An evaluation of quiet room design and its effects on children and adolescents

2.50
Hdl Handle:
http://hdl.handle.net/10755/153884
Type:
Presentation
Title:
An evaluation of quiet room design and its effects on children and adolescents
Abstract:
An evaluation of quiet room design and its effects on children and adolescents
Conference Sponsor:Sigma Theta Tau International
Conference Year:1992
Conference Date:August 6 - 8, 1992
Author:Glod, Carol, MS/MSc
P.I. Institution Name:Northeastern University College of Nursing
Title:Clinical Specialist
Over the years, a variety of techniques have been used by

psychiatric staff to decrease agitation and control assaultive

behavior. Nearly every inpatient psychiatric unit contains quiet

rooms (QR) to manage behavior, which commonly consist of bare white

walls, at times without a window, and which may only contain a

mattress. A computer search of the literature failed to reveal any

published reports on the design of the quiet room to provide

optimal calming effects in either adults or children. Thus we

sought to modify QR design (pastel paint, picturesque mural,

carpeting) to see if we could produce a more rapid calming effects.

The final subject pool consisted of 19 in-patients (14 males, 5

females) ages 5 to 16 who were randomly assigned and assessed in

both a modified QR and at least 1 of 4 standard QRs.



Design: We selected for further study all children who had been

placed in each QR for threatening or assaultive behavior or

inability to respond to lesser behavioral restrictions. Thus a

within subject design was employed so that each patient served as

their own control. Patients were evaluated by one of four raters

using a time-sample approach, with ratings made at 5 minute

intervals throughout the time they remained in the QR. A simple

assessment tool was used based on the Overt Aggressive Scale of

Yudofsky (AM. J. Psychiatry, 1986, 143:35-9). Degree of behavioral

activity and agitation was also evaluated using the simple 0 to 4

scale. Interventions, including holding, prn medications, and

restraint were also recorded.



Results: Data were analyzed using a two repeated measures ANOVA,

so that each subject served as their own control. Possible

confounding effects were addressed through ANCOVA procedures.

Rater-based assessment of verbal aggression, physical aggression

against self, motor activity, and total aggression revealed

significant effects of quiet room. The modified quiet room exerted

stronger calming effects, producing overall reduction in verbal

aggression (Fâ1,18Õ=8.13 p<.020), physical aggression (Fâ1,18Õ=8.93

p<.01), motor activity (Fâ1,18Õ=9.44 p<.01), and total aggression

(Fâ1,18Õ=21.47 p<.001). With the exception of physical aggression

toward self, a significant effect of time arose over the course of

the 30 minute observation period. Verbal aggression, total

aggression, and motor activity also demonstrated a quiet room by

time interaction. Subjects spent less time in the modified quiet

room, however this failed to reach statistical significance. (36

versus. 46 minutes; Fâ1,16Õ=2.72, ns). Use of prn medications also

differed based on QR placement. In the standard QR, 10 of 19

patients required prn medications after QR placement, while in the

modified QR only 4 required prns (X2=4.07, p<.05). Thus modifying

QR design may have important effects on aggression and physical

agitation as well as the need for prn medication. Further studies

are necessary to assess anti-aggressive effects of quiet room

design on various patient populations and diagnoses.



Repository Posting Date:
26-Oct-2011
Date of Publication:
6-Aug-1992
Sponsors:
Sigma Theta Tau International

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleAn evaluation of quiet room design and its effects on children and adolescentsen_GB
dc.identifier.urihttp://hdl.handle.net/10755/153884-
dc.description.abstract<table><tr><td colspan="2" class="item-title">An evaluation of quiet room design and its effects on children and adolescents</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Sigma Theta Tau International</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">1992</td></tr><tr class="item-conference-date"><td class="label">Conference Date:</td><td class="value">August 6 - 8, 1992</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Glod, Carol, MS/MSc</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">Northeastern University College of Nursing</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">Clinical Specialist</td></tr><tr><td colspan="2" class="item-abstract">Over the years, a variety of techniques have been used by<br/><br/>psychiatric staff to decrease agitation and control assaultive<br/><br/>behavior. Nearly every inpatient psychiatric unit contains quiet<br/><br/>rooms (QR) to manage behavior, which commonly consist of bare white<br/><br/>walls, at times without a window, and which may only contain a<br/><br/>mattress. A computer search of the literature failed to reveal any<br/><br/>published reports on the design of the quiet room to provide<br/><br/>optimal calming effects in either adults or children. Thus we<br/><br/>sought to modify QR design (pastel paint, picturesque mural,<br/><br/>carpeting) to see if we could produce a more rapid calming effects.<br/><br/>The final subject pool consisted of 19 in-patients (14 males, 5<br/><br/>females) ages 5 to 16 who were randomly assigned and assessed in<br/><br/>both a modified QR and at least 1 of 4 standard QRs.<br/><br/><br/><br/>Design: We selected for further study all children who had been<br/><br/>placed in each QR for threatening or assaultive behavior or<br/><br/>inability to respond to lesser behavioral restrictions. Thus a<br/><br/>within subject design was employed so that each patient served as<br/><br/>their own control. Patients were evaluated by one of four raters<br/><br/>using a time-sample approach, with ratings made at 5 minute<br/><br/>intervals throughout the time they remained in the QR. A simple<br/><br/>assessment tool was used based on the Overt Aggressive Scale of<br/><br/>Yudofsky (AM. J. Psychiatry, 1986, 143:35-9). Degree of behavioral<br/><br/>activity and agitation was also evaluated using the simple 0 to 4<br/><br/>scale. Interventions, including holding, prn medications, and<br/><br/>restraint were also recorded.<br/><br/><br/><br/>Results: Data were analyzed using a two repeated measures ANOVA,<br/><br/>so that each subject served as their own control. Possible<br/><br/>confounding effects were addressed through ANCOVA procedures.<br/><br/>Rater-based assessment of verbal aggression, physical aggression<br/><br/>against self, motor activity, and total aggression revealed<br/><br/>significant effects of quiet room. The modified quiet room exerted<br/><br/>stronger calming effects, producing overall reduction in verbal<br/><br/>aggression (F&acirc;1,18&Otilde;=8.13 p&lt;.020), physical aggression (F&acirc;1,18&Otilde;=8.93<br/><br/>p&lt;.01), motor activity (F&acirc;1,18&Otilde;=9.44 p&lt;.01), and total aggression<br/><br/>(F&acirc;1,18&Otilde;=21.47 p&lt;.001). With the exception of physical aggression<br/><br/>toward self, a significant effect of time arose over the course of<br/><br/>the 30 minute observation period. Verbal aggression, total<br/><br/>aggression, and motor activity also demonstrated a quiet room by<br/><br/>time interaction. Subjects spent less time in the modified quiet<br/><br/>room, however this failed to reach statistical significance. (36<br/><br/>versus. 46 minutes; F&acirc;1,16&Otilde;=2.72, ns). Use of prn medications also<br/><br/>differed based on QR placement. In the standard QR, 10 of 19<br/><br/>patients required prn medications after QR placement, while in the<br/><br/>modified QR only 4 required prns (X2=4.07, p&lt;.05). Thus modifying<br/><br/>QR design may have important effects on aggression and physical<br/><br/>agitation as well as the need for prn medication. Further studies<br/><br/>are necessary to assess anti-aggressive effects of quiet room<br/><br/>design on various patient populations and diagnoses.<br/><br/><br/><br/></td></tr></table>en_GB
dc.date.available2011-10-26T12:35:10Z-
dc.date.issued1992-08-06en_GB
dc.date.accessioned2011-10-26T12:35:10Z-
dc.description.sponsorshipSigma Theta Tau Internationalen_GB
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