Development and validation of a scale of healthcare professional attitudes to the liberation from restraint use with dependent people
Keywords:
Attitudes. Restraint. Geriatric. Scale.Abstract
Background. There are studies on the prevalence and use of restraints but not a measuring instrument to eliminate subjectivity in evaluation of their use in clinical practice and research in our environment.
Objective. Design and validation of a scale of measurement of attitudes of health care professionals towards the use of physical and pharmacological restraints.
Methods. Descriptive and correlational study for scale validation. Following a literature review, we developed a list of items that were subjected to a validity analysis: validity of content through judges, validity of criterion through external variable contrast, and validity of construct using exploratory factor analysis. Reliability was analysed using the Cronbach alpha coefficient.
Results. Two hundred and seventy-six people answered the questionnaire, 82.4% (224) women and 17.6% (48) men, average age 38.65 years. The 40 item scale provided a Cronbach alpha of 0.897. Four dimensions were obtained explaining 46.758% of the total variance. The factors were named: Autonomy (15.084% of the variance), safety (12.228%), environment (8.463%) and avoidance (6.062%). Except for the last one, all the subscales obtained an alpha superior to 0.717.
There were differences due to the experience in Alzheimer care. Staff with experience score significantly lower in Factor 1 and Factor 3, and higher in Factor 2, but there is no difference in the overall computation. Moreover, by gender, women scored higher in Factor 1.
Conclusions. This scale is a significant step forward in the study of the attitudes of health care professionals as it enquires into underlying causes.
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References
1. HAMERS JP, GULPERS MJ, Y STRIK, W. Use of physical restraints with cognitively impaired nursing homes residents. J Adv Nurs 2004; 45: 246-251.
https://doi.org/10.1046/j.1365-2648.2003.02885.x
2. ENGBERG J, CASTLE N, MCCAFFREY D. Physical restraint initiation in nursing homes and sub sequent resident health. Gerontologist 2008; 48: 442-452.
https://doi.org/10.1093/geront/48.4.442
3. BURGUEÑO AA. MEMORIA DEL PROGRAMA Desatar al Anciano y al Enfermo de Alzheimer. Confederación Española de Organizaciones de Mayores 2007. [consultado 05-06-2013]: Disponible en: http://www.ceoma.org/alzheimer/index.php
4. GALÁN CM, TRINIDAD D, RAMOS P, GÓMEZ JP, ALASTRUEY J, ONRUBIAA ET AL. Uso de sujeciones físicas en una población anciana ingresada en residencias públicas. Rev Esp Geriatr Gerontol 2008; 43: 208-213.
https://doi.org/10.1016/S0211-139X(08)71184-3
5. VIDÁN MT, SÁNCHEZ E, ALONSO M, MONTERO B, MARTÍNEZ DE LA CASA A, ORTIZ FJ ET AL. Deterioro funcional durante la hospitalización en ancianos: beneficios del ingreso en el servicio de geriatría. Rev Esp Geriatr Gerontol 2008; 43: 133-138.
https://doi.org/10.1016/S0211-139X(08)71172-7
6. TINETTI ME, LIU WL, GINTER SF. Mechanical restraint use and fall-related injuries among residents of skilled nursing facilities. Ann Intern Med 1992; 116: 369-374.
https://doi.org/10.7326/0003-4819-116-5-369
7. CAPEZUTI E, STRUMPF NE, EVANS LK, GRISSO JA, MAISLIN G. The relation ship between physical restraint removal and falls and injuries among nursing home residents. J Gerontol A Biol Sci Med Sci 1998; 53: M47-52.
https://doi.org/10.1093/gerona/53A.1.M47
8. CAPEZUTI E, EVANS L, STRUMPF N. Physical restraint use and falls in nursing home residents. J Am Geriatr Soc 1996; 44: 627-633.
https://doi.org/10.1111/j.1532-5415.1996.tb01822.x
9. COTTER VT. Restraint free care in older adults with dementia. Keio J Med 2005; 54: 80-84.
https://doi.org/10.2302/kjm.54.80
10. KNOX, J. Reducing physical restraint use in residential aged care: implementation of an evidence-based approach to improve practice. Int J Evid Based Healthc 2007; 5: 102-107.
https://doi.org/10.1111/j.1479-6988.2007.00059.x
11. KOCH S, LYON C, LYON K.S. Case study approach to removing physical restraint. Int J Nurs Pract 2001; 7: 156-161. http://www.scopus.com.scopeesprx.elsevier.com/search/submit/citedby.url?eid=2-s2.0-84872350129&refeid=2-s2.0-0035383379&src=s&origin=reflist&refstat=core
https://doi.org/10.1046/j.1440-172X.2001.00259.x
12. KOCH S, NAY R, WILSON, J. Restraint removal: tension between protective custody and human rights. Int J Older People Nurs 2006; 1: 151-158.
https://doi.org/10.1111/j.1748-3743.2006.00030.x
13. BURGUEÑO AA, IBORRA I, MARTÍNEZ P, PÉREZ V. Prevalencia comunicada de sujeciones físicas: Resultado de la aplicación de un sistema de información para un benchmarking anónimo entre residencias españolas del Programa desatar al anciano y al enfermo de Alzheimer. Agathos: Atención sociosanitaria y bienestar 2008; 1: 4-11.
14. The University of Texas MD Anderson Cancer Center Restraints Improvement Group: Alternatives for Physical Restraint: Myths and Truths about Physical Restraints; Including a Nursing Survey on Restraint Practices. ISPUB 1999; 3.
15. KARLSSON S, BUCHT G, ERIKSSON S, SANDMAN P. Factors relating to the use of physical restraints in geriatric care settings. J Am Geriatr Soc 2001; 49: 1722-1728.
https://doi.org/10.1046/j.1532-5415.2001.49286.x
16. 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.
https://doi.org/10.1111/j.1547-5069.2010.01341.x
17. CHUANG Y , HUANG H. Nurses' feelings and thoughts about using physical restraints on hospitalized older patients. J Clin Nurs 2007; 16: 486-494.
https://doi.org/10.1111/j.1365-2702.2006.01563.x
18. PRAT F. Bioética en residencias. Problemas éticos en la persona mayor. Santander: Sal Terrae, 2008.
19. BERMEJO JC, VILLACIEROS M, CARABIAS R. Experimento de aprendizaje sobre cuestiones éticas a partir de una mesa de diálogo interactivo. Gerokomos 2013; 24 (3): (En prensa)
20. CARVAJAL A, CENTENO C, WATSON R, MARTÍNEZ M, SANZ A. ¿Cómo validar un instrumen¬to de medida de la salud? An Sist Sanit Na¬var 2011; 34: 63-72.
https://doi.org/10.4321/S1137-66272011000100007
21. COLTON D, XIONG H. Reducing seclusion and restraint: Questionnaire for organizational assessment. J Psychiatr Pract 2010; 16: 358-366.
https://doi.org/10.1097/01.pra.0000388632.74899.86
22. HAMERS J, GULPERS M. Reducing physical restraints in nursing homes. Results of a pilot study. Abstract, 19th IAGG World Congress of Gerontology and Geriatrics. J Nutr Health Aging 2009; 13, S17.
23. LINDENMANN R. FREIHEITSBESCHR ¨ankende Maßnahmen: Einstellung von Pflegepersonen und Pr¨ avalenz in den ¨offentlichen geriatrischen Institutionen der Stadt Luzern. [Physical restraints: Attitudes of nursing staff and prevalence in state-run geriatric institutions in thecity of Luzern]. Master'sthesis. Maastricht University, Maastricht, the Netherlands 2006.
24. JOVELL A. El itinerario de la incertidumbre. An Sist Sanit Navar 2013; 36: 5-7.
https://doi.org/10.4321/S1137-66272013000100001
25. BERMEJO JC. Cuidar a las personas mayores dependientes. Santander: Sal Terrae. 2002.
26. BAZO MT. Negligencia y malos tratos a las personas mayores en España. Rev Esp Geriatr Gerontol 2001; 36: 8-14.
https://doi.org/10.1016/S0211-139X(01)74673-2
27. NAPIERKOWSKI D. Restringir la utilización de sujeciones. Nursing 2003; 21: 18-22.
https://doi.org/10.1016/S0212-5382(03)71836-6
28. GALISKY D. Educación médica en geriatría. Rev Esp Geriatr Geronto l1999; 23: 109-112.
29. WOOLHEAD G, CALNAN M, DIEPPE P, TADO W. Dignity in older age: what do older people in the United Kingdom think? Age Ageing 2004; 33: 165-170.
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