Faculty of Health, Medicine and Lifesciences, CAPHRI Care and Public Health Research Institute, Maastricht University, Maastricht, The Netherlands.
Department of Nursing, White Yellow Cross Limburg, Genk, Belgium.
J Clin Nurs. 2022 Jul;31(13-14):1998-2007. doi: 10.1111/jocn.15457. Epub 2020 Sep 11.
To gain insight into the request, use and associated factors of involuntary treatment in people with dementia (PwD) receiving professional home care in the Netherlands and Belgium.
Most of the PwD remain living at home as long as possible. Due to complex care needs, this can result in an increased risk for care provided against the wishes of the client and/or to which the client resists, referred to as involuntary treatment.
Secondary data analyses of two cross-sectional surveys.
Dementia case managers and district nurses filled in a questionnaire for each PwD in their caseload. This study included data of 627 PwD receiving professional home care in the Netherlands and 217 in Belgium. The same methodology (questionnaire and variables) was used in both samples. Descriptive statistics and multi-level logistic regression analyses were used to analyse the data. The study adhered to the STROBE checklist.
More than half of the PwD (50.7%) living at home received involuntary treatment (Belgium 68.2% and the Netherlands 44.7%). Nonconsensual care (82.7%) was the most common, followed by psychotropic medication (40.7%) and physical restraints (18.5%). Involuntary treatment use was associated with living alone, greater ADL dependency, lower cognitive ability, higher family caregiver burden and receiving home care in Belgium versus the Netherlands. Involuntary treatment was most often requested by family caregivers.
Involuntary treatment is often used in PwD, which is in line with previous findings indicating dementia as a risk factor for involuntary treatment use. More research is needed to gain insight into variations in prevalence across other countries, which factors influence these differences and what countries can learn from each other regarding prevention of involuntary treatment.
To provide person-centred care, it is important to study ways to prevent involuntary treatment in PwD and to stimulate dialogue between professional and family caregivers for alternative interventions.
深入了解在荷兰和比利时接受专业家庭护理的痴呆症患者（PwD）中，非自愿治疗的请求、使用情况和相关因素。
大多数 PwD 尽可能长时间地留在家里。由于护理需求复杂，这可能会增加违背客户意愿提供护理的风险，或者客户会抗拒这种护理，这被称为非自愿治疗。
两项横断面调查的二次数据分析。
痴呆症个案经理和地区护士为他们的服务对象中的每位 PwD 填写了一份问卷。这项研究包括在荷兰接受专业家庭护理的 627 名 PwD 和在比利时接受护理的 217 名 PwD 的数据。两个样本都使用了相同的方法（问卷和变量）。使用描述性统计和多水平逻辑回归分析来分析数据。研究遵守 STROBE 清单。
超过一半（50.7%）住在家里的 PwD 接受了非自愿治疗（比利时 68.2%，荷兰 44.7%）。非自愿护理（82.7%）最为常见，其次是精神科药物（40.7%）和身体约束（18.5%）。非自愿治疗的使用与独居、更大的 ADL 依赖性、较低的认知能力、更高的家庭照顾者负担以及在比利时而不是荷兰接受家庭护理有关。非自愿治疗通常是由家庭照顾者要求的。
非自愿治疗在 PwD 中经常使用，这与以前的研究结果一致，表明痴呆症是使用非自愿治疗的一个风险因素。需要进一步研究，以了解在其他国家的患病率差异、哪些因素影响这些差异以及各国可以从彼此那里学到什么，以防止非自愿治疗。
为了提供以患者为中心的护理，重要的是研究预防痴呆症患者非自愿治疗的方法，并促进专业人员和家庭照顾者之间的对话，以寻求替代干预措施。
