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Running Head: CONCEPT OF RESTRAINT IN NURSING HOME PRACTISE
Topic: Topi c: A review of T!e concep" of re#"rain" in nur#ing !o$e prac"ice: a $i%ed&$e"!od #"ud' in nur#ing !o$e# for peop(e wi"! de$en"ia) Na$e: Cour#e: In#"ruc"or)# Na$e: *a"e:
CONCEPT OF RESTRAINT IN NURSING HOME PRACTISE
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T!e re#earc! ar"ic(e #e(ec"ed i# "!e concep" of re#"rain" in nur#ing !o$e prac"ice, -' Sandra A, .wi#/en, I" focu##e# on a $i%ed $e"!od #"ud' in nur#ing !o$e# for peop(e wi"! de$en"ia, *e$en"ia i# a genera( gen era( (o## of 0rain func"ion "!a" occur# wi"! cer"ain di#ea#e#, I" affec"# $e$or'1 (anguage1 "!in2ing1 0e!avior1 and /udg$en", In non&"ec!nica( (anguage1 i" i# a dec(ine in $en"a( a0i(i"' #evere enoug! "o in!i0i" dai(' (ife ac"ivi"ie#, T!e re#earc! pro0(e$ i#1 under#"anding "!e differen" concep"# of re#"rain" a# prac"iced in nur#ing !o$e#1 $ore #pecifica(('1 under#"anding !ow profe##iona( caregiver# in nur#ing !o$e# and fa$i(' $e$0er# of peop(e (iving wi"! de$en"ia perceive "!e concep" of re#"rain", T!e $ain ai$ or "!e purpo#e of "!i# re#earc! i# "o e%p(ore and gain $ore in#ig!" on !ow 0o"! care profe##iona(# of nur#ing !o$e re#iden"# wi"! de$en"ia and fa$i(' $e$0er# of peop(e p eop(e !aving de$en"ia in "!e Ne"!er(and# e%perience and define "!e concep" of re#"rain", T!e $e"!od of re#"rain" i# "!e independen" varia0(e1 a# "!e differen" $e"!od# of re#"rain" u#ed rai#ed differen" opinion# and effec" on "!e dependen" varia0(e#, T!e dependen" dependen " varia0(e inc(uded 0o"! "!e profe##iona( caregiver# of "!e nur#ing !o$e# and "!e fa$i(' $e$0er# or re(a"ive# re(a"ive# of "!e de$en"ia pa"ien"#, T!e e%"raneou# varia0(e# are "!e de$en"ia pa"ien"#1 "!e dependen"# varia0(e# reac"ion "o "!e variou# re#"raining $e"!od# u#ed on "!e$ $a' affec" "!e #"ud' a(#o "!eir reac"ion "o "!e differen" re#"rain"# u#ed $u#" 0e "a2en in"o accoun", T!e re#earc! 3ue#"ion# a#2ed inc(uded1 w!a" in"erven"ion# u#ed 0' "!e nur#e# were regarded a# re#"rain"# 0' "!e profe##iona( caregiver# and "!e fa$i(' $e$0er#, In addi"ion1 w!ic! for$# of re#"rain"# cau#ed "!e$ w!ic! (eve(# of $ora( di#"re##, T!e re#earc! !'po"!e#i# wa# "!a" "!e defini"ion and under#"anding of "!e concep" conce p" of re#"rain"# 0' profe##iona( caregiver# and in
CONCEPT OF RESTRAINT IN NURSING HOME PRACTISE
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nur#ing !o$e care# were no" on(' unre#"ric"ed 0u" a(#o a$0iguou#1 in "!a" "!e caregiver# did no" fu((' under#"and "!e ru(e# or regu(a"ion# governing re#"rain" u#e, T!e nur#ing "!eor' and or fra$ewor2 prac"iced 0' "!e nur#ing !o$e# T!e u#e of variou# p!'#ica( re#"rain"# !ave no" on(' (ed "o variou# nega"ive #ide effec"# 0u" a(#o in #o$e in#"ance# dea"!, Fur"!er1 nur#e# w!o u#e "!e#e re#"rain"# on peop(e a" "i$e# repor" $ora( di#"re##, T!i# canno" on(' affec" "!eir a0i(i"' "o give pa"ien"# good a""en"ion and care1 0u" i" can a(#o decrea#e "!eir #e(f&e#"ee$, A""e$p"# A""e$p"# !ave 0een $ade "o no" on(' decrea#e 0u" a(#o g guide uide "!e u#e of re#"rain"# on pa"ien"# and even a("erna"ive# $e"!od# of "o u#ing re#"rain"# are 0eing re#earc!ed on, 5!en "r'ing "o no" on(' cur"ai( "!e u#e of re#"rain"# 0u" a(#o find a("erna"ive $e"!od#1 i" i# i$pera"ive for "!e view of "!e nur#e# and caregiver# on "!e concep" of re#"rain"# "o 0e con#idered, T!e i$por"ance of "!i# i# "o define c(ear('1 c(ear('1 w!ere e%ac"(' re#"ric"ion of freedo$ and re#"rain" differ, 6Mo'(e1 +7879 T!e nur#ing "!eor' and or fra$ewor2 prac"iced 0' "!e nur#ing !o$e# i# "!e prac"ice "!eorie#1 $ore #pecifica((' -e""' Neu$ann)#) #'#"e$ $ode( fra$ewor2 w!ic! focu##e# $ore on "!e re#pon#e of "!e c(ien" #'#"e$ "o ei"!er ac"ua( or po"en"ia( environ$en" en viron$en" #"re##or#, I" goe# a!ead "o advi#e "!e u#e of #evera( (eve(# of nur#ing nu r#ing preven"ion in"erven"ion for re"aining1 a""aining1 and $ain"aining op"i$a( c(ien" #'#"e$ we((ne##, -' "!i#1 #!e define# "!e $a/or concern of a nur#e i# preven"ing #"re##, If #"re## i# no" we(( preven"ed "!en "!e nur#e #!ou(d pro"ec" "!e pa"ien")# pa"ien")# 0a#ic #"ruc"ure and find or $ain"ain a $a%i$u$ (eve( of we((ne##, 6Par2er 6+7879 T!e re#earc! $e"!od and de#ign were no" on(' #ound 0u" a(#o va(id in "!a" "!e re#earc!er u#ed re(ied $ore on "!e pri$ar' da"a #ource# "!an #econdar' da"a #ource# #uc! a# (i"era"ure review#1 fur"!er1 "!e re#earc!er conduc"ed 0o"! 3uan"i"a"ive and 3ua(i"a"ive re#earc! "o fur"!er increa#e "!e
CONCEPT OF RESTRAINT IN NURSING HOME PRACTISE
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#o(idne## of "!e #"ud', T!e re#earc!er u#ed in"erview#1 3ue#"ionnaire1 and focu# group di#cu##ion# "!a" invo(ved a(( affec"ed par"ie# and !ence avoided ge""ing a 0ia#ed re#u(", T!e re#earc!er1 !owever fai(ed "o con#ider "!e effec" of "!e#e re#"rain"# "o "!e co$for"# of "!e pa"ien"# and in#"ead u#ed a repre#en"a"ive of "!e fa$i(' "o give "!eir view# on "!e re#"raining re#"raining $e"!od u#ed, A# $uc! a# a de$en"ia pa"ien" !a# pro0(e$# wi"! "!eir "!in2ing capaci"'1 capaci"'1 i" i# i$por"an" "!a" "!e re#earc!er cou(d !ave fac"ored "!e effec"# of #o$e of "!e#e re#"rain"# "o no" on(' "!eir p!'#ica( co$for"1 0u" "o w!a" (eve( "!e' "!e ' affec"ed "!e$, An e%a$p(e fi%a"ion $ig!" (ead "o !ur"ing "!e pa"ien" w!ere "!e 0e("# !ave ! ave 0een "ired 0e i" aroun around d "!e ar$# or "!e (eg# or "!e !ead and a(#o !aving "!e$ for a (ong period wi(( !ave a "o(( on "!e pa"ien" 0' $a2ing "!e$ ge" "ired 3uic2(', T!e #"ud' !owever wa# a0(e "o fu((' re#o(ve "!e 3ue#"ion 0' ge""ing "!e differen" opinion# fro$ "!e caregiver# and "!e fa$i(' $e$0er# "!e re#earc!er wa# a0(e "o prove "!a" "!e differen" per#pec"ive# of "!e differen" profe##iona(# profe##iona(# cau#ed a$0igui"' in "!e defini"ion of "!e concep" of re#"rain"#, T!e #a$p(e #i<e #e(ec"ed wa# repre#en"a"ive of "!e popu(a"ion and !ence !en ce fea#i0(e "o give a non&0ia#ed re#u(", T!e caregiver# were +=> w!i(#" #even nur#ing !o$e# par"icipa"ed in "!e re#earc!, Nine fa$i(' $e$0er# were a(#o inc(uded in "!e re#earc!, T!e (ega( and e"!ica( i##ue# o0#erved inc(uded "!e pro"ec"ion of "!e !u$an# u#ed 0' anon'$i<ing "!e par"icipan"#1 and infor$ed con#en" "o 0e inc(uded in "!e #"ud' w wa# a# #oug!", Fur"!er1 a $edica( e"!ic# governing co$$i""ee approved "!e #"ud' pro"oco(, p ro"oco(, In Ne"!er(and#1 "!e !ea("! (aw# do no" c(ear(' define "!e concep"# of re#"ric"ion of freedo$ or re#"rain" 0u" i" on(' "ouc!e# on in"erven"ion# "!a" are con#idered a# re#"rain"#, Hence1 "!e cu("ure of "!e peop(e in "!i#
CONCEPT OF RESTRAINT IN NURSING HOME PRACTISE
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coun"r' wa# rig!" for "!i# #"ud' a# i" did no" cur"ai( cu r"ai( or inf(uence "!e re#u("# or did no" in"erfere wi"! an' of "!e in"erven"ion# "!e nur#e# were "o u#e -' u#ing 0o"! 3ua(i"a"ive and 3uan"i"a"ive in nur#ing !o$e# "!a" u#ed 0o"! #urvei((ance "ec!no(og' and "!o#e "!a" u#ed i" rare('1 "!e "!e re#earc!er# were a0(e "o find #i$i(ar re#u("# on "!e percep"ion# and defini"ion# of "!e concep" of re#"rain", Mo#" nur#e# regarded regarded fi%a"ion 6u#e of 0e("#91 a "a0(e"op on c!air1 geria"ric geria"ric c!air#1 and 0ed rai(# a# re#"rain"#, T!e re#earc! a(#o found "!a" "!e#e re#"rain"#1 a# we(( a# "!e u#e of #urvei((ance "ec!no(og' and #afe"' 0e("#1 were a cau#e of $ora( di#"re## "o "!e caregiver#, T!e 3ua(i"a"ive par" of "!e re#earc! wa# a "!ree&par" inve#"iga"ion of "!e pre#u$ed percep"ion of "!e re#iden"1 "!e in"en"ion of "!e care profe##iona(# and "!e degree of inva#ion of p privac' rivac' T!e re#u("# #!owed "!a" "!e differen" peop(e1 "!e 2e' peop(e1 nur#ing p!'#ician#1 and "!e fa$i(' $e$0er# !ad differen" view# on defining "!e concep" of o f re#"rain"# wi"! #o$e #"a"ing "!a" a# (ong a# i" wa# for "!e 0enefi" of "!e pa"ien"#1 i" wa# no" n o" a re#"rain" a" a((, T!e re#u("# of "!i# #"ud' $a' affec" nur#ing prac"ice a# i" $a' (ead "o "!e di#"ingui#!ing of w!a" e%ac"(' re#"rain" i# and give guide(ine# in "!e fu"ure on "!e $a%i$u$ #"andard "!a" coun"rie# can u#e, Nur#ing #"uden"# can app(' "!e re#u("# of "!e#e #"ud' "o no" on(' !e(p "!e$ w!i(#" prac"icing #o a# "o avoid "!e adver#e #ide effec"# of #o$e re#"raining $e"!od# on "!e$ #uc! a# $ora( di#"re## and (ow #e(f&e#"ee$#1 0u" "o !e(p "!e$ provide good pa"ien" care "o "!eir c(ien"#, Fur"!er1 i" can !e(p "!e nur#ing #"uden"# avoid #o$e re#"raining $e"!od# "!a" wi(( 0e in"ruding in"o "!eir c(ien")# privacie#,
CONCEPT OF RESTRAINT IN NURSING HOME PRACTISE
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Reference# Cape<u"i1 E,1 S"ru$pf1 N, E,1 Evan#1 , B,1 Gri##o1 , A,1 D Mai#(in1 G, 68>9, T!e Re(a"ion#!ip -e"ween P!'#ica( Re#"rain" Re$ova( and Fa((# and In/urie# A A$ong $ong Nur#ing Ho$e Re#iden"#, The Journals of Gerontology Series A: Biological Sciences and Medical Sciences 1 53A 53A6891 6891 M;=&M?+, Hug!e#1 R, 6+7879, Rights, 6+7879, Rights, risk and restraint-fre restraint-freee care of older eole erson-centred erson-centred aroaches in health and social care, care, ondon: e##ica Bing#(e' Pu0(i#!er#, McCor$ac21 -, 6+7849, !ractice 6+7849, !ractice de"elo#ent in nursing and healthcare 6+nd healthcare 6+nd ed,9, C!ic!e#"er1 5e#" Su##e%: o!n 5i(e' D Son#, Mo'(e1 5,1 5,1 -or0a#i1 S,1 5a((i#1 5a((i#1 M,1 O(oren#!aw1 R,1 D Gracia1 N, 6+7889, Acu"e care $anage$en" of o(der peop(e wi"! de$en"ia: a 3ua(i"a"ive per#pec"ive, per#pec"ive, Journal Journal of $linical %ursing 1 &'64&;91 &'64&;91 ;+7&;+>,
