The use of seclusion and physical restraint is viewed as a practice incompatible with the vision of recovery, and its therapeutic benefit remains unsubstantiated. This Open Forum describes an initiative that began in 1999 at two crisis centers that was designed to completely eliminate the practice of seclusion and restraint. Seclusion and restraint elimination strategies included strong leaders...

Background. The use of coercion within the psychiatric services is problematic and raises a range of ethical, legal, and clinical questions. "Physical restraint" is an emergency procedure used in psychiatric hospitals to control patients that pose an imminent physical danger. We wished to review the literature published in scientific peer-reviewed journals describing studies on the use of physi...

BACKGROUND Physical restraints are still frequently used in nursing home residents despite growing evidence for the ineffectiveness and negative consequences of these methods. Therefore, reduction in the use of physical restraints in psycho-geriatric nursing home residents is very important. The aim of this study was to investigate the short-term effects of an educational intervention on the us...

BACKGROUND: In view of the issues surrounding physical restraint use, it is important to have a method of measurement as valid and reliable as possible. We determined the sensitivity and specificity of physical restraint use a) reported by nursing staff and b) reviewed from medical and nursing records in nursing home settings, by comparing these methods with direct observation. METHODS: We samp...

OBJECTIVES Physical restraints are often used to prevent falls and to secure medical devices in older people in hospitals. Restraint reduction has been advocated on the grounds that physical restraints have negative psychological effects and are not effective in preventing falls. The potential effect of restraint reduction on length of hospital stay (LOS) has not been investigated. This study w...

The appropriateness of and justification for physical restraint procedures in intellectual disabilities settings is an emotive issue. It creates a number of ethical dilemmas for nursing staff. This article examines the views of service users and nursing staff from secure residential facilities where restraint is used frequently. Both groups were asked to rate three videotaped restraint procedur...

OBJECTIVE To investigate the relationship among BMI, smoking consumption, dietary restraint, smoking to control weight, physical self-perception and self-esteem in young female adolescents. METHODS 702 grade 9 students (14-15 yrs old) completed self-reported validated measures in classroom settings. RESULTS 26.7% of students had smoked in the last 30 days. Cigarette consumption was low with...

OBJECTIVES To develop an internationally accepted research definition of physical restraint. DESIGN Comprehensive literature search followed by a web-based, three-round, modified Delphi technique comprising reviews and feedback. SETTING Clinical care settings. PARTICIPANTS An international group of 48 experts consisting of researchers and clinicians from 14 countries who have made sustain...

This study examined the impact of the Nursing Home Reform Act of 1987 on residentand-facility-level risk factors for physical restraint use in nursing homes. Data on the 1990 and 1993 cohorts were obtained from 268 facilities in 10 states, and data on a 1996 cohort were obtained from the Medical Expenditure Panel Survey, which sampled more than 800 nursing homes nationwide. Multivariate logisti...