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Use of physical restraint in nursing homes in Spain and relation with resident characteristics: a retrospective multi-centre cohort study with a self-organised maps approach

Published online by Cambridge University Press:  18 June 2019

José-María Blasco
Affiliation:
Group in Physiotherapy of the Ageing Process, Department of Physiotherapy, University of Valencia, Valencia, Spain
Celedonia Igual-Camacho
Affiliation:
Group in Physiotherapy of the Ageing Process, Department of Physiotherapy, University of Valencia, Valencia, Spain
Francisco-José Pérez-Moltó
Affiliation:
Department of Anatomy and Human Embryology, University of Valencia, Valencia, Spain
Pablo García-Molina
Affiliation:
Department of Nursing, University of Valencia, Valencia, Spain
Juan Gómez-Salgado*
Affiliation:
Department of Sociology, Social Work and Public Health, University of Huelva, Huelva, Spain Safety and Health Posgrade Program, Universidad Espíritu Santo, Guayaquil, Ecuador
María-José Wazen-Hervás
Affiliation:
Department of Physiotherapy, University of Valencia, Valencia, Spain
*
*Corresponding author. Email: jgsalgad@gmail.com

Abstract

This is a retrospective cohort study based on data from five nursing homes which aims to appraise how physical and cognitive characteristics of nursing home residents were associated with the use of restraints, and to provide information on their prevalence in Spain. The goal was to assess, in a visual way, the possible interactions between the nursing homes residents’ characteristics and their association with the use of restraints. Motivation, risk factors, characteristics of the residents analysed by validated rating systems that assess mobility, level of dependence, cognitive condition and nutritional status, and their association with the use of restraints, were described by means of linear and non-linear multivariate approaches in the form of self-organised maps. Findings showed that the prevalence of restraints was high when compared to other developed countries. The visual analysis reinforced the knowledge that a greater impairment was associated with the use of restraints and vice versa. However, the residents’ characteristics were not always associated with the use of restraints. Subjective factors seem to play a relevant role in decision-making, so it is important to assess risk factors continuously and determine the actual need for the use of restraints from an individual perspective by basing the criteria on specific objectives, and on consistent, reproducible and reliable methods. Initiatives to minimise these subjective factors should be promoted. Likewise, a clear definition of physical restraints should be offered at each centre. In addition, effective legislation that clearly states the need, alternatives and motivation for the use of restraints is needed.

Type
Article
Copyright
Copyright © Cambridge University Press 2019

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