Authors (including presenting author) :
Kwong WY (1), Tang TL (1)
Affiliation :
(1) Child and Adolescent Psychiatry, Castle Peak Hospital
Introduction :
Patients with Intellectual Disability may display more challenging behaviour when their needs aren’t met. In PSID, Castle Peak Hospital (CPH), patients with severe challenging behaviour often had frequent readmission and prolonged hospitalisation. The average length of stay was 8.9 years. It demanded on manpower for observing, managing the behavior problem and documentation. Moreover, patients were often unable to participate in various therapeutic trainings. Its impacts reflected on their placement problem, congested ward environment, carers stress, staff and patient incidents, application of physical restraint and the service quality as well as the team morale. In view of this, staff applied the evidence-based practice (EBP) for managing the problems including: 1. Positive Behaviour Support; 2. Applied Behaviour Analysis; 3. Social skills training; 4. Supplemented with art/ music activities and gardening as a way of reinforcement in Intellectual Disability Activity Centre of Excellence (IDACE).
Objectives :
to
(1) promote and apply EBP; (2) reduce the severity of challenging behaviour; (3) reduce the frequency of application of physical restraint; (4) improve staff and carers’ satisfaction in managing the challenging behaviour; (5) improve the quality of life domains including able to attend various therapeutic trainings, ground parole during visiting hours, Day/ home Leave, join leisure activities in dayroom and placement arrangement.
Methodology :
A ‘Pre-test’ vs ‘Post-test’ design was adopted and data collected in July 2024 and Dec 2024 respectively.
Subjects were (1) 20 patients; (2) staff; (3) carers.
Outcome measures were categorised as: (1) severity of challenging behaviour [Challenging Behaviour Index (CBI)]; (2) frequency of application of physical restraint; (3) satisfaction survey among carers and staff 4) quality of life domains.
Result & Outcome :
CBI results indicated that the severity of challenging behaviour reduced 77%.
Frequency of application of physical restraint reduced 70%.
Staff mean satisfaction score increased from 3/10 to 8.4/10, and carers’ mean satisfaction score increased from 3/10 to 9/10.
The quality of life domains were also improved by being able to attend therapeutic trainings, joined leisure activities in dayroom, enjoyed ground parole with relatives, had day/ home leave and placement planning, and discharged to community after 10 years of hospitalization. Therefore, EBP should be promoted and applied for managing the challenging behaviors in PSID, CPH.
