The health consequences of using physical restraints in nursing homes.
BACKGROUND
Using a national longitudinal sample of nursing homes residents (N = 264,068), we examine whether physical restraint use contributes to subsequent physical or psychological health decline.


METHODS
The minimum data set, the on-line survey certification and recording system, and the area resource file were the data sources used. This data represented the period of 2004 and 2005. To control for the difference in characteristics between residents who were subsequently physically restrained and who were not, we use a propensity score matching method.


RESULTS
For all outcomes examined (except depression), that is, behavior issues, cognitive performance, falls, walking dependence, activities of daily living, pressure ulcers, and contractures, were all significantly worse for restrained residents compared with matched residents who were not restrained.


CONCLUSIONS
Physical restraint use represents poor clinical practice, and the benefits to residents of further reducing physical restraint use in nursing homes are substantial.
Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA 15261, USA. castlen@pitt.edu
Nicholas G
NG
Castle
John
J
Engberg
D000058:Accidental Falls / Q000706:statistics & numerical data; D000203:Activities of Daily Living; D000368:Aged; D003863:Depression / Q000209:etiology; D006304:Health Status; D006707:Homes for the Aged / Q000706:statistics & numerical data*; D006801:Humans; D008603:Mental Health; D009735:Nursing Homes / Q000706:statistics & numerical data*; D012149:Restraint, Physical / Q000009:adverse effects*; D016138:Walking / Q000706:statistics & numerical data