A study on status and factors associated with the use of physical restraints among residents of long-term care institutions in a city

Hul Chi Huang, Chung Yi Li

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Abstract

To investigate the rate of and factors associated with the use of physical restraints among residents of long-term care institutions. Methods: This is a cross-sectional study involving 848 residents sampled from 20 residential institutions using probability proportional to size (PPS) across a total of 178 residential institutions in one city. Information on the use of physical restraints and disease history was collected using observation and chart review. Physical functioning, balance and leg muscle power were also measured and recorded. x2 and simple t test were used to compare differences in characteristics between residents who were and were not physically restrained. A logistic regression model was used to identify factors significantly associated with odds of any type of physical restraint use or multiple physical restraint use. Results: The rate of any physical restraint use and multiple physical restraint use was estimated at 74.1% (95% confidence interval, CI=71.2-77.0%) and 47.8% (95% CI=39.9%-55.6%). Compared to those not physically restrained, residents who were physically restrained had a higher rate of cerebrovascular disease, dementia and pressure sores, and had been resident in the institution for longer. Restrained residents had a significant deficit in their scores for activity of daily living (ADL), Mini Mental State Examination (MMSE) and muscle power of both legs. The leading reason given for using physical restraints was "preventing a fall" (79.8%). Multivariate analysis showed that an increased ADL score was significantly associated with reduced odds of the use of any physical restraint (Adjusted Odds Ratio, AOR=0.98, 95% CI=0.97-0.99) or the use of multiple physical restraints (AOR=0.95, 95% CI=0.93-0.97). Residents from institutions with a second grade by accreditation, whose families had signed an agreement for physical restraints, also showed a significantly increased AOR for the use of physical restraints. Conclusions: The use rate of physical restraint was higher in this Taiwanese residential sample compared to rates found in Europe and United States. Use rate varied within the institution and was associated with signed agreement and poorer physical functioning as indicated by the residents' ADL scores. (Taiwan J Public Health. 2009;28(2):132-143).

Original languageEnglish
Pages (from-to)132-143
Number of pages12
JournalTaiwan Journal of Public Health
Volume28
Issue number2
Publication statusPublished - 2009 Apr 1

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All Science Journal Classification (ASJC) codes

  • Public Health, Environmental and Occupational Health

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