Restraint use in residents with dementia living in residential aged care facilities: a scoping review

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Author(s)
Pu, Lihui
Moyle, Wendy
Year published
2020
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AIMS AND OBJECTIVES: To provide an overview of restraint use in residents with dementia in the context of residential aged care facilities. BACKGROUND: Restraints are commonly used in people with dementia living in residential aged care facilities to manage behaviours and reduce injuries, but the concept of restraint use in people with dementia remains ambiguous, and current practices to reduce restraint use in long-term care residents with dementia remains unclear. DESIGN: A scoping review using the methodological frameworks of Arskey and O'Malley and colleagues. METHODS: Nine databases (CINAHL, MEDLINE, EMBASE, PubMed, ...
View more >AIMS AND OBJECTIVES: To provide an overview of restraint use in residents with dementia in the context of residential aged care facilities. BACKGROUND: Restraints are commonly used in people with dementia living in residential aged care facilities to manage behaviours and reduce injuries, but the concept of restraint use in people with dementia remains ambiguous, and current practices to reduce restraint use in long-term care residents with dementia remains unclear. DESIGN: A scoping review using the methodological frameworks of Arskey and O'Malley and colleagues. METHODS: Nine databases (CINAHL, MEDLINE, EMBASE, PubMed, Scopus, Web of Science, OVID, Cochrane Central Register of Controlled Trials, and ProQuest) were searched from 2005 to May 20, 2019. Articles were included if they were written in English, peer-reviewed and used any research method that described restraint use in residents with dementia living in residential care settings. The PRISMA-ScR checklist was used. RESULTS: From 1585 articles, 23 met the inclusion criteria. There is a lack of a clear definition of restraint use and the prevalence of restraint use varied from 30.7% to 64.8% depending on the different operational concepts. People with dementia were at a higher risk for restraint use and the decision-making process for restraint use were largely ignored in the literature. The effect of staff educational interventions to reduce restraint use was inconsistent due to varying delivery duration and content. CONCLUSIONS: The prevalence of restraint use in people with dementia living in residential care settings remains high alongside the absence of a clear definition of restraint use. More research about the decision-making process involved in using restraint and development of effective interventions are needed. RELEVANCE TO CLINICAL PRACTICE: Better education about the decision-making regarding staff, conditions of residents and organisations for restraint use is needed to improve the care for people with dementia living in care settings.
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View more >AIMS AND OBJECTIVES: To provide an overview of restraint use in residents with dementia in the context of residential aged care facilities. BACKGROUND: Restraints are commonly used in people with dementia living in residential aged care facilities to manage behaviours and reduce injuries, but the concept of restraint use in people with dementia remains ambiguous, and current practices to reduce restraint use in long-term care residents with dementia remains unclear. DESIGN: A scoping review using the methodological frameworks of Arskey and O'Malley and colleagues. METHODS: Nine databases (CINAHL, MEDLINE, EMBASE, PubMed, Scopus, Web of Science, OVID, Cochrane Central Register of Controlled Trials, and ProQuest) were searched from 2005 to May 20, 2019. Articles were included if they were written in English, peer-reviewed and used any research method that described restraint use in residents with dementia living in residential care settings. The PRISMA-ScR checklist was used. RESULTS: From 1585 articles, 23 met the inclusion criteria. There is a lack of a clear definition of restraint use and the prevalence of restraint use varied from 30.7% to 64.8% depending on the different operational concepts. People with dementia were at a higher risk for restraint use and the decision-making process for restraint use were largely ignored in the literature. The effect of staff educational interventions to reduce restraint use was inconsistent due to varying delivery duration and content. CONCLUSIONS: The prevalence of restraint use in people with dementia living in residential care settings remains high alongside the absence of a clear definition of restraint use. More research about the decision-making process involved in using restraint and development of effective interventions are needed. RELEVANCE TO CLINICAL PRACTICE: Better education about the decision-making regarding staff, conditions of residents and organisations for restraint use is needed to improve the care for people with dementia living in care settings.
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Journal Title
Journal of Clinical Nursing
Copyright Statement
© 2020 John Wiley & Sons Ltd. This is the peer reviewed version of the following article: Restraint use in residents with dementia living in residential aged care facilities: a scoping review, Journal of Clinical Nursing, 2020, which has been published in final form at https://doi.org/10.1111/jocn.15487. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving (http://olabout.wiley.com/WileyCDA/Section/id-828039.html)
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This publication has been entered in Griffith Research Online as an advanced online version.
Subject
Nursing
Health services and systems
Public health
Psychology
Dementia
Long term care
Restraint
Scoping review