Impact of Joint Crisis Plan

Study Overview
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Brief Summary
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For some patients in department psychiatric, isolation measures are put in place. But the measures is not pleasant for the patient or for the care team. That's why care team are trying to find ways to improve patient care, including asking them how they would like to be treated. One of the solutions is called the Joint Crisis Plan. A Joint Crisis Plan is a personalized procedure for a patient. It describes the attitude, the care, the measures in case of crisis with the patient and his family. Patients indicate their wishes regarding their care. However, there is no real scientific proof of the effectiveness of this Joint Crisis Plan, especially to reduce isolation measures.

Detailed Description
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The primary objective of this study is to evaluate efficacy of the Joint Crisis Plan.

Official Title
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Impact of Joint Crisis Plan on the Duration of Isolation Measures in Psychiatry.

Conditions
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Mental Disorders

Intervention / Treatment
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* Procedure: Joint Crisis Plan


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patients >18 years Patients having had at least one isolation, restraint or forced hospitalization measure in the 24 months before inclusion Followed by nurses of a mobile team of psychiatry sector Saint Etienne Social security affiliation Signed informed consent Exclusion Criteria: Patient having already had a Joint Crisis Plan for less than 6 months. Patient does not speak French Pregnant and lactating women

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Other
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Experimental group<br>Patients will benefit from regular care + Joint Crisis Plan | Procedure: Joint Crisis Plan<br>* A Joint Crisis Plan will be drafted with the patient and a nurse<br>|
| No Intervention: Control group<br>Patients will benefit from regular care | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Duration of isolation | Measured in hours. | Months: 12 | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Perception of constraint | Measured by the MacArthur Coercion Scale. Each True = 0, and each False = 1, perceived cohesion scale score is between 0 and 5, Negative pressures scale score is between 0 and 6, Voice scale score is between 0 and 3, Affective Reactions to Hospitalization score is between 0 and 6. | Months: 12 | 
| Number of hospitalizations |  | Months: 12 | 
| Number of isolation |  | Months: 12 | 
| Number of physical restraints |  | Months: 12 | 
| Duration of physical restraint | Measured in hours | Months: 12 | 
| Experience of discrimination and stigmatization | Measured by the Internalized Stigma of Mental Illness. This scale is a 29 items scale with stigma graded on a 4 point scale (Strongly disagree-1, Disagree-2, Agree-3 and strongly agree-4) which are divided into fivecomponents/domains (alienation, stereotype endorsement, perceived discrimination, social withdrawal and stigma resistance). Higher scores indicate higher level of self stigma. | Months: 12 | 
| Number of violent events |  | Months: 12 | 
| Number of emergency room visits for psychiatric opinion |  | Months: 12 | 
| Adhesion and feeling of nurses in relation to Joint Crisis Plan | Measured by focus-groups and individual interviews of nurses | Months: 12 | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Joint Crisis Plan, Internalized Stigma of Mental Illness (ISMI), Isolation, physical restraint, Psychiatry