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Trial registered on ANZCTR
Registration number
ACTRN12610000082000
Ethics application status
Approved
Date submitted
15/01/2010
Date registered
22/01/2010
Date last updated
11/07/2012
Type of registration
Retrospectively registered
Titles & IDs
Public title
Effects of implementing a comfort room in an acute mental health unit on seclusion rates and client’s level of distress.
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Scientific title
Does the use of a comfort room reduce distress and reduce the use of seclusion for patients in an acute mental health inpatient unit, compared with no comfort room.
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Secondary ID [1]
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Nil
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Universal Trial Number (UTN)
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Depression
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Schizophrenia and related psychoses
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Personality disorders
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Bipolar affective disorder
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Anxiety disorders
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Substance use disorders
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Condition category
Condition code
Mental Health
256718
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0
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Depression
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Mental Health
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0
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Schizophrenia
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Mental Health
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0
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Psychosis and personality disorders
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
The introduction and use of a "comfort room" in an acute inpatient mental health unit. Comfort rooms are specialised rooms, which have a range of comforting materials and resources in them to assist an individual who is distressed to relax and perform “self-soothing” routines (e.g., relaxation exercises, self-massage, use of weighted blankets / comfort wraps). Inpatients will have access to the room (24 hours per day) to allow them to soothe themselves at times of distress to reduce the need for other, more invasive procedures such as intramuscular medication and/or seclusion. Duration of intervention will be 12 months.
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Intervention code [1]
255823
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Other interventions
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Comparator / control treatment
Previous rates of seclusion prior to the introduction of the comfort room (from the 12 months prior to the introduction of the room: that is, October 2008 to September 2009).
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Control group
Historical
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Outcomes
Primary outcome [1]
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Self-reported level of distress (on a scale of 1 to 10)
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Assessment method [1]
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Timepoint [1]
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Pre and post each occasion of use of the comfort room over a 12 month duration.
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Primary outcome [2]
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Observations of intensity of behaviour by staff (rated on a scale of 1 to 10; e.g., level of distress, anger, anxiety, irritibility, paranoia)
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Assessment method [2]
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Timepoint [2]
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Pre and post each occasion of use of the comfort room over a 12 month duration.
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Secondary outcome [1]
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Rates of use of seclusion (collected / measured from the seclusion register maintined on the unit).
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Assessment method [1]
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Timepoint [1]
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12 months prior to the introduction of the comfort room compared with the 12 months following introduction (a 6-month review will also occur).
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Eligibility
Key inclusion criteria
Current inpatient of the acute mental health unit. Patients self-select to use the comfort room or are encouraged to use the room by staff members.
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Minimum age
18
Years
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Maximum age
65
Years
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
No specific exclusion criteria.
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Non-randomised trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
Patients self-select to use the comfort room or are encouraged to use the room by staff members.
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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Masking / blinding
Open (masking not used)
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Who is / are masked / blinded?
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Intervention assignment
Single group
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Other design features
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Phase
Not Applicable
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Type of endpoint/s
Safety/efficacy
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Statistical methods / analysis
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Recruitment
Recruitment status
Recruiting
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Date of first participant enrolment
Anticipated
20/10/2009
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Actual
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Date of last participant enrolment
Anticipated
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Actual
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Date of last data collection
Anticipated
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Actual
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Sample size
Target
100
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
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Funding & Sponsors
Funding source category [1]
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Charities/Societies/Foundations
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Name [1]
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Susan Harris Fund
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Address [1]
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Financial Services, Concord Repatriation General Hospital, Hospital Road, Concord, NSW, 2139
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Country [1]
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Australia
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Primary sponsor type
Hospital
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Name
Area Mental Health Services, Sydney South West Area Health Service
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Address
c/- Area Mental Health Services, Concord Repatriation General Hospital, Hospital Road, Concord, NSW, 2139
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Country
Australia
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Secondary sponsor category [1]
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None
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Name [1]
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Address [1]
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Country [1]
251634
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
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Ethics Review Committee (Royal Prince Alfred Hospital [RPAH] Zone), Sydney South West Area Health Service
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Ethics committee address [1]
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Research Development Office, Level 3, Building 92, Royal Prince Alfred Hospital, Missenden Road, Camperdown, NSW, 2050
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Ethics committee country [1]
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Australia
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Date submitted for ethics approval [1]
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Approval date [1]
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09/10/2009
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Ethics approval number [1]
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X09-0261 & HREC/09/RPAH/428
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Summary
Brief summary
Comfort rooms are specialised rooms, often within an inpatient psychiatric unit, which have a range of comforting materials and resources in them to assist an individual who is distressed to relax and perform “self-soothing” routines (e.g., relaxation exercises, self-massage, use of weighted blankets / comfort wraps) Previous investigations have demonstrated the utility of comfort rooms in reducing levels of distress in clients and also in reducing the use of seclusion and restraint. The aim of this project is to evaluate the effectiveness of the introduction of a comfort room into and acute inpatient mental health unit. Outcomes will be measured by a number of indicators: (1) rate of utilisation of the comfort room; (2) average length of time individuals remain in the comfort room; (3) behaviours observed before and after use of the comfort room; (4) what resources were used by the individual whilst in the comfort room; and (5) rates of seclusion before and after the introduction of the comfort room. Additionally, clients will be asked to report their subjective level of distress before and after using the room. This will be done by way of two simple questions asked by a member of nursing staff following the client leaving the comfort room: “Before you went into the comfort room, how distressed were you feeling on a scale of 1 to 10” and “Now, how distressed are you feeling, on a scale of 1 to 10”. Asking clients to rate their level of distress prior to using the comfort room is considered inappropriate, as any such delay in accessing the comfort room is not in keeping with the philosophy of quick and early access to the comfort room to promote best self-management of distress. It is hypothesised that the introduction of the comfort room will reduce distress experienced by clients by providing a comfortable environment and resources to self-sooth and de-stress. This hypothesis will be tested in the following ways: (1) Does the use of the comfort room reduce the level of self-reported distress experienced by clients? (2) Are fewer disruptive / disturbed behaviours noted in clients following the use of the comfort room? (3) Do rates of seclusion reduce following the introduction of the comfort room? The potential significance of this study is large. Similar projects are readily implementable (with limited capital outlay) in a range of settings across Australia and the results of this study have the potential to inform and change clinical practice in inpatient psychiatric units, leading to better outcomes for a large number of individuals across Australia. The results of this study will also add to the developing knowledge base around interventions designed to reduce the use of seclusion in Australian psychiatric inpatient units.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Address
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Country
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Phone
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Fax
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Email
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Contact person for public queries
Name
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Theresa Novak
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Address
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Missenden Psychiatric Unit, Building 92, Royal Prince Alfred Hospital, Missenden Road, Camperdown, NSW, 2050
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Country
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Australia
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Phone
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+ 61 2 9515 5878
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Fax
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+ 61 2 9515 8932
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Email
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[email protected]
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Contact person for scientific queries
Name
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Justin Scanlan
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Address
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Level 1 Administration, Concord Centre for Mental Health, CRGH, Hospital Road, Concord, NSW, 2139
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Country
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Australia
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Phone
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+ 61 2 9767 8985
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Fax
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+61 2 9767 8901
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Email
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[email protected]
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No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
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