Identification of characteristics associated with psychomotor agitation for individualised nursing interventions in acute psychiatric care settings: a real world experience

Abstract Introduction A key nursing skill during psychiatric hospitalisation is the ability to implement de-escalation interventions to manage psychomotor agitation while avoiding coercive measures. This study aimed to evaluate the relationship between sociodemographic and clinical variables and the management of psychomotor agitation by nursing staff. Methods This pre-experimental, longitudinal, prospective study was conducted over 11 months in the Short-Term Hospitalisation Unit at the Consorcio Hospitalario Provincial de Castellón (Spain). A total of 714 verbal de-escalations performed on 165 patients (58.8% male; mean age = 37.64) were analysed. The level of psychomotor agitation, the intervention implemented, and the clinical and sociodemographic variables were recorded for each verbal de-escalation through ad hoc scales. Results Female sex ( B = 6.34; p < 0.001), affective disorder ( B = 1.59; p < 0.001), and substance use ( B = 7.08; p < 0.001) were associated with more verbal de-escalation interventions. Female sex ( B = 6.05; p < 0.001) was also associated with these interventions occurring during later stages of admission, while personality disorder ( B = − 8.01; p < 0.001) and substance use were associated with interventions occurring earlier in admission ( B = − 3.61; p = 0.005). Personality disorder was associated with a higher likelihood of requiring oral (OR = 1.66; p = 0.026) or intramuscular chemical restraint (OR = 2.87; p = 0.016), while affective disorder was associated with a lower likelihood of requiring oral chemical restraint (OR = 0.81; p = 0.001). Conclusions Verbal de-escalation is an essential nursing skill required during acute psychiatric hospitalisation. Identifying characteristics associated with psychomotor agitation based on sex, diagnosis, and substance use may help prevent or reduce agitation episodes and support nursing staff in designing personalised de-escalation interventions for different patient profiles.