Koopmans R T, Wiersma F S, Bouwsma M, van Engelen H G
Verpleeghuis Joachim en Anna, zorgcentrum voor ouderen, Nijmegen.
Tijdschr Gerontol Geriatr. 1998 Apr;29(2):67-73.
All representatives of psychogeriatric patients of two Dutch nursing homes (in Nijmegen and Amsterdam) were asked for their opinion about the use of (physical) restraints. Questions referred to characteristics of the respondents and their relatives in the nursing home, information provided by the nursing home, and decision-making. Furthermore respondents' opinion was studied by means of statements on six patient cases for whom respondents could choose the application of any type of restraint or no restraint. 77% (321) of all 416 representatives who were sent a questionnaire responded. The majority (75%) was well informed on the existence of several types of physical restraints, one third of the respondents, however, answered that information provided by the nursing home in this respect was lacking. 55% of the respondents answered that there was only a need for information on physical restraint when a problem concerning their family member actually occurs. Almost 90% of the respondents wanted to play an active role in decision-making or at least be informed before or shortly after application of a restraint. From the answers on the statements a majority of the respondents may be concluded to choose for safety above freedom for their relatives. Belts tied to a chair or bed, but also chairs with tables across, were judged to be the most restraining and influential on the mood of the relatives. The answers regarding the six patient cases show that a majority of the respondents choose any type of restraint. In most cases they choose for less restraining devices and for devices with less or no influence on the mood. About one-third of the representatives of the Amsterdam nursing home answered that their relatives ever had had any application of a restraint, while in the Nijmegen nursing home this prevalence was twice as high. In many aspects Amsterdam respondents were more critical about the application of restraints. This could probably be explained by the difference in policy of restraint application between the two nursing homes.
