Kristien Scheepmans1, Bernadette Dierckx de Casterlé2, Louis Paquay3, Koen Milisen4. 1. Wit-Gele Kruis van Vlaanderen, Nursing Department, Brussels, Belgium; Department of Public Health and Primary Care, Academic Centre for Nursing and Midwifery, KU Leuven, Leuven, Belgium. 2. Department of Public Health and Primary Care, Academic Centre for Nursing and Midwifery, KU Leuven, Leuven, Belgium. 3. Wit-Gele Kruis van Vlaanderen, Nursing Department, Brussels, Belgium. 4. Department of Public Health and Primary Care, Academic Centre for Nursing and Midwifery, KU Leuven, Leuven, Belgium; Division of Geriatric Medicine, Department of Internal Medicine, Leuven University Hospitals, Leuven, Belgium. Electronic address: koen.milisen@kuleuven.be.
Abstract
OBJECTIVES: To get insight into restraint use in older adults receiving home care and, more specifically, into the definition, prevalence and types of restraint, as well as the reasons for restraint use and the people involved in the decision-making process. DESIGN: Systematic review. DATA SOURCES: Four databases (i.e. Pubmed, CINAHL, Embase, Cochrane Library) were systematically searched from inception to end of April 2017. REVIEW METHODS: The study encompassed qualitative and quantitative research on restraint use in older adults receiving home care that reported definitions of restraint, prevalence of use, types of restraint, reasons for use or the people involved. We considered publications written in English, French, Dutch and German. One reviewer performed the search and made the initial selection based on titles and abstracts. The final selection was made by two reviewers working independently; they also assessed study quality. We used an integrated design to synthesise the findings. RESULTS: Eight studies were reviewed (one qualitative, seven quantitative) ranging in quality from moderate to high. The review indicated there was no single, clear definition of restraint. The prevalence of restraint use ranged from 5% to 24.7%, with various types of restraint being used. Families played an important role in the decision-making process and application of restraints; general practitioners were less involved. Specific reasons, other than safety for using restraints in home care were noted (e.g. delay to nursing home admission; to provide respite for an informal caregiver). CONCLUSIONS: Contrary to the current socio demographical evolutions resulting in an increasing demand of restraint use in home care, research on this subject is still scarce and recent. The limited evidence however points to the challenging complexity and specificity of home care regarding restraint use. Given these serious challenges for clinical practice, more research about restraint use in home care is urgently needed.
OBJECTIVES: To get insight into restraint use in older adults receiving home care and, more specifically, into the definition, prevalence and types of restraint, as well as the reasons for restraint use and the people involved in the decision-making process. DESIGN: Systematic review. DATA SOURCES: Four databases (i.e. Pubmed, CINAHL, Embase, Cochrane Library) were systematically searched from inception to end of April 2017. REVIEW METHODS: The study encompassed qualitative and quantitative research on restraint use in older adults receiving home care that reported definitions of restraint, prevalence of use, types of restraint, reasons for use or the people involved. We considered publications written in English, French, Dutch and German. One reviewer performed the search and made the initial selection based on titles and abstracts. The final selection was made by two reviewers working independently; they also assessed study quality. We used an integrated design to synthesise the findings. RESULTS: Eight studies were reviewed (one qualitative, seven quantitative) ranging in quality from moderate to high. The review indicated there was no single, clear definition of restraint. The prevalence of restraint use ranged from 5% to 24.7%, with various types of restraint being used. Families played an important role in the decision-making process and application of restraints; general practitioners were less involved. Specific reasons, other than safety for using restraints in home care were noted (e.g. delay to nursing home admission; to provide respite for an informal caregiver). CONCLUSIONS: Contrary to the current socio demographical evolutions resulting in an increasing demand of restraint use in home care, research on this subject is still scarce and recent. The limited evidence however points to the challenging complexity and specificity of home care regarding restraint use. Given these serious challenges for clinical practice, more research about restraint use in home care is urgently needed.
Authors: Sara Vandervelde; Kristien Scheepmans; Koen Milisen; Theo van Achterberg; Ellen Vlaeyen; Johan Flamaing; Bernadette Dierckx de Casterlé Journal: BMC Geriatr Date: 2021-01-25 Impact factor: 3.921
Authors: Vincent Ra Moermans; Angela Mhj Mengelers; Michel Hc Bleijlevens; Hilde Verbeek; Bernadette Dierckx de Casterle; Koen Milisen; Elizabeth Capezuti; Jan Ph Hamers Journal: Nurs Ethics Date: 2021-12-06 Impact factor: 2.874