Hostname: page-component-78c5997874-t5tsf Total loading time: 0 Render date: 2024-11-17T02:12:23.528Z Has data issue: false hasContentIssue false
  • English
  • Français

Physical restraint use in institutional care of old people in Sweden in 2000 and 2007

Published online by Cambridge University Press:  14 March 2012

Tony Pellfolk ,
Per-Olof Sandman ,
Yngve Gustafson ,
Stig Karlsson  and
Hugo Lövheim
Tony Pellfolk
Affiliation:
Department of Community Medicine and Rehabilitation, Geriatric Medicine, Umeå University, Umeå, Sweden
Per-Olof Sandman
Affiliation:
Department of Neurobiology, Care Sciences and Society, Division of Nursing, Karolinska Institutet, Stockholm, Sweden
Yngve Gustafson
Affiliation:
Department of Community Medicine and Rehabilitation, Geriatric Medicine, Umeå University, Umeå, Sweden
Stig Karlsson
Affiliation:
Department of Nursing, Umeå University, Umeå, Sweden
Hugo Lövheim*
Affiliation:
Department of Community Medicine and Rehabilitation, Geriatric Medicine, Umeå University, Umeå, Sweden
*
Correspondence should be addressed to: Hugo Lövheim, Department of Community Medicine and Rehabilitation, Geriatric Medicine, S 901 87 Umeå, Sweden. Phone: +46 90 785 8859; Fax: +46 90 13 06 23. Email: [email protected].
Get access Rights & Permissions [Opens in a new window]

Abstract

Background: Physical restraint use is common in institutional care for old people and mainly used to prevent falls, despite the fall-preventive effect of physical restraints being questioned in previous research. The aim of the study was to investigate the use of physical restraints in Sweden in 2000 and 2007.

Methods: Data were collected from two comparable census surveys conducted in all institutional care units for old people in 2000 (n = 3,669) and 2007 (n = 2,914). Information on residents’ characteristics and physical restraint use was collected using the Multi-Dimensional Dementia Assessment Scale (MDDAS).

Results: In 2000 16.0% (95% confidence interval (CI) 14.8%–17.2%) of the residents were restrained compared to 18.2% (95% CI 16.8%–19.6%) in 2007 (p = 0.017). Adjusting for residents' characteristics showed that residents in 2007 were more likely to be physically restrained, relative to the residents in 2000 (odds ratio (OR) 1.031, 95% CI 1.005–1.058, p = 0.017). In 2007 the residents had been restrained longer, and a higher proportion were restrained for unknown reasons.

Conclusions: Physical restraint use is still common. Moreover, the findings of this study suggest a small increase (OR 1.031) in the prevalence of physical restraint use from 2000 to 2007 adjusted for residents’ characteristics.

Keywords

restraintphysical restraintdementianursing homegeriatric careBPSD
Type
Research Article
Information
International Psychogeriatrics , Volume 24 , Issue 7 , July 2012 , pp. 1144 - 1152
Copyright
Copyright © International Psychogeriatric Association 2012

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Adolfsson, R., Gottfries, C. G., Nyström, L. and Winblad, B. (1981). Prevalence of dementia disorders in institutionalized Swedish old people: the work load imposed by caring for these patients. Acta Psychiatrica Scandinavica, 63, 225–244.CrossRefGoogle ScholarPubMed
Bueno-Cavanillas, A., Padilla-Ruiz, F., Jimenez-Moleon, J. J., Peinado-Alonso, C. A. and Galvez-Vargas, R. (2000). Risk factors in falls among the elderly according to extrinsic and intrinsic precipitating causes. European Journal of Epidemiology, 16, 849–859. doi: 10.1023/A:1007636531965.CrossRefGoogle ScholarPubMed
Chuang, Y. H. and Huang, H. T. (2007). Nurses’ feelings and thoughts about using physical restraints on hospitalized older patients. Journal of Clinical Nursing, 16, 486–494. doi: 10.1111/j.1365-2702.2006.01563.x.CrossRefGoogle ScholarPubMed
Ejaz, F. K., Jones, J. A. and Rose, M. S. (1994). Falls among nursing home residents: an examination of incident reports before and after restraint reduction programs. Journal of the American Geriatrics Society, 42, 960–964.CrossRefGoogle ScholarPubMed
Evans, D. and FitzGerald, M. (2002). Reasons for physically restraining patients and residents: a systematic review and content analysis. International Journal of Nursing Studies, 39, 735–743.CrossRefGoogle ScholarPubMed
Evans, D., Wood, J. and Lambert, L. (2002). A review of physical restraint minimization in the acute and residential care settings. Journal of Advanced Nursing, 40, 616–625. doi: 10.1046/j.1365-2648.2002.02422.x.CrossRefGoogle ScholarPubMed
Evans, D., Wood, J. and Lambert, L. (2003). Patient injury and physical restraint devices: a systematic review. Journal of Advanced Nursing, 41, 274–282. doi: 10.1046/j.1365-2648.2003.02501.x.CrossRefGoogle ScholarPubMed
Feng, Z. et al. (2009). Use of physical restraints and antipsychotic medications in nursing homes: a cross-national study. International Journal of Geriatric Psychiatry, 24, 1110–1118. doi: 10.1002/gps.2232.CrossRefGoogle ScholarPubMed
Godkin, M. D. and Onyskiw, J. E. (1999). A systematic overview of interventions to reduce physical restraint use in long-term care settings. Online Journal of Knowledge Synthesis for Nursing, 6, 81–94. doi: 10.1111/j.1524-475X.1999.00081.x.Google ScholarPubMed
Hamers, J. P. and Huizing, A. R. (2005). Why do we use physical restraints in the elderly? Zeitschrift fur Gerontologie und Geriatrie, 38, 19–25. doi: 10.1007/s00391-005-0286-x.CrossRefGoogle ScholarPubMed
Huizing, A. R., Hamers, J. P., Gulpers, M. J. and Berger, M. P. (2006). Short-term effects of an educational intervention on physical restraint use: a cluster randomized trial. BMC Geriatrics, 6. doi: 10.1186/1471-2318-6-17.CrossRefGoogle ScholarPubMed
Huizing, A. R., Hamers, J. P., de Jonge, J., Candel, M. and Berger, M. P. (2007). Organisational determinants of the use of physical restraints: a multilevel approach. Social Science and Medicine, 65, 924–933. doi: 10.1016/j.socscimed.2007.04.030.CrossRefGoogle ScholarPubMed
Karlsson, S., Nyberg, L. and Sandman, P. (1997). The use of physical restraints in elder care in relation to fall risk. Scandinavian Journal of Caring Sciences, 11, 238–242.CrossRefGoogle ScholarPubMed
Karlsson, S., Bucht, G., Eriksson, S. and Sandman, P. O. (2001). Factors relating to the use of physical restraints in geriatric care settings. Journal of the American Geriatrics Society, 49, 1722–1728. doi: 10.1046/j.1532-5415.2001.49286.x.CrossRefGoogle Scholar
Kirkevold, Ø., Laake, K. and Engedal, K. (2003). Use of restraints and surveillance in Norwegian wards for the elderly. International Journal of Geriatric Psychiatry, 18, 491–497. doi: 10.1002/gps.883.CrossRefGoogle ScholarPubMed
Lee, J. S., Hui, E., Chan, F., Chi, I. and Woo, J. (2008). Associated factors of falls in nursing home residents in Hong Kong and the role of restraints: a cross-sectional survey using the Resident Assessment Instrument (RAI) 2.0. Aging Clinical and Experimental Research, 20, 447–453.CrossRefGoogle Scholar
Ljunggren, G., Phillips, C. D. and Sgadari, A. (1997). Comparisons of restraint use in nursing homes in eight countries. Age and Ageing, 26 (Suppl. 2), 43–47. doi: 10.1093/ageing/26.suppl_2.43.CrossRefGoogle ScholarPubMed
Lövheim, H., Sandman, P. O., Kallin, K., Karlsson, S. and Gustafson, Y. (2006). Relationship between antipsychotic drug use and behavioral and psychological symptoms of dementia in old people with cognitive impairment living in geriatric care. International Psychogeriatrics, 18, 713–726. doi: 10.1017/S1041610206003930.CrossRefGoogle ScholarPubMed
Lövheim, H., Sandman, P. O., Kallin, K., Karlsson, S. and Gustafson, Y. (2008). Symptoms of mental health and psychotropic drug use among old people in geriatric care, changes between 1982 and 2000. International Journal of Geriatric Psychiatry, 23, 289–294. doi: 10.1002/gps.1876.CrossRefGoogle ScholarPubMed
Lundin-Olsson, L., Jensen, J., Nyberg, L. and Gustafson, Y. (2003). Predicting falls in residential care by a risk assessment tool, staff judgement, and history of falls. Aging Clinical and Experimental Research, 15, 51–59.CrossRefGoogle ScholarPubMed
Meyer, G., Kopke, S., Haastert, B. and Muhlhauser, I. (2009a). Comparison of a fall risk assessment tool with nurses’ judgement alone: a cluster-randomised controlled trial. Age and Ageing, 38, 417–423. doi: 10.1093/ageing/afp049.CrossRefGoogle Scholar
Meyer, G., Kopke, S., Haastert, B. and Muhlhauser, I. (2009b). Restraint use among nursing home residents: cross-sectional study and prospective cohort study. Journal of Clinical Nursing, 18, 981–990. doi: 10.1111/j.1365-2702.2008.02460.x.CrossRefGoogle ScholarPubMed
National Board of Health and Welfare (2008). Vård och omsorg om äldre. [Current Developments in Care of the Elderly in Sweden]. Stockholm: Socialstryrelsen.Google Scholar
Pekkarinen, L., Elovainio, M., Sinervo, T., Finne-Soveri, H. and Noro, A. (2006). Nursing working conditions in relation to restraint practices in long-term care units. Medical Care, 44, 1114–1120. doi: 10.1097/01.mlr.0000237198.90970.64.CrossRefGoogle ScholarPubMed
Pellfolk, T., Gustafson, Y., Bucht, G. and Karlsson, S. (2010). Effects of a restraint minimization program on staff knowledge, attitudes, and practice: a cluster randomized trial. Journal of the American Geriatrics Society, 58, 62–69. doi: 10.1111/j.1532-5415.2009.02629.x.CrossRefGoogle Scholar
Sandman, P. O., Adolfsson, R., Norberg, A., Nyström, L. and Winblad, B. (1988). Long-term care of the elderly: a descriptive study of 3600 institutionalized patients in the county of Vasterbotten, Sweden. Comprehensive Gerontology A, 2, 120–132.Google ScholarPubMed
Suen, L. K. et al. (2006). Use of physical restraints in rehabilitation settings: staff knowledge, attitudes and predictors. Journal of Advanced Nursing, 55, 20–28. doi: 10.1111/j.1365-2648.2006.03883.x.CrossRefGoogle ScholarPubMed
Tinetti, M. E., Liu, W. L. and Ginter, S. F. (1992). Mechanical restraint use and fall-related injuries among residents of skilled nursing facilities. Annals of Internal Medicine, 116, 369–374.CrossRefGoogle ScholarPubMed
Tinetti, M. E., Liu, W. L., Marottoli, R. A. and Ginter, S. F. (1991). Mechanical restraint use among residents of skilled nursing facilities: prevalence, patterns, and predictors. JAMA, 265, 468–471.CrossRefGoogle Scholar
Weiner, C., Tabak, N. and Bergman, R. (2003). The use of physical restraints for patients suffering from dementia. Nursing Ethics, 10, 512–525. doi: 10.1191/0969733003ne633oa.CrossRefGoogle ScholarPubMed