OBJECTIVE: One aim of the multi-site EUNOMIA-project was to establish a European recommendation for the best clinical practice of administering coercive measures. This article reports the results on mechanical restraint. METHODS: Local expert groups in 11 countries worked out their recommendations mostly in semi-structured group discussions. By use of a system of categories developed with a content-analytical method, these national documents were comparatively assessed, and integrated into a common clinical recommendation. RESULTS: Legal and clinical pre-conditions for the use of mechanical restraint, specific instructions for the clinical behaviour of different professional groups, ethical issues, and procedural aspects of quality assurance are reported in detail. CONCLUSIONS: Compared with established clinical guidelines, similarities concerning basic principles of clinical use appear to be higher than similarities concerning practical details. Future development of guidelines for the best practice of coercive measures urgently needs the use of advanced methodology.
OBJECTIVE: One aim of the multi-site EUNOMIA-project was to establish a European recommendation for the best clinical practice of administering coercive measures. This article reports the results on mechanical restraint. METHODS: Local expert groups in 11 countries worked out their recommendations mostly in semi-structured group discussions. By use of a system of categories developed with a content-analytical method, these national documents were comparatively assessed, and integrated into a common clinical recommendation. RESULTS:Legal and clinical pre-conditions for the use of mechanical restraint, specific instructions for the clinical behaviour of different professional groups, ethical issues, and procedural aspects of quality assurance are reported in detail. CONCLUSIONS: Compared with established clinical guidelines, similarities concerning basic principles of clinical use appear to be higher than similarities concerning practical details. Future development of guidelines for the best practice of coercive measures urgently needs the use of advanced methodology.