title: The concept of restraint in nursing home practice: a mixed-method study in nursing homes for people with dementia.
abstract: BACKGROUND
  Although in most developed countries the use of restraints is regulated and restricted by law, the concept of restraint in nursing home care remains ambiguous. This study aims to explore how care professionals and family members of nursing home residents with dementia in the Netherlands experience and define the concept of restraint.
  
  
  METHODS
  Individual interviews were held with relatives (n = 7) and key persons (n = 9) in seven nursing homes. We also conducted eight focus group discussions with nursing home staff. In addition, a structured questionnaire was administered to the nurses of participating nursing homes.
  
  
  RESULTS
  In the questionnaire, over 80% of the respondents indicated considering "fixation" (e.g. use of belts) as a restraint and 50 to 70% of the respondents regarded other physical interventions, such as geriatric chairs and bedrails, as restraints. The interviews and focus group discussions show that the residents' perception of the intervention, the staff's intention behind the intervention and concerns of privacy are the criteria used by the respondents in defining an intervention as a restraint.
  
  
  CONCLUSIONS
  When trying to diminish restraint use, it is important to be aware of the "local logic" of care practice and to take into account the fact that, for staff and relatives, an intervention is only regarded as a restraint when it is bothering a resident or when an intervention is used for the sole purpose of restricting freedom and/or when interventions invade the privacy of a resident.
authors.affiliation: Department of Nursing Home Medicine/EMGO Institute for Health and Care Research, VU Medical Center, Amsterdam, The Netherlands.
authors.forename: Sandra A
authors.initials: SA
authors.lastname: Zwijsen
authors.forename: Marja F I A
authors.initials: MF
authors.lastname: Depla
authors.forename: Alistair R
authors.initials: AR
authors.lastname: Niemeijer
authors.forename: Anneke L
authors.initials: AL
authors.lastname: Francke
authors.forename: Cees M P M
authors.initials: CM
authors.lastname: Hertogh
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001291:Attitude of Health Personnel; D003704:Dementia / Q000150:complications / Q000451:nursing*; D005190:Family / Q000523:psychology; D005260:Female; D017144:Focus Groups; D006707:Homes for the Aged; D006801:Humans; D008297:Male; D028642:Persons with Psychiatric Disorders / Q000523:psychology; D009426:Netherlands; D009735:Nursing Homes; D009740:Nursing Staff / Q000523:psychology; D010818:Practice Patterns, Physicians'; D011595:Psychomotor Agitation / Q000209:etiology / Q000628:therapy; D012149:Restraint, Physical / Q000379:methods / Q000523:psychology; D012938:Social Perception; D011795:Surveys and Questionnaires