Variation of the Occurrence of Physical Restraint Use in the Long-Term Care: A Scoping Review

Abstract

Physical restraints in the long-term care setting are still commonly used in several countries with a prevalence ranging from 6% to 85%. Trying to have a broad and extensive overlook on the physical restraints use in long-term care is important to design interventions to prevent and/or reduce their use. Therefore, the aim of this scoping review was to analyze the range of occurrence of physical restraint in nursing homes, long-term care facilities, and psychogeriatric units. Pubmed, CINAHL, Ovid PsycINFO- databases were searched for studies with concepts about physical restraint use in the European long-term care setting published between 2009 and 2019, along with a hand search of the bibliographies of the included studies. Data on study design, data sources, clinical setting and sample characteristics were extracted. A total of 24 studies were included. The median occurrence of physical restraint in the European long-term care setting was still high (26.5%; IQR 16.5% to 38.5%) with a significant variability across the studies. The heterogeneity of data varied according to study design, data sources, clinical setting, physical restraint’s definition, and patient characteristics, such as ADLs dependence, presence of dementia and psychoactive drugs prescription.

Association of surveillance technology and staff opinions with physical restraint use in nursing homes: Cross‐sectional study

“…42 A recent scoping review concluded that reported rates of restraint use decreased (nonsignificantly) over the last decade, which is to take into account when comparing our findings to results from earlier studies. 10 While the current study's data indicate a relatively low prevalence (11.1%) of restraint use, there is high variability between units (range: 0.0%-63.6%), and despite research findings suggesting that restraint-free nursing is an achievable goal in NHs, only 30.1% of our sample's units were providing such care. 43 We also investigated the relationship between the use of surveillance technologies and rates of physical restraint use.…”

“…Staff generally assess bedrails as less restrictive than belts, which partly explains the differences in prevalence between the two general types of restraints 42 . A recent scoping review concluded that reported rates of restraint use decreased (nonsignificantly) over the last decade, which is to take into account when comparing our findings to results from earlier studies 10 . While the current study's data indicate a relatively low prevalence (11.1%) of restraint use, there is high variability between units (range: 0.0%–63.6%), and despite research findings suggesting that restraint‐free nursing is an achievable goal in NHs, only 30.1% of our sample's units were providing such care 43 …”

“…Prevalence for physical restraint use ranges widely internationally. Beyond country‐specific differences, the heterogeneity of research methods and wide variations in conceptual and operational definitions impedes international comparisons 1,2,10 . A 2021 meta‐analysis reported a pooled prevalence of 37% in Europe and of 22% in North America, 2 while a 2021 scoping review reported a median occurrence of 26.5% in European NHs, with substantial variability (range: 7.7%–60.5%) 10 .…”

“…1,2,10 A 2021 meta-analysis reported a pooled prevalence of 37% in Europe and of 22% in North America, 2 while a 2021 scoping review reported a median occurrence of 26.5% in European NHs, with substantial variability (range: 7.7%-60.5%). 10 Several factors have been investigated in relation to physical restraint use, such as public reporting policies, organizational characteristics (e.g., staffing), organizational culture, and resident characteristics. While resident characteristicsespecially higher levels of cognitive deficiency and dependency-have been repeatedly significantly associated with increased restraint use, most other factors have produced mixed results.…”

“…Beyond country-specific differences, the heterogeneity of research methods and wide variations in conceptual and operational definitions impedes international comparisons. 1,2,10 A 2021 meta-analysis reported a pooled prevalence of 37% in Europe and of 22% in North America, 2 while a 2021 scoping review reported a median occurrence of 26.5% in European NHs, with substantial variability (range: 7.7%-60.5%). 10 Several factors have been investigated in relation to physical restraint use, such as public reporting policies, organizational characteristics (e.g., staffing), organizational culture, and resident characteristics.…”