Department of Educational and Family Sciences, Faculty of Behavioural and Movement Sciences, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.
J Intellect Disabil Res. 2023 Dec;67(12):1216-1226. doi: 10.1111/jir.12991. Epub 2022 Nov 20.
On 1 January 2020, the Care and Coercion Act came into effect in the Netherlands, subjecting involuntary care to more strict regulations and monitoring. This study tested changes in recordings of involuntary care during the transitional year of 2020 and after full implementation in 2021, which coincided with the first severe test of the new regulations, when COVID-19 lockdown measures were taken on 16 March 2020.
Data consisted of weekly counts of involuntary care from 1 January 2017 to 31 December 2021, taken from the care data of more than 3000 clients with intellectual disabilities and challenging behaviour of 's Heeren Loo, a large long-term care organisation in the Netherlands. An interrupted time series design was used to compare the period under the former law with the period under the new law and to the period during and after implementation, taking into account the impact of the COVID-19 lockdown measures on recordings of involuntary care.
Under the new act in Week 1 of 2020, a statistically significant drop occurred in involuntary care counts, after which these counts gradually decreased. The start of 2021, the year in which the act was fully implemented, showed an initial increase in counts of involuntary care, followed by a decrease (all Ps < .001). The introduction of the COVID-19 lockdown measures did not statistically affect the weekly counts of involuntary care.
The decrease in registered involuntary care after the Care and Coercion Act came into effect is a first indication of the efficacy of this new law that requires careful multidisciplinary consultations around the right of clients to respect their self-determination. Follow-up research should examine whether the impact of the new law aligns with clients' experiences of self-determination.
2020 年 1 月 1 日，《护理与强制法》在荷兰生效，对非自愿护理实行更严格的规定和监督。本研究检测了 2020 年过渡年和 2021 年全面实施后的非自愿护理记录变化，这恰逢新法规的首次严峻考验，即 2020 年 3 月 16 日实施新冠疫情封锁措施。
数据包括 2017 年 1 月 1 日至 2021 年 12 月 31 日每周非自愿护理次数，来自荷兰大型长期护理组织“s Heeren Loo”的 3000 多名智障和行为障碍客户的护理数据。采用中断时间序列设计，比较前法时期、新法时期和实施期间及之后的时期，同时考虑新冠疫情封锁措施对非自愿护理记录的影响。
在 2020 年第 1 周新法案下，非自愿护理次数出现统计学显著下降，之后逐渐减少。2021 年开始全面实施该法案时，非自愿护理次数最初增加，随后减少（均 P<.001）。新冠疫情封锁措施的引入并未对非自愿护理的每周计数产生统计学影响。
《护理与强制法》生效后，登记的非自愿护理减少，这是该新法有效性的初步迹象，需要围绕客户尊重其自决权进行仔细的多学科咨询。后续研究应检查新法律的影响是否与客户的自决体验一致。
