Use of restraints on older patients with dementia: reports from nurses and nursing assistants in Hong Kong

Abstract

Physical restraint is a common method of behavior control in elder care. The most frequently cited reason for the use of restraint is to protect the safety of older persons. However, there is ample evidence that the use of restraint is not only ineffective in achieving this goal but also causes a great deal of physical and psychological suffering. This study examines the prevalence and correlates of the use of restraint on older patients with dementia in the hospital setting in Hong Kong. A total of 187 nursing staff was recruited through convenient sampling. Participants provided information on their demographic characteristics, co-worker emotional support, burnout symptoms, attitudes toward patients with dementia, and their experience of restraint use in dementia care. Results showed that restraint use is common among nurses in hospital medical wards in Hong Kong - more than two-thirds (69%) of the participants reported using physical restraint in the past 3 months. Pearson correlation analysis results show that use of physical restraint was negatively correlated with the age of participants (r = - .44, p < .01) and co-worker emotional support (r = - .20, p < .05), but positively correlated with emotional exhaustion (r = .21, p < .01). Attitudes towards patients with dementia, depersonalization and lack of personal achievement were not related to restraint use (p>.05). To reduce the use of restraint in dementia care, we should cultivate a supportive environment and reduce job stress among nursing staff.