Sensory Room at an Acute Psychiatric Unit
Condition: Psychiatric Disorder
MeSH terms: Mental Disorders; Problem Behavior
Study type: Interventional

Summary: 
      the aim of the presented study is to explore the effectiveness of a sensory room in reducing
      seclusion, restraint and aggression at an acute psychiatric ward.
    

Detailed description: 
      Background In recent years, there has been an increase in violence in mental health centers
      in Israel. Until recently, the phenomenon was treated under mechanical restrictions and
      patient isolation. Today the trend is to reduce the use of restrictions, with the main
      alternative being the provision of medication and de-escalation techniques, one of which is
      sensory stimulation using sensory rooms. A sensory room in the psychiatric unit has been
      found as an effective intervention for reducing patients' distress and aggression. However,
      the effectiveness of using the room has not yet been studied in Israel and in relation to
      pain.

      Method

      The experimental study will be conducted in two phases each lasting three months in an acute
      psychiatric ward:

        1. Without intervention (control group).

        2. With intervention. Data on restrictions and aggression events will be collected
           throughout the two phases, and the participants will undergo an evaluation process using
           self reports.

      In addition,subjects who will participate in the intervention (study group) will wear an
      Empatica-E4 wristband to monitor autonomous metrics during their stay in the sensory
      stimulation room and will undergo a brief interview regarding their experience using the
      room.Thus the intervention phase (Study group) will comprise mixed methods.

      Population Eighty men aged 18-50, a convenience sample, who speaks Hebrew; treated with
      psychiatric medication for at least two weeks; and hospitalized for up to 70 days.

      Expected results:

      Statistical significant group differences will be found in the sum of ward restrictions
      (i.e., sedatives, physical restraint, and seclusion), showing less during phase 2 (study
      group): The study group (2nd phase) will receive fewer sedatives and use less physical
      restraint and seclusion.

      Statistical significant group differences will be found in the aggression incidents showing
      fewer reports of aggression in the study group.

      Statistical significant differences will be found in the HRV indices between pre and post
      sensory room treatment, showing reduced values post treatment.

      statistically significant correlations will be found between sensory over-responsivity and
      the number of aggression events so that higher sensory responsiveness (SOR) will be
      correlated with more aggression events.

      statistically significant correlations will be found between sensitivity to pain and the
      number of aggression incidents: higher pain sensitivity will be correlated with fewer
      incidents of aggression.
    

Intervention name(s): sensory room
Intervention type(s): Behavioral
Intervention description(s): the room has dimmed lighting, sensing games, essential oils, picture books and cookbooks, two heavy blankets (weighing 9 kg and 11 kg), a rocking chair, and a vestibular plate. The occupational therapist will accompany the first entry into the room to create a sensory profile, adjust and instruct on the means, and write a treatment card. The treatment card will record the patient's choices and instructions for arranging the room, and it will be used by the staff members who will admit the patient as needed. Each patient will be able to stay in the room for self-treatment according to the individual treatment card prepared at the first sensory room treatment, up to half an hour.
Allocation: Non-Randomized
Intervention model: Sequential Assignment
Intervention model description: Two phases, First with no intervention (=control group), second with intervention(study group).
Masking: None (Open Label)
Primary purpose: Health Services Research
Keywords: psychiatric disorder; sensory processing; sensory room; seclusion; restraint; aggression; acute psychiatric ward