.name.fl_str_mv |
Repositorio - Universidad de Ciencias Aplicadas y Ambientales UDCA. |
| repository.mail.fl_str_mv |
bdigital@metabiblioteca.com |
| _version_ |
1814213302708862976 |
| spelling |
Coral Ibarra, Rosa del Carmen, dir.Ardila Salamanca, Kelly Geraldine2018-08-29T14:02:30Z2018-08-29T14:02:30Z2018https://repository.udca.edu.co/handle/11158/924ENF006 A72c 201823 páginasRestraint patients is a method that is used in mental health settings, it has generated controversy and has been banned in some countries. It is used to control aggressive behaviors of patients. In many cases, it is done without the consent of relatives or the patient. Aims: To identify the ethical considerations of the nursing professional in decision-making in the face of the physical restriction of patients with mental illness. Methodology: We searched the databases: ProQuest, Scopus, Science Direct and PubMed. We used the keyword "restraint" and the Descriptors in Health Sciences (DeCs): Ethics "," Nursing "," Mental disorders ". The inclusion criteria were: articles published between 2010 and 2017, in the languages: English, Spanish and Portuguese and this information was analyzed in categories of analysis. Results: Three categories were identified: Ethical problems before the restriction method, Attitudes towards this method and Support mechanisms that they use. Conclusions: The restriction of patients with mental illness generates ethical conflicts in nursing professionals. Different support mechanisms are required to make assertive decisions regarding the use of this methodLa restricción de pacientes, es un método que se usa en los entornos de salud mental, ha generado controversia y ha sido prohibido en algunos países. Se usa para controlar comportamientos agresivos de los pacientes. En muchos de los casos se realiza sin consentimiento de familiares o del propio paciente. Objetivo: Identificar las consideraciones éticas del profesional de enfermería en la toma de decisiones frente a la restricción física de pacientes con enfermedad mental. Metodología: Se realizó la búsqueda en las bases de datos: ProQuest, Scopus, Science Direct y PubMed. Se utilizó la palabra clave “restraint” y los Descriptores en Ciencias de la Salud (DeCs): Ethics”, “Nursing”, “Mental disorders”. Los criterios de inclusión fueron: artículos publicados entre los años 2010 a 2017, en los idiomas: inglés, español y portugués y se analizó esta información en categorías de análisis. Resultados: Se identificaron 3 categorías: Problemas éticos ante el método de restricción, Actitudes frente a este método y Mecanismos de apoyo que se utilizan. Conclusiones: La restricción de pacientes con enfermedad mental genera conflictos éticos en los profesionales de enfermería. Se requiere de diferentes mecanismos de apoyo para la toma de decisiones asertivas frente a la utilización de este métodoPregradoEnfermero(a)application/pdfspaDerechos Reservados - Universidad de Ciencias Aplicadas y Ambientaleshttps://creativecommons.org/licenses/by-nc-sa/4.0/info:eu-repo/semantics/openAccessAtribución-NoComercial-CompartirIgual 4.0 Internacional (CC BY-NC-SA 4.0)http://purl.org/coar/access_right/c_abf2Consideraciones éticas en la restricción de pacientes con trastorno mentalTrabajo de grado - Pregradohttp://purl.org/coar/resource_type/c_7a1finfo:eu-repo/semantics/bachelorThesisinfo:eu-repo/semantics/publishedVersionTexthttp://purl.org/redcol/resource_type/TPhttp://purl.org/coar/version/c_970fb48d4fbd8a85Trastornos mentalesEnfermería - Etica profesionalEnfermeríaEnfermeríaEticaTrastorno mentalAlvarado García A. La ética del cuidado. Rev Aquichán, [Internet]. 2004 [consultado 09 de octubre de 2017]; 4(1), 30-39. Disponible en: http://www.scielo.org.co/scielo.php?script=sci_arttext&pid=S1657- 59972004000100005&lng=en&tlng=es.Garzón. N. Toma de decisiones Éticas. En Peña, B Ética y bioética: memorias cátedra Manuel Ancízar. División Académica y Cultural. Bogotá. Editorial 2001. p. 171-190Piñón Gaytán F. El problema ético en la filosofía de Kant. (Spanish). Política y Cult [Internet]. 2013;(39):99–112. Available from: http://search.ebscohost.com/login.aspx?direct=true&db=fua&AN=88269613&lang=es&site=ehost-liveOrganización Panamericana S, Protección Social M. Regulación de la Enfermería en América Latina [Internet]. 56. 2011. 61-76 p. Available from: http://www.paho.org/hq/index.php?option=com_docman&task=doc_view&gid=16768&Itemid=721&lang =enJiménez- Garrote J. Fundamentación Ética en el Paciente Psiquiátrico. Rev Bioética [Internet]. 2007 [consultado 09 de octubre de 2017] 7 (2), 16-19 Disponible en: http://www.cbioetica.org/revista/72/721619.pdfTamyres-Araújo AD, Rocha-Pires L, Pedrería-Silva L, Caje Mora LV, C. M. Physical restraint in patients in intensive care units: Exploratory. Rev Online Brazilian Journal of Nursing [Internet]. 2017 [consultado 16 de noviembre de 2017] Disponible en: https://bibliobd.udca.edu.co:2118/docview/1958788754/9C28A615DDFC46E6PQ/1?accountid=47900Fernández Rodríguez Á, Zabala Blanco J. Restricción física: Revisión y reflexión ética. Gerokomos. 2014;25(2):63–7.Guevara-Narváez C., Escobar-Córdoba FE, Fontecha J. Restricción en pacientes agitados atendidos en unidades de cuidado médico primario. Rev de La Facultad De Medicina [Internet]. 2004 [consultado 02 de diciembre de 2017]; 52(3), 199-211. Disponible en: https://search.proquest.com/docview/1677568895?accountid=47900Luengas-Ramírez LM. Medidas de Sujeción en Pacientes Hospitalizados. Rev Actualizaciones en enfermería [Internet]. 2007 [consultado 02 de diciembre de 2017]; 10(2):28-30. Disponible en: https://encolombia.com/medicina/revistas-medicas/enfermeria/ve-102/medidasdesujecion/Sastre-Rus M, Campaña-Castillo F. Contención mecánica: definición conceptual. Rev [Internet]. 2014 [consultado 02 de diciembre de 2017]; 8( 1 ). Disponible en: http://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S1988-348X2014000100007&lng=es. http://dx.doi.org/10.4321/S1988-348X2014000100007.Martínez A. ¿ Contención Física O Castigo? Un Recorte Histórico De Sus Antecedentes. V Congr Int Investig y Práctica Prof en Psicol XX Jornadas Investiación Noveno Encuentro Investig en Psicol del MERCOSUR Fac Psicol - Univ Buenos Aires [Internet]. 2013;95–7. Available from: http://www.aacademica.com/000-054/295%5CnActaKorkeila H, Koivisto AM, Paavilainen E, Kylmä J. Psychiatric Nurses’ Emotional and Ethical Experiences Regarding Seclusion and Restraint. Issues Ment Health Nurs. 2016;37(7):464–75.Pettit SA, Bowers L, Tulloch A, Cullen AE, Moylan LB, Sethi F, et al. Acceptability and use of coercive methods across differing service configurations with and without seclusion and/or psychiatric intensive care units. J Adv Nurs. 2017;Korkeila H, Koivisto AM, Paavilainen E, Kylmä J. Psychiatric Nurses’ Emotional and Ethical Experiences Regarding Seclusion and Restraint. Issues Ment Health Nurs. 2016;37(7):464–75.McCann T V., Baird J, Muir-Cochrane E. Attitudes of clinical staff toward the causes and management of aggression in acute old age psychiatry inpatient units. BMC Psychiatry. 2014;14(1).Nenadović M, Katanić M, Tocilovac-Nina M, Kostić V, Peruncić M, Simonović P, et al. Most common diagnoses requiring physical restriction of psychiatric patients: humanity at the test. Srp Arh Celok Lek. 2011;Carr PG. The use of mechanical restraint in mental health: A catalyst for change? J Psychiatr Ment Health Nurs. 2012;Landeweer EGM, Abma TA, Widdershoven GAM. The essence of psychiatric nursing: Redefining nurses’ identity through moral dialogue about reducing the use of coercion and restraint. Adv Nurs Sci. 2010;Sacks MH, Walton MF. Seclusion and Restraint as Measures of the Quality of Hospital Care: Any Exceptions? Psychiatr Serv. 2014;Steinert T, Lepping P, Bernhardsgrütter R, Conca A, Hatling T, Janssen W, et al. Incidence of seclusion and restraint in psychiatric hospitals: a literature review and survey of international trends. Social psychiatry and psychiatric epidemiology. 2010Vítolo F. Inmovilización física y contención racional de pacientes. Biblio Virtu NOBLE. 2013;(4):1– 15.Hernández Figaredo Pablo. Psychiatry and Medical Ethics. Rev Hum Med [Internet]. 2007 Ago [citado 2018 Mar 27] ; 7( 2 ): . Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S1727- 81202007000200001&lng=es.Strout TD. Perspectives on the experience of being physically restrained: An integrative review of the qualitative literature. Int J Ment Health Nurs 2010;19(6):416-427.Jalil R, Huber JW, Sixsmith J, Dickens GL. Mental health nurses’ emotions, exposure to patient aggression, attitudes to and use of coercive measures: Cross sectional questionnaire survey. Int J Nurs Stud. 2017Lam K, Kwan JSK, Wai Kwan C, Chong AML, Lai CKY, Lou VWQ, et al. Factors Associated With the Trend of Physical and Chemical Restraint Use Among Long-Term Care Facility Residents in Hong Kong: Data From an 11-Year Observational Study. J Am Med Dir Assoc. 2017;Kuivalainen S, Vehviläinen-Julkunen K, Louheranta O, Putkonen A, Repo-Tiihonen E, Tiihonen J. Seasonal variation of hospital violence, seclusion and restraint in a forensic psychiatric hospital. Int J Law Psychiatry. 2017;Simpson SA, Joesch JM, West II, Pasic J. Risk for physical restraint or seclusion in the psychiatric emergency service (PES). Gen Hosp Psychiatry. 2014;Graziani K, Vedana G, Maria Da Silva D, Aparecida C, Ventura A, Cristina B, et al. Physical and mechanical restraint in psychiatric units: Perceptions and experiences of nursing staff. Arch Psychiatr Nurs [Internet]. 2017;1–0. Available from: https://doi.org/10.1016/j.apnu.2017.11.027Organización de las Naciones Unidas. La Declaración Universal de Derechos Humanos 1998 http://www.un.org/es/universal-declaration-human-rights/Republica de Colombia. Congreso de Colombia. Ley 911 de 2004, octubre 4, por la cual se dictan disposiciones en materia de responsabilidad deontológica para el ejercicio de la profesión de Enfermería en Colombia; se establece el régimen disciplinario correspondiente y se dictan otras disposiciones. [Internet]. [Consultado 25 de abril de 2018]. Disponible en: https://www.mineducacion.gov.co/1621/articles-105034_archivo_pdf.pdfRepublica de Colombia. Congreso de Colombia. Ley 1616 de 2013, enero 21, por medio de la cual se expide la ley de salud mental y se dictan otras disposiciones". [Internet]. [Consultado 25 de abril de 2018]. Disponible en: http://wsp.presidencia.gov.co/Normativa/Leyes/Documents/2013/LEY%201616%20DEL%2021%20DE% 20ENERO%20DE%202013.pdfGuzman-Parra J, Aguilera Serrano C, García-Sánchez JA, Pino-Benítez I, Alba-Vallejo M, MorenoKüstner B, et al. Effectiveness of a Multimodal Intervention Program for Restraint Prevention in an Acute Spanish Psychiatric Ward. J Am Psychiatr Nurses Assoc. 2016;Perkins E, Prosser H, Riley D, Whittington R. Physical restraint in a therapeutic setting; a necessary evil? Int J Law Psychiatry. 2012D. Winkler, A. Naderi-Heiden, A. Strnad, E. Pjrek, J. Scharfetter, S. Kasper, R. Frey, Intensive care in psychiatry, In European Psychiatry, Volume 26, Issue 4, 2011, Pages 260-264, ISSN 0924-9338, https://doi.org/10.1016/j.eurpsy.2010.10.008. (http://www.sciencedirect.com/science/article/pii/S0924933810002245)Xiang YT, Sha S, Zhang QE, Wu PP, Jin X. Physical restraint for psychiatric patients and its associations with clinical characteristics and the National Mental Health Law in China. Psychiatry Res. 2016Choe K, Song EJ, Jung CH. Ethical Problems Experienced by Psychiatric Nurses in Korea. Arch Psychiatr Nurs. 2012;Reitan SK, Helvik AS, Iversen V. Use of mechanical and pharmacological restraint over an eight-year period and its relation to clinical factors. Nord J Psychiatry. 2018Lejman E, Westerbotn M, Pöder U, Wadensten B. The ethics of coercive treatment of people with dementia. Nursing Ethics. 2013Tranvåg O, Petersen KA, Nåden D. Dignity-preserving dementia care: A metasynthesis. Nurs Ethics. 2013;Van Doeselaar M, Sleegers P, Hutschemaekers G. Professionals’ attitudes toward reducing restraint: The case of seclusion in The Netherlands. Psychiatr Q. 2008;Yamamoto M, Aso Y. Placing physical restraints on older people with dementia. Nurs Ethics. 2009;Gaskin CJ1, Elsom SJ, Happell B. (2007) Interventions for reducing the use of seclusion in psychiatric facilities: review of the literature. Br J Psychiatry. 2007 Oct;191:298-303. 10.1192/bjp.bp.106.034538Husum, T. L., Bjørngaard, J. H., Finset, A., & Ruud, T. (2010). A cross-sectional prospective study of seclusion, restraint and involuntary medication in acute psychiatric wards: Patient, staff and ward characteristics. BMC Health Services Research, 10, 89. doi:http://dx.doi.org/10.1186/1472-6963-10-89De Benedictis, L., Dumais, A., Sieu, N., Mailhot, M., Létourneau, G., Tran, M. M., . . . Lesage, A. D. (2011). Staff perceptions and organizational factors as predictors of seclusion and restraint on psychiatric wards. Psychiatric Services, 62(5), 484-91. Retrieved from https://search.proquest.com/docview/865201819?accountid=47900Goulet M-H, Larue C, Stafford M-C, Dumais A. Profiles of Patients Admitted to a Psychiatric Intensive Care Unit: Secluded with or without Restraint. Can J Psychiatry. 2013;Zwijsen SA, Smalbrugge M, Zuidema SU, Koopmans RT, Bosmans JE, Van Tulder MW, et al. Grip on challenging behaviour: A multidisciplinary care programme for managing behavioural problems in nursing home residents with dementia. Study protocol. BMC Health Serv Res. 2011;Bowers L, Nijman H, Simpson A, Jones J. The relationship between leadership, teamworking, structure, burnout and attitude to patients on acute psychiatric wards. Soc Psychiatry Psychiatr Epidemiol. 2011;Fariña-López E, Estévez-Guerra GJ, Gandoy-Crego M, Polo-Luque LM, Gómez-Cantorna C, Capezuti EA. Perception of Spanish nursing staff on the use of physical restraints. J Nurs Scholarsh. 2014;Molewijk B, Kok A, Husum T, Pedersen R, Aasland O. Staff’s normative attitudes towards coercion: The role of moral doubt and professional context - A cross-sectional survey study. BMC Med Ethics. 2017;Huf G, Coutinho ESF, Adams CE. Physical restraints versus seclusion room for management of people with acute aggression or agitation due to psychotic illness (TREC-SAVE): A randomized trial. Psychol Med. 2012;Cleary M, Hunt GE, Walter G. Seclusion and its context in acute inpatient psychiatric care. J Med Ethics. 2010;36(8):459–62.Vuckovich PK, Artinian BM. Ustifying oercion. 2005;12(4).Bowers L, Nijman H, Simpson A, Jones J. The relationship between leadership, teamworking, structure, burnout and attitude to patients on acute psychiatric wards. Soc Psychiatry Psychiatr Epidemiol. 2011;Carr PG. The use of mechanical restraint in mental health: A catalyst for change? J Psychiatr Ment Health Nurs. 2012;Choe K, Song EJ, Jung CH. Ethical Problems Experienced by Psychiatric Nurses in Korea. Arch Psychiatr Nurs. 2012;Cleary M, Hunt GE, Walter G. Seclusion and its context in acute inpatient psychiatric care. J Med Ethics. 2010;36(8):459–62.D. Winkler, A. Naderi-Heiden, A. Strnad, E. Pjrek, J. Scharfetter, S. Kasper, R. Frey, Intensive care in psychiatry, In European Psychiatry, Volume 26, Issue 4, 2011, Pages 260-264, ISSN 0924-9338, https://doi.org/10.1016/j.eurpsy.2010.10.008. (http://www.sciencedirect.com/science/article/pii/S0924933810002245)De Benedictis, L., Dumais, A., Sieu, N., Mailhot, M., Létourneau, G., Tran, M. M., . . . Lesage, A. D. (2011). Staff perceptions and organizational factors as predictors of seclusion and restraint on psychiatric wards. Psychiatric Services, 62(5), 484-91. Retrieved from https://search.proquest.com/docview/865201819?accountid=47900Fariña-López E, Estévez-Guerra GJ, Gandoy-Crego M, Polo-Luque LM, Gómez-Cantorna C, Capezuti EA. Perception of Spanish nursing staff on the use of physical restraints. J Nurs Scholarsh. 2014;Fernández Rodríguez Á, Zabala Blanco J. Restricción física: Revisión y reflexión ética. Gerokomos. 2014;25(2):63–7.Garzón. N. Toma de decisiones Éticas. En Peña, B Ética y bioética: memorias cátedra Manuel Ancízar. División Académica y Cultural. Bogotá. Editorial 2001. p. 171-190 Gaskin CJ1, Elsom SJ, Happell B. (2007) Interventions for reducing the use of seclusion in psychiatric facilities: review of the literature. Br J Psychiatry. 2007 Oct;191:298-303. 10.1192/bjp.bp.106.034538Goulet M-H, Larue C, Stafford M-C, Dumais A. Profiles of Patients Admitted to a Psychiatric Intensive Care Unit: Secluded with or without Restraint. Can J Psychiatry. 2013;Graziani K, Vedana G, Maria Da Silva D, Aparecida C, Ventura A, Cristina B, et al. Physical and mechanical restraint in psychiatric units: Perceptions and experiences of nursing staff. Arch Psychiatr Nurs [Internet]. 2017;1–0. Available from: https://doi.org/10.1016/j.apnu.2017.11.027Guevara-Narváez C., Escobar-Córdoba FE, Fontecha J. Restricción en pacientes agitados atendidos en unidades de cuidado médico primario. Rev de La Facultad De Medicina [Internet]. 2004 [consultado 02 de diciembre de 2017]; 52(3), 199-211. Disponible en: https://search.proquest.com/docview/1677568895?accountid=47900Guzman-Parra J, Aguilera Serrano C, García-Sánchez JA, Pino-Benítez I, Alba-Vallejo M, Moreno-Küstner B, et al. Effectiveness of a Multimodal Intervention Program for Restraint Prevention in an Acute Spanish Psychiatric Ward. J Am Psychiatr Nurses Assoc. 2016;Hernández Figaredo Pablo. Psychiatry and Medical Ethics. Rev Hum Med [Internet]. 2007 Ago [citado 2018 Mar 27] ; 7( 2 ): . Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S1727- 81202007000200001&lng=es.Huf G, Coutinho ESF, Adams CE. Physical restraints versus seclusion room for management of people with acute aggression or agitation due to psychotic illness (TREC-SAVE): A randomized trial. Psychol Med. 2012;Husum, T. L., Bjørngaard, J. H., Finset, A., & Ruud, T. (2010). A cross-sectional prospective study of seclusion, restraint and involuntary medication in acute psychiatric wards: Patient, staff and ward characteristics. BMC Health Services Research, 10, 89. doi:http://dx.doi.org/10.1186/1472-6963-10-89Jalil R, Huber JW, Sixsmith J, Dickens GL. Mental health nurses’ emotions, exposure to patient aggression, attitudes to and use of coercive measures: Cross sectional questionnaire survey. Int J Nurs Stud. 2017Jiménez- Garrote J. Fundamentación Ética en el Paciente Psiquiátrico. Rev Bioética [Internet]. 2007 [consultado 09 de octubre de 2017] 7 (2), 16-19 Disponible en: http://www.cbioetica.org/revista/72/721619.pdfKorkeila H, Koivisto AM, Paavilainen E, Kylmä J. Psychiatric Nurses’ Emotional and Ethical Experiences Regarding Seclusion and Restraint. Issues Ment Health Nurs. 2016;37(7):464–75.Kuivalainen S, Vehviläinen-Julkunen K, Louheranta O, Putkonen A, Repo-Tiihonen E, Tiihonen J. Seasonal variation of hospital violence, seclusion and restraint in a forensic psychiatric hospital. Int J Law Psychiatry. 2017;Lam K, Kwan JSK, Wai Kwan C, Chong AML, Lai CKY, Lou VWQ, et al. Factors Associated With the Trend of Physical and Chemical Restraint Use Among Long-Term Care Facility Residents in Hong Kong: Data From an 11-Year Observational Study. J Am Med Dir Assoc. 2017;Landeweer EGM, Abma TA, Widdershoven GAM. The essence of psychiatric nursing: Redefining nurses’ identity through moral dialogue about reducing the use of coercion and restraint. Adv Nurs Sci. 2010;Lejman E, Westerbotn M, Pöder U, Wadensten B. The ethics of coercive treatment of people with dementia. Nursing Ethics. 2013Luengas-Ramírez LM. Medidas de Sujeción en Pacientes Hospitalizados. Rev Actualizaciones en enfermería [Internet]. 2007 [consultado 02 de diciembre de 2017]; 10(2):28-30. Disponible en: https://encolombia.com/medicina/revistas-medicas/enfermeria/ve-102/medidasdesujecion/Martínez A. ¿ Contención Física O Castigo? Un Recorte Histórico De Sus Antecedentes. V Congr Int Investig y Práctica Prof en Psicol XX Jornadas Investiación Noveno Encuentro Investig en Psicol del MERCOSUR Fac Psicol - Univ Buenos Aires [Internet]. 2013;95–7. Available from: http://www.aacademica.com/000-054/295%5CnActaMcCann T V., Baird J, Muir-Cochrane E. Attitudes of clinical staff toward the causes and management of aggression in acute old age psychiatry inpatient units. BMC Psychiatry. 2014;14(1).Molewijk B, Kok A, Husum T, Pedersen R, Aasland O. Staff’s normative attitudes towards coercion: The role of moral doubt and professional context - A cross-sectional survey study. BMC Med Ethics. 2017;Nenadović M, Katanić M, Tocilovac-Nina M, Kostić V, Peruncić M, Simonović P, et al. Most common diagnoses requiring physical restriction of psychiatric patients: humanity at the test. Srp Arh Celok Lek. 2011;Organización de las Naciones Unidas. La Declaración Universal de Derechos Humanos 1998 http://www.un.org/es/universal-declaration-human-rights/Organización Panamericana S, Protección Social M. Regulación de la Enfermería en América Latina [Internet]. 56. 2011. 61-76 p. Available from: http://www.paho.org/hq/index.php?option=com_docman&task=doc_view&gid=16768&Itemid=721&lang =enPerkins E, Prosser H, Riley D, Whittington R. Physical restraint in a therapeutic setting; a necessary evil? Int J Law Psychiatry. 2012Pettit SA, Bowers L, Tulloch A, Cullen AE, Moylan LB, Sethi F, et al. Acceptability and use of coercive methods across differing service configurations with and without seclusion and/or psychiatric intensive care units. J Adv Nurs. 2017;Piñón Gaytán F. El problema ético en la filosofía de Kant. (Spanish). Política y Cult [Internet]. 2013;(39):99–112. Available from: http://search.ebscohost.com/login.aspx?direct=true&db=fua&AN=88269613&lang=es&site=ehost-live Reitan SK, Helvik AS, Iversen V. Use of mechanical and pharmacological restraint over an eight-year period and its relation to clinical factors. Nord J Psychiatry. 2018República de Colombia. Congreso de Colombia. Ley 1616 de 2013, enero 21, por medio de la cual se expide la ley de salud mental y se dictan otras disposiciones". [Internet]. [Consultado 25 de abril de 2018]. Disponible en: http://wsp.presidencia.gov.co/Normativa/Leyes/Documents/2013/LEY%201616%20DEL%2021%20DE% 20ENERO%20DE%202013.pdfRepública de Colombia. Congreso de Colombia. Ley 911 de 2004, octubre 4, por la cual se dictan disposiciones en materia de responsabilidad deontológica para el ejercicio de la profesión de Enfermería en Colombia; se establece el régimen disciplinario correspondiente y se dictan otras disposiciones. [Internet]. [Consultado 25 de abril de 2018]. Disponible en: https://www.mineducacion.gov.co/1621/articles-105034_archivo_pdf.pdfSacks MH, Walton MF. Seclusion and Restraint as Measures of the Quality of Hospital Care: Any Exceptions? Psychiatr Serv. 2014;Sastre-Rus M, Campaña-Castillo F. Contención mecánica: definición conceptual. Rev [Internet]. 2014 [consultado 02 de diciembre de 2017]; 8( 1 ). Disponible en: http://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S1988-348X2014000100007&lng=es. http://dx.doi.org/10.4321/S1988-348X2014000100007.Simpson SA, Joesch JM, West II, Pasic J. Risk for physical restraint or seclusion in the psychiatric emergency service (PES). Gen Hosp Psychiatry. 2014;Steinert T, Lepping P, Bernhardsgrütter R, Conca A, Hatling T, Janssen W, et al. Incidence of seclusion and restraint in psychiatric hospitals: a literature review and survey of international trends. Social psychiatry and psychiatric epidemiology. 2010Strout TD. Perspectives on the experience of being physically restrained: An integrative review of the qualitative literature. Int J Ment Health Nurs 2010;19(6):416-427.Tamyres-Araújo AD, Rocha-Pires L, Pedrería-Silva L, Caje Mora LV, C. M. Physical restraint in patients in intensive care units: Exploratory. Rev Online Brazilian Journal of Nursing [Internet]. 2017 [consultado 16 de noviembre de 2017] Disponible en: https://bibliobd.udca.edu.co:2118/docview/1958788754/9C28A615DDFC46E6PQ/1?accountid=47900Tranvåg O, Petersen KA, Nåden D. Dignity-preserving dementia care: A metasynthesis. Nurs Ethics. 2013;Van Doeselaar M, Sleegers P, Hutschemaekers G. Professionals’ attitudes toward reducing restraint: The case of seclusion in The Netherlands. Psychiatr Q. 2008;Vítolo F. Inmovilización física y contención racional de pacientes. Biblio Virtu NOBLE. 2013;(4):1–15.Vuckovich PK, Artinian BM. Ustifying oercion. 2005;12(4).Xiang YT, Sha S, Zhang QE, Wu PP, Jin X. Physical restraint for psychiatric patients and its associations with clinical characteristics and the National Mental Health Law in China. Psychiatry Res. 2016 Yamamoto M, Aso Y. Placing physical restraints on older people with dementia. Nurs Ethics. 2009;Zwijsen SA, Smalbrugge M, Zuidema SU, Koopmans RT, Bosmans JE, Van Tulder MW, et al. Grip on challenging behaviour: A multidisciplinary care programme for managing behavioural problems in nursing home residents with dementia. Study protocol. BMC Health Serv Res. 2011;Facultad de Ciencias de la SaludEnfermeríaPublicationORIGINALConsideraciones éticas en la restricción de pacientes con trastorno mental.pdfConsideraciones éticas en la restricción de pacientes con trastorno mental.pdfapplication/pdf626009https://repository.udca.edu.co/bitstreams/621d15de-4412-4171-a0fe-cd0a98531d70/download41293f0350dbfe696bba95a9aacaa536MD51LICENSElicense.txtlicense.txttext/plain; charset=utf-814775https://repository.udca.edu.co/bitstreams/30ef38ac-79e8-4d76-90f4-525947c90e8d/downloadf661acf14bedbf9f5d13897a0387e751MD52TEXTConsideraciones éticas en la restricción de pacientes con trastorno mental.pdf.txtConsideraciones éticas en la restricción de pacientes con trastorno mental.pdf.txtExtracted texttext/plain67120https://repository.udca.edu.co/bitstreams/52b0f9c4-bf93-41aa-a0d4-6ebb42eaded2/downloadab73266d953c65e188c9fb805493f3dfMD53THUMBNAILConsideraciones éticas en la restricción de pacientes con trastorno mental.pdf.jpgConsideraciones éticas en la restricción de pacientes con trastorno mental.pdf.jpgGenerated Thumbnailimage/jpeg2843https://repository.udca.edu.co/bitstreams/475a2dcf-800f-45a7-a275-1c9636fc5f54/download46a81b2e699357234b1e047f5a32072cMD5411158/924oai:repository.udca.edu.co:11158/9242024-05-09 14:31:13.442https://creativecommons.org/licenses/by-nc-sa/4.0/Derechos Reservados - Universidad de Ciencias Aplicadas y Ambientalesopen.accesshttps://repository.udca.edu.coRepositorio - Universidad de Ciencias Aplicadas y Ambientales UDCA.bdigital@metabiblioteca.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 |