RABİA BİLİCİ, Mustafa SERCAN, Evren TUFAN

Psikiyatri kliniklerinde yalıtım ve bağlama uygulamaları

Psikiyatri kliniklerinde yatarak tedavi gören hastaların kendilerine, diğer hastalara veya hastane çalışanlarına yönelik zarar verici davranışlarına engel olmak amacıyla yalıtım ve bağlama (tecrit ve tespit) gibi kısıtlayıcı yöntemler uygulanmaktadır. Yalıtımın beklenen sonucu, tehlikeyi bertaraf etmek ve/veya hastanın ruhsal durumunun servisteki diğer hastalara katılabilecek kadar ilerlemesini sağlamaktır. Toplumlardaki yalıtım ve bağlama uygulamaları tarih boyunca dönemin kültürel özelliklerinden etkilenmiştir. Bu yazıda, ilk çağlardan günümüze kadarki yalıtım ve bağlama olaylarının kısa tarihçesi, uygulamanın gerekçesi, endikasyon ve kontrendikasyonları, uygulamaya bağlı komplikasyonlar gözden geçirilmiştir. Ayrıca yalıtım ve bağlama uygulamalarını azaltma girişimleri hakkında farklı ülkelerdeki uygulamalar gözden geçirilerek, başarılı olan programların öğelerine yer verilmiştir. Konuya ilişkin yasal düzenlemelere ve ülkemizdeki duruma da değinilmiştir.

Using of seclusion and restraint in psychiatry clinics

Restrictive methods such as seclusion and restraint are used for patients hospitalized in psychiatry clinics in order to prevent their harmful behaviors against themselves, other patients or hospital employees. The expected outcome of seclusion is to overcome the threat, and/or to raise patient’s mental health status to a certain level that he/she can join other patients in the clinic. Seclusion and restraint practice in the society is affected by the cultural features of that period throughout the history. In this paper, brief history of seclusion and restraint interventions that come from the early ages to the present day, reasons for these applications, their indications and contraindications, complications associated with these applications are reviewed. Moreover, interventions implemented in different countries to reduce the use of seclusion and restraints are reviewed, and the key elements of successful programs are included. Legal regulations on this issue and current status in our country are also mentioned.

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