Effects of a Multifactorial Intervention to Reduce Physical Restraints for Care Providers in Nursing Homes

Study Overview
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Brief Summary
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Scholars from around the world have been strongly advocating restraint-free care in long-term care institutions. Therefore, the aim of this study was to evaluate the effects of a multifactorial intervention to reduce physical restraints for care providers in nursing homes.

Detailed Description
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In Taiwanese nursing homes, the use of physical restraints on residents as a protective measure is fairly common. However, physical restraints can be seen as a violation of human rights, and there is no guarantee of the effectiveness or safety of such physical restraints.This study was to evaluate the effects of a multifactorial intervention to reduce physical restraints for care providers in nursing homes. A cluster randomized controlled trial was conducted using pretest-posttest control group design. A purposive sampling of participants was chosen from care providers of 6 nursing home institutions in Taiwan, who were then randomly assigned to the experimental group (3 nursing homes) or the control group (3 nursing homes). The experimental group underwent multifactorial interventions to reduce physical restraint.

Official Title
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The Effects of a Multifactorial Intervention to Reduce Physical Restraints for Care Providers in Nursing Homes: A Cluster Randomized Controlled Trial

Conditions
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Nursing Homes, Intervention, Older People

Intervention / Treatment
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* Other: multifactorial interventions


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: A full-time care provider Worked in a nursing home for more than three months Care providers have imposed physical restraints on elderly residents aged 60 or above Within the last month. Exclusion Criteria: • can't speak or read chinese, Vietnamese, Indonesian
Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Health Services Research
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| No Intervention: comparison group<br>The Control Group received no extra care. | |
| Experimental: Intervention Group<br>Intervention Group, Intervention with follow-up, will have a multifactorial interventions to reduce physical restraint. | Other: multifactorial interventions<br>* The experimental group underwent multifactorial interventions to reduce physical restraint, including developing routines for physical restraint, promoting institutional policies to reduce the use of physical restraint, developing alternative methods, education, and consultations.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| knowledge | The Knowledge of Restraints use scale . The Knowledge of Restraints use scale was used to assess the knowledge component. The scale consists of 20 items scored as 1 (true) or 0 (false or uncertainty). A higher score indicates more knowledge; total scores range from 0 to 20. | 8 minutes | 
| Attitudes | The Attitudes of Restraints use scale . The Attitudes of Restraints use scale was used to assess participants' attitudes about restraint use. The scale is a 15 items with a 5-point Likert scale ranging from 1 (not at all agree) to 5 (most agree); the range of total scores is from 15 to 75. Higher scores indicate more negative attitudes about physical restraint use. | 8 minutes | 
| Behavior | The Behavior of restraints use scale . The Behavior of restraints use scale was used to assess care providers' behavior about restraint use. The scale consists of 13 items scored as 1 (yes) or 0 (no); the range of total scores is from 0 to 13. The higher the score, the better the behavior. | 4 minutes | 
| physical restraint use | the percentage of physical restraint use | 1 minutes | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Restraint types | The percentage of restraint types use. The restraint types including device (wrist belt, waist belt, ankle belt, vest in wheel chair, belt in wheel chair, wheel chair with a table board, hand mitts, special sheet etc), area (trunk, waist, ankle, wrist), belt in bed, belt in wheel chair, day time, night, whole day. | 1 minutes | 
| Multiple restraints | the percentage of multiple restraints | 1 minutes | 
| agitated and inappropriate behavior | the percentage of agitated and inappropriate behavior | 1 minutes | 
| Extubation rate | the percentage of extubation | 1 minutes | 
| falls rate | the percentage of falls | 1 minutes | 
| psychotropic medication prescriptions | the percentage of psychotropic medication prescriptions | 1 minutes | 
| fall-related fractures | the percentage of fall-related fractures | 1 minutes | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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care providers, restraints