Knowledge, perceptions, and experiences of family caregivers and home care providers of physical restraint use with home-dwelling elders: a cross-sectional study in Japan

BMC Geriatrics

Toshiyuki Ojima¹  Sadami Kurata² 

[1] Department of Community Health and Preventive Medicine, Hamamatsu University School of Medicine, Hamamatsu, Japan;Gerontological Nursing, Faculty of Nursing, Hamamatsu University School of Medicine, Hamamatsu, Japan

关键词: Home care providers;    Family caregivers;    Aged;    Physical restraints;   

Others  :  855206
DOI  :  10.1186/1471-2318-14-39

 received in 2013-05-30, accepted in 2014-03-20,  发布年份 2014

【 摘 要 】

Background

The use of physical restraints by family caregivers with home-dwelling elders has not been extensively studied but it might be widespread. Furthermore, it is also not clear how home care providers who support family caregivers perceive the use of physical restraint in elders’ homes. This study assessed family caregivers’ and home care providers’ knowledge and perceptions of physical restraint used with elders living at home in Japan, a country with the highest proportion of elders in the world and where family caregiving is common.

Methods

We undertook a cross-sectional study of 494 family caregivers, 201 home helpers, 78 visiting nurses, 131 visiting physicians, and 158 care managers of home-dwelling frail elders needing some care and medical support in Japan, using questionnaires on knowledge of 11 physical restraint procedures prohibited in institutions and 10 harmful effects of physical restraints, perceptions of 17 reasons for requiring physical restraints, and experiences involving physical restraint use.

Results

Family caregivers were aware of significantly fewer recognized prohibited physical restraint procedures and recognized harmful effects of physical restraint than home care providers, and differences among home care providers were significant. The average importance rating from 1 (least) to 5 (most) of the 17 reasons for requiring physical restraints was significantly higher among family caregivers than home care providers, and significantly different among the home care providers. Moreover, these differences depended in part on participation in physical restraint education classes. While 20.1% of family caregivers had wavered over using physical restraints, 40.5% of home care providers had seen physical restraints used in elders’ homes and 16.7% had advised physical restraint use or used physical restraints themselves.

Conclusions

Knowledge and perceptions of physical restraints differed between family caregivers and home care providers and were also diverse among home care providers. Because both groups might be involved in physical restraint use with home-dwelling elders, home care providers should acquire standardized and appropriate knowledge and perceptions of physical restraints to help family caregivers minimize abusive physical restraint use.

【 授权许可】

   
2014 Kurata and Ojima; licensee BioMed Central Ltd.

【 图 表 】

【 参考文献 】

• [1]Meyer G, Köpke S, Haastert B, Mühlhauser I: Restraint use among nursing home residents: cross-sectional study and prospective cohort study. J Clin Nurs 2009, 18:981-990.
• [2]De Veer AJE, Francke AL, Buijse R, Friele RD: The use of physical restraints in home care in the Netherlands. J Am Geriatr Soc 2009, 57:1881-1886.
• [3]Hamers JPH, Huizing AR: Why do we use physical restraints in the elderly? Z Gerontol Geriatr 2005, 38:19-25.
• [4]The use of restraints with dementia patients [http://www.alzbrain.org/pdf/handouts/2020.%20THE%20USE%20OF%20RESTRAINTS%20IN%20THE%20ELDERLY%20PATIENT.pdf webcite]
• [5]Survey on perception of family caring the elderly with dementia toward physical restraint and its change [http://www.dcnet.gr.jp/cms/contents/data/40/96/LIST_PDF.pdf webcite]
• [6]Higashihata H: Current status of the use of assistive products by elderly persons with dementia and related risk management from the viewpoint of expert advisors for the provision of assistive products. Bull Int Univ Health Welfare 2010, 14:29-40.
• [7]Lai CK, Wong IY: Families’ perspectives on the use of physical restraints. Contemp Nurse 2008, 27:177-184.
• [8]Hamers JP, Meyer G, Kopke S, Lindenmann R, Groven R, Huizing AR: Attitudes of Dutch, German and Swiss nursing staff towards physical restraint use in nursing home residents, a cross-sectional study. Int J Nurs Stud 2009, 46:248-255.
• [9]Haut A, Kolbe N, Strupeit S, Mayer H, Meyer G: Attitudes of relatives of nursing home residents toward physical restraints. J Nurs Scholarsh 2010, 42:448-456.
• [10]Sandhu SK, Mion LC, Khan RH, Ludwick R, Claridge J, Pile JC, Harrington M, Winchell J, Dietrich MS: Likelihood of ordering physical restraints: influence of physician characteristics. J Am Geriatr Soc 2010, 58:1272-1278.
• [11]Tamiya N, Noguchi H, Nishi A, Reich MR, Ikegami N, Hashimoto H, Shibuya K, Kawachi I, Campbell JC: Population ageing and wellbeing: lessons from Japan’s long-term care insurance policy. Lancet 2011, 378:1183-1192.
• [12]Kato G, Tamiya N, Kashiwagi M, Sato M, Takahashi H: Relationship between home care service use and changes in the care needs level of Japanese elderly. BMC Geriatr 2009, 9:58. BioMed Central Full Text
• [13]Kashiwagi M, Tamiya N, Sato M, Yano E: Factors associated with the use of home-visit nursing services covered by the long-term care insurance in rural Japan: a cross-sectional study. BMC Geriatr 2013, 13:1. BioMed Central Full Text
• [14]Situation surrounding long-term care insurance [http://www.mhlw.go.jp/stf/shingi/2r9852000001anru-att/2r9852000001ao3r.pdf webcite]
• [15]Regarding the number of elder people with dementia [http://www.mhlw.go.jp/stf/houdou/2r9852000002iau1-att/2r9852000002iavi.pdf webcite]
• [16]Report on long-term care benefit expense - fiscal year 2011 [http://www.mhlw.go.jp/toukei/saikin/hw/kaigo/kyufu/11/dl/11.pdf webcite]
• [17]Comprehensive Survey of People’s Living Conditions - Fiscal Year 2011 [http://www.mhlw.go.jp/toukei/saikin/hw/k-tyosa/k-tyosa11/dl/12.pdf webcite]
• [18]Nishi A, Tamiya N, Kashiwagi M, Takahashi H, Sato M, Kawachi I: Mothers and daughters-in-law: a prospective study of informal care-giving arrangements and survival in Japan. BMC Geriatr 2010, 10:61. BioMed Central Full Text
• [19]Current Status of the Social Situation, Well-Being, Participation in Development and Rights of Older Persons Worldwide [http://www.un.org/esa/socdev/ageing/documents/publications/current-status-older-persons.pdf webcite]
• [20]The return of the multi-generational family household. Pew research center social & demographic trends report [http://www.pewsocialtrends.org/files/2010/10/752-multi-generational-families.pdf webcite]
• [21]Bredthauer D, Becker C, Eichner B, Koczy P, Nikolaus T: Factors relating to the use of physical restraints in psychogeriatric care: a paradigm for elder abuse. Z Gerontol Geriatr 2005, 38:10-18.
• [22]Yamamoto M, Aso Y: Placing physical restraints on older people with dementia. Nurs Ethics 2009, 16:192-202.
• [23]Long-term care insurance Act [http://www.japaneselawtranslation.go.jp/law/detail_main?vm=&id=94 webcite]
• [24]Baseline survey reports toward abandonment of physical restraints in long-term care insurance reimbursed facilities [http://yokuseihaishi.org/index.php?%E8%B3%87%E6%96%99%E9%9B%86 webcite]
• [25]Survey on the response to Act on prevention of elderly abuse and support for attendants of elderly persons - fiscal year 2011 [http://www.mhlw.go.jp/stf/houdou/2r9852000002rd8k-att/2r9852000002rda1.pdf webcite]
• [26]Guidebook for zero physical restraint campaign [http://www.ipss.go.jp/publication/j/shiryou/no.13/data/shiryou/syakaifukushi/854.pdf webcite]
• [27]Strumpf NE, Evans LK: Physical restraint of the hospitalized elderly: perceptions of patients and nurses. Nurs Res 1988, 37:132-137.
• [28]Akamine Y, Yokota T, Kuniyoshi M, Uza M, Takakura M: Reliability and validity of the Japanese version of physical restraint use questionnaire. Ryukyu Med J 2003, 22:21-28.
• [29]Pellfolk TJE, Gustafson Y, Bucht G, Karlsson S: Effects of a restraint minimization program on staff knowledge, attitudes, and practice: a cluster randomized trial. J Am Geriatr Soc 2010, 58:62-69.
• [30]Moore K, Haralambous B: Barriers to reducing the use of restraints in residential elder care facilities. J Adv Nurs 2007, 58:532-540.
• [31]Karlsson S, Bucht G, Eriksson S, Sandman PO: Factors relating to the use of physical restraints in geriatric care settings. J Am Geriatr Soc 2001, 49:1722-1728.
• [32]Yamamoto M: Dilemmas faced by nurses in elderly care: investigations with quantities and free-answer data obtained from questionnaires regarding physical restraints. Bull Osaka Prefecture Coll Health Sci 2004, 9:19-26.
• [33]Chiba Y, Yamamoto-Mitani N, Kawasaki M: A national survey of the use of physical restraint in long-term care hospitals in Japan. J Clin Nurs 2012, 21:1314-1326.
• [34]Mion LC, Sandhu SK, Khan RH, Ludwick R, Claridge JA, Pile J, Harrington M, Dietrich MS, Winchell J: Effect of situational and clinical variables on the likelihood of physicians ordering physical restraints. J Am Geriatr Soc 2010, 58:1279-1288.
• [35]Nay R, Koch S: Overcoming restraint use: examining barriers in Australian aged care facilities. J Gerontol Nurs 2006, 32:33-38.
• [36]Ginter SF, Mion LC: Falls in the nursing home: preventable or inevitable? J Gerontol Nurs 1992, 18:43-48.
• [37]Gastmans C, Milisen K: Use of physical restraint in nursing homes: clinical-ethical considerations. J Med Ethics 2006, 32:148-152.
• [38]Cooper C, Selwood A, Blanchard M, Walker Z, Blizard R, Livingston G: Abuse of people with dementia by family carers: representative cross sectional survey. BMJ 2009, 338:b155.
• [39]Grossfeld-Schmitz M, Donath C, Holle R, Lauterberg J, Ruckdaeschel S, Mehlig H, Marx P, Wunder S, GraSZel E: Counsellors contact dementia caregivers - predictors of utilisation in a longitudinal study. BMC Geriatr 2010, 10:24. BioMed Central Full Text
• [40]Dubuc N, Dubois M-F, Raiche M, Gueye ND, Hebert R: Meeting the home-care needs of disabled older persons living in the community: does integrated services delivery make a difference? BMC Geriatr 2011, 11:67. BioMed Central Full Text
• [41]Given B, Sherwood PR, Given CW: What knowledge and skills do caregivers need? Am J Nurs 2008, 108:28-34.
• [42]Gulpers MJ, Bleijlevens MH, Ambergen T, Capezuti E, van Rossum E, Hamers JP: Belt restraint reduction in nursing homes: effects of a multicomponent intervention program. J Am Geriatr Soc 2011, 59:2029-2036.
• [43]Selwood A, Cooper C, Owens C, Blanchard M, Livingston G: What would help me stop abusing? The family carer’s perspective. Int Psychogeriatr 2009, 21:309-313.
• [44]Lachs MS, Pillemer K: Elder abuse. Lancet 2004, 364:1263-1272.
• [45]Heath JM, Kobylarz FA, Brown M, Castaño S: Interventions from home-based geriatric assessments of adult protective service clients suffering elder mistreatment. J Am Geriatr Soc 2005, 53:1538-1542.
• [46]Nakanishi M, Hoshishiba Y, Iwama N, Okada T, Kato E, Takahashi H: Impact of the elder abuse prevention and caregiver support law on system development among municipal governments in Japan. Health Policy 2009, 90:254-261.
• [47]Möhler R, Richter T, Kopke S, Meyer G: Interventions for preventing and reducing the use of physical restraints in long-term geriatric care. Cochrane Database Syst Rev 2011, (2):Art. No.:CD007546. doi:10.1002/14651858.CD007546.pub2