Education on physical restraint reduction in dementia care: A review of the literature

ABSTRACTBackground:In April 2016, the Japanese government introduced an additional benefit for dementia care in acute care hospitals (dementia care benefit) into the universal benefit schedule of public healthcare insurance program. The benefit includes a financial disincentive to use physical restraint. The present study investigated the association between the dementia care benefit and the use of physical restraint among inpatients with dementia in general acute care settings.Methods:A national cross-sectional study design was used. Eight types of care units from acute care hospitals under the public healthcare insurance program were invited to participate in this study. A total of 23,539 inpatients with dementia from 2,355 care units in 937 hospitals were included for the analysis. Dementia diagnosis or symptoms included any signs of cognitive impairment. The primary outcome measure was “use of physical restraint.”Results:Among patients, the point prevalence of physical restraint was 44.5% (n= 10,480). Controlling for patient, unit, and hospital characteristics, patients in units with dementia care benefit had significantly lower percentage of physical restraint than those in any other units (42.0% vs. 47.1%; adjusted odds ratio, 0.76; 95% confident interval [0.63, 0.92]).Conclusions:The financial incentive may have reduced the risk of physical restraint among patients with dementia in acute care hospitals. However, use of physical restraint was still common among patients with dementia in units with the dementia care benefit. An educational package to guide dementia care approach including the avoidance of physical restraint by healthcare professionals in acute care hospitals is recommended.

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Effects of a Web-Based Educational Program Regarding Physical Restraint Reduction in Long-Term Care Settings on Nursing Students: A Cluster Randomized Controlled Trial

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18136698 ◽

2021 ◽

Vol 18 (13) ◽

pp. 6698

Author(s):

Eun-Hi Kong ◽

Myoungsuk Kim ◽

Seonho Kim

Keyword(s):

Nursing Students ◽

Educational Program ◽

Physical Restraint ◽

Nursing Schools ◽

Control Group ◽

Term Care ◽

Web Based ◽

Restraint Reduction ◽

Cluster Randomized ◽

The Web

Physical restraint is still frequently used in many countries. However, a lack of education hinders physical restraint reduction in long-term care facilities. No study has yet to examine the effects of physical restraint reduction education on nursing students. This study aimed to evaluate the effects of a web-based educational program of physical restraint reduction on nursing students’ knowledge and perceptions. A cluster randomized controlled and single-blind design was used. This study was conducted at four nursing schools in South Korea. A total of 169 undergraduate nursing students completed this study. Using random allocation, two nursing schools (85 students) were allocated as the experimental group and the other two schools (84 students) as the control group. The experimental group received the web-based educational program, and the control group did not receive the educational program. Data were collected immediately before and after the web-based educational program. The experimental group’s knowledge and perceptions significantly improved between pre-test and post-test. The analysis of covariance showed statistically significant differences between groups in knowledge (p < 0.001) and perceptions (p < 0.001) over time, revealing positive effects of the web-based educational program. The web-based educational program regarding physical restraint reduction positively affected nursing students’ knowledge and perceptions. Future studies are required to examine the educational program’s longitudinal effects with more rigorous measurements and research methods.

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Minimising the use of physical restraint in acute mental health services: The outcome of a restraint reduction programme (‘REsTRAIN YOURSELF’)

International Journal of Nursing Studies ◽

10.1016/j.ijnurstu.2019.03.016 ◽

2019 ◽

Vol 95 ◽

pp. 40-48 ◽

Cited By ~ 12

Author(s):

Joy Duxbury ◽

John Baker ◽

Soo Downe ◽

Fiona Jones ◽

Paul Greenwood ◽

...

Keyword(s):

Mental Health ◽

Mental Health Services ◽

Health Services ◽

Physical Restraint ◽

Restraint Reduction

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Evaluation of Person-Centredness in Rehabilitation for People Living with Dementia Is Needed: A Review of the Literature

Journal of Aging Research ◽

10.1155/2019/8510792 ◽

2019 ◽

Vol 2019 ◽

pp. 1-9 ◽

Cited By ~ 1

Author(s):

Kate Allen Christensen ◽

Karen-Margrethe Lund ◽

Jette Thuesen

Keyword(s):

Occupational Therapy ◽

Dementia Care ◽

Complex Nature ◽

Review Of The Literature ◽

Know How ◽

Effective Strategies ◽

Search Terms ◽

Year 2000 ◽

Analytical Frameworks ◽

Expected Increase

Background. With an expected increase in the prevalence of dementia, change in care policies and healthcare systems worldwide is needed. Rehabilitation is increasingly recognised as contributing to dementia care. Rehabilitation subscribes to person-centredness, and thus, evaluations of person-centredness in rehabilitation for people living with dementia are relevant in order for healthcare professionals to know how best to practice person-centredness. Aim. The aim of this study was to identify methods of evaluating person-centeredness in rehabilitation for people living with dementia. Materials and Methods. Review of the literature using the search terms dementia, person-centredness, and rehabilitation or occupational therapy. Databases searched included: CINAHL, PubMed, Embase, PsycINFO, OTseeker, and SveMed+. The study included peer-reviewed articles from year 2000 to 2018 in Danish, English, Norwegian, or Swedish. Results. Only one academic article met the inclusion criteria. In that article, person-centred practice was evaluated using observation and interview as well as analytical frameworks from person-centred care and occupational therapy. Conclusion. Evaluations of person-centred practice in rehabilitation for people living with dementia in peer-reviewed literature are lacking. Evaluations are needed to identify effective strategies to pursue and uphold person-centred care. Given the dearth of research on evaluations of person-centredness in rehabilitation, this article included research in person-centred dementia care in the discussion, which potentially can inspire practice and research of rehabilitation for people living with dementia. To understand the complex nature of person-centredness, a variety of research methodologies of qualitative and quantitative characters are recommended for evaluations.

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