The treatment of adult patients with a mental disability. Part 3: The use of restraint

Bridgman, Andrew; Wilson, Margaret

doi:10.1038/sj.bdj.4800720

Cited by 8 publications

(3 citation statements)

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“…Representa, además, un reto para el profesional de la salud y le plantea una serie de implicaciones éticas y legales, que ameritan un estudio serio y permanente. [36][37][38]…”

Section: Discussionunclassified

Asociación Entre El Estado Mental Y La Condición Oral De La Persona Adulta Mayor Institucionalizada De Bucaramanga Y Su Área Metropolitana: Estudio Preliminar

et al. 2018

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RESUMEN Objetivo: Evaluar la asociación entre algunos factores sociodemográficos y el estado mental con la condición oral de la persona adulta mayor institucionalizada, de Bucaramanga y su área metropolitana. Materiales y Métodos: Se evaluaron 284 individuos institucionalizados; 45% fueron mujeres y 55% hombres, con un promedio de edad de 77.7 ± 8.8 años y un rango entre 60 y 96 años. La función cognitiva se determinó con el Mini-Mental y la Escala de Depresión Geriátrica valoró el nivel de depresión. La condición oral se evaluó por otro grupo de investigación perteneciente a la Universidad Santo Tomás, que trabajó simultáneamente en la recolección de los datos. Resultados: El COP-D≥23, Indice de Caries Radicular (RCI) ≥80, CPITN≥2 y el edentulismo total fueron los más frecuentes en esta población, con prevalencias de 88.4%, 55.2%, 84.8% y 55%, respectivamente. Se encontró un deterioro mental de 38%, 40.3% de depresión leve y 15% de depresión moderada. El deterioro mental se asoció con una condición periodontal de leve a severa OR 8.96, IC 95% (0.72-111.7) (p=0.10). A pesar de no hallar significancia estadística para los otros indicadores orales, es importante considerar la condición mental como factor de riesgo importante para tener una mala higiene oral (ICP≥2), RCI≥80 y CPITN≥2. La condición mental no se encontró asociada con edentulismo total en este estudio. Conclusiones: Es necesario valorar integralmente la persona mayor, para determinar como interactúan aspectos sociales, culturales, funcionales, sensoriales y mentales sobre su salud oral y bienestar.

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“…Representa, además, un reto para el profesional de la salud y le plantea una serie de implicaciones éticas y legales, que ameritan un estudio serio y permanente. [36][37][38]…”

Section: Discussionunclassified

Asociación Entre El Estado Mental Y La Condición Oral De La Persona Adulta Mayor Institucionalizada De Bucaramanga Y Su Área Metropolitana: Estudio Preliminar

et al. 2018

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“…Acquiring consent and assent will involve the provision of detailed explanations of the technique to be used and the rationale for its use. Only in the case of life‐threatening emergencies should restraint be used without consent (Chambers 1993; Bridgman & Wilson 2000). Thirdly, there should be careful and comprehensive record‐keeping, including the rationale for the use of restraint, documentation of alternative approaches that have been attempted, information given to the patient and their representatives, and evidence of consent.…”

Section: Guidelines For the Use Of Restraint In Dentistrymentioning

confidence: 99%

Restrictive Behaviour Management Procedures with People with Intellectual Disabilities who Require Dental Treatment

Newton

2009

Research Intellect Disabil

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Background Dental disease is more common among people with intellectual disabilities than in the general population. Improvements in oral health require individuals to engage in daily oral hygiene and regular visits to a dental practitioner; both may be challenging for the individual with intellectual impairment. Materials and Methods A review of policies relating to behaviour management and physical restraint for individuals with intellectual disabilities and challenging behaviours was undertaken. Published studies of behaviour management in individuals with intellectual disabilities attending for dental treatment were reviewed. Reference to studies of children with average IQ and other populations were made where appropriate. Results There is little published evidence regarding behaviour management for people with intellectual disabilities who require dental treatment. Current policies place great emphasis on pharmacological management and restrictive behaviour management techniques. There is a paucity of studies which have employed a functional analysis framework. There are few incentives for dentists to implement positive approaches to behaviour management as current systems of payment reward the completion of numbers of treatments and thus there is an incentive to complete treatments quickly rather than to spend time with patients. Conclusions There is a need for research addressing the behaviour management of individuals with intellectual disabilities who require dental treatment, particularly the efficacy of non-restrictive techniques and the provision of incentives that reward the use of positive behaviour management among dentists. The use of restrictive techniques should be carefully monitored for compliance with best practice guidelines.

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“…In turn, these matters may impede the doctor's possibility of carrying out a satisfactory health assessment as a basis for diagnosis and treatment, as well as jeopardising the safety of the examination (Lennox et al, 1997; Romer, 2009). Thus, in some of these cases, professionals use restraints to ensure safe and efficient examination and treatment (Bridgman & Wilson, 2000; Romer, 2009; Sparby et al, 2016).…”

Section: Introductionmentioning

confidence: 99%

Mediating the interface between voluntariness and coercion: A qualitative study of learning disability nurses’ work in medical examinations of people with intellectual disability

Sparby

Olsvold

Obstfelder

2020

Journal of Clinical Nursing

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Aims and Objectives:To gain knowledge of prevention and use of restraints in provision of medical care to people with intellectual disability. To this end, we explore how learning disability nurses in community services support the individual through medical examinations when facing resistance.Background: Despite increased focus on limiting restraints, there is a lack of knowledge of how restraints are prevented and used in the delivery of physical health care to people with intellectual disability. Design:We used an ethnographic comparative case design (n = 6). Methods:The study was carried out in Norway. The analysis is based on data from semi-structured interviews, participant observation and document studies, in addition to health sociological perspectives on how to support individuals to make their body available for medical examination and intervention. The SRQR checklist was used.Results: Learning disability nurses strove to ensure that examinations were carried out on the individual's terms, supporting the individual in three phases: preparing for the examination, facilitating the examination and, when facing resistance, intervening to ensure safe and compassionate completion of the examination. Conclusions:Supporting the person was a precarious process where professionals had to balance considerations of voluntariness and coercion, progress and breakdown, safety and risk of injury, and dignity and violation. Through their support, learning disability nurses helped to constitute the "resistant" individual as "a cooperative patient," whose body could be examined within the knowledge and methods of medicine, but who could also be safeguarded as a human being through the strain of undergoing examination.Relevance to clinical practice: The article sheds light on how restraints are used in the medical examination and treatment of people with intellectual disabilities and demonstrates the significance of professional support workers' contributions, both

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The treatment of adult patients with a mental disability. Part 3: The use of restraint

Cited by 8 publications

References 2 publications

Asociación Entre El Estado Mental Y La Condición Oral De La Persona Adulta Mayor Institucionalizada De Bucaramanga Y Su Área Metropolitana: Estudio Preliminar

Asociación Entre El Estado Mental Y La Condición Oral De La Persona Adulta Mayor Institucionalizada De Bucaramanga Y Su Área Metropolitana: Estudio Preliminar

Restrictive Behaviour Management Procedures with People with Intellectual Disabilities who Require Dental Treatment

Mediating the interface between voluntariness and coercion: A qualitative study of learning disability nurses’ work in medical examinations of people with intellectual disability

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