Comparisons of restraint use in nursing homes in eight countries

TitleComparisons of restraint use in nursing homes in eight countries
Publication TypeJournal Article
Year of Publication1997
AuthorsLjunggren G., Phillips C.D, Sgadari A.
JournalAge & Ageing
IssueSUPPL. 2
Keywords*home for the aged, *immobilization, *nursing home, Aged, article, case mix, chair, cognitive defect/th [Therapy], Comparative Study, daily life activity, Denmark, developed country, france, Human, Iceland, Italy, Japan, limb, major clinical study, performance, physical capacity, physical disability/th [Therapy], priority journal, resident, sitting, spain, sweden, United States

Background: the use of restraints in nursing homes varies among countries and institutions. However, in many countries, no reliable data exist, although restraints use is acknowledged. Method: we compare data of the type of restraints used (trunk, limb or chair that prevents rising) and the intensity of its use in eight countries: Denmark, France, Iceland, Italy, Japan, Spain, Sweden and the USA. We report these data in total and for groups of residents with similar functional abilities and cognitive performance, thus avoiding to a certain extent the case-mix differences between samples from different countries. Results: the total use of restraints in these cross-sectional samples showed a very low prevalence in Denmark, Iceland and Japan (less than 9%). Between 15 and 17% were seen in France, Italy, Sweden and the USA, while Spain showed almost 40%. These major differences among the countries persist, even when one controls for physical and cognitive abilities. There are also differences in the types and intensity of restraints used in different countries. In all countries, there is a constant increase in use of restraints with increasing activities of daily living difficulties and cognitive dysfunction.