Harris J
British Institute of Learning Disabilities, Kidderminster, Worcerstershire, U.K.
Res Dev Disabil. 1996 Mar-Apr;17(2):99-134. doi: 10.1016/0891-4222(95)00036-4.
This paper reviews the published research literature on the use of physical restraint with mentally retarded adults and children. Research on three types of restraint is included. One type involves one or more person(s) holding another. A second method is where a mechanical device is fitted to limit movement or reduce injury. The third type is where the person voluntarily applies a personal or mechanical restraint. The following conclusions emerged: (a) there are numerous processes which contribute to the outcomes associated with restraint, and these are poorly understood; (b) different processes mediate the outcomes for contingent and noncontingent restraint; (c) both noncontingent and contingent restraint can result in long-term reductions in target behaviours, especially when fading procedures are employed (noncontingent restraint) and where staff or carers are involved in the treatment plan (contingent restraint); (d) self-restraint seems to be maintained by the reinforcing effects of the restraint procedure or by escape from the aversive consequences of self-injury; (e) there are (negative) reinforcing consequences for staff who use restraint procedures in service settings; (f) and both staff and clients risk injury, especially from emergency or unplanned restraint.
本文回顾了已发表的关于对智障成人及儿童使用身体约束的研究文献。研究涵盖了三种约束类型。一种类型是一个或多个人抱住另一个人。第二种方法是安装机械设备以限制行动或减少伤害。第三种类型是个人自愿使用个人约束或机械约束。得出了以下结论：（a）有许多因素促成了与约束相关的结果，而这些因素目前还鲜为人知；（b）不同的因素介导了偶然约束和非偶然约束的结果；（c）非偶然约束和偶然约束都能导致目标行为的长期减少，特别是在采用消退程序时（非偶然约束）以及工作人员或护理人员参与治疗计划时（偶然约束）；（d）自我约束似乎是由约束程序的强化作用或逃避自我伤害的厌恶后果所维持；（e）在服务环境中使用约束程序的工作人员会有（负面的）强化后果；（f）工作人员和服务对象都有受伤的风险，特别是在紧急或无计划的约束情况下。
