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Trauma Does Not Predict Patients’ Experiences With Constant Observation

KROLL, DAVID S., MD; THOM, ROBYN, MD; VAN LUNTEREN, JENNIFER, MD; TORETTA, CARA, MD; CROWLEY, BRITTANY, MD; KNOTTS, PAULA, RN; FROMSON, JOHN, MD

Journal of Psychiatric Practice®: July 2018 - Volume 24 - Issue 4 - p 299–304
doi: 10.1097/PRA.0000000000000318
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Objective: Little is known about which patient factors are associated with a positive or negative experience of constant observation (CO) in a general hospital or emergency department. We hypothesized that posttraumatic stress disorder (PTSD) would predict a more negative experience with CO.

Methods: A survey regarding the positive and negative aspects of being observed by a staff member was administered to 83 patients who were admitted to an inpatient psychiatric unit after experiencing CO; 55 of these patients had a history of trauma and 13 were diagnosed with PTSD. A total score reflecting the overall positive or negative experience of CO was calculated for each survey response. The survey also included 4 follow-up questions regarding the importance of individual observer characteristics (eg, sex), which were scored individually along a Likert scale.

Results: Neither PTSD, trauma history, nor any other participant characteristic was associated with either a positive or negative overall experience with CO. Female participants were more likely than males to consider the sex and age of their staff observers to be important.

Conclusions: Neither PTSD nor trauma history predicts a negative or positive experience with CO. A predictive model regarding which patients are likely to experience CO positively or negatively remains to be established.

KROLL: Department of Psychiatry, Brigham and Women’s Hospital, Boston, MA

THOM, VAN LUNTEREN, TORETTA, CROWLEY, and FROMSON: Department of Psychiatry, Brigham and Women’s Hospital, and Harvard Medical School, Boston, MA

KNOTTS: Department of Nursing, Brigham and Women’s Faulkner Hospital, Boston, MA

D.S.K. has received research funding and a speaking honorarium from Avasure, LLC. The remaining authors declare no conflicts of interest.

Please send correspondence to: David S. Kroll, MD, 75 Francis Street, Boston, MA 02115 (e-mail: dskroll@bwh.harvard.edu).

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