Page 20 - Reduction of coercive measures

Summary and general discussion
explanation for the intervention effect could be increased awareness of, and thus recording, of coercive measures. In order to differentiate the effects of the program through awareness raising and changes in care practice, the experimental effect on coercive measures that had already been registered before the multidisciplinary expert team started to consult was investigated in the current research. The effectiveness of the program was also statistically significant for this subgroup of coercive measures, increasing confidence that the intervention was indeed effective in reducing actual coercive measures.
Limitations
Several limitations should be taken into account when interpreting the results of the studies. First, limitations concerning the study described in Chapter two concerned the possibility that the observer did not observe all coercive measures, for example when certain coercive measures were applied out of sight and outside the hearing distance of the observer. Another limitation concerns the bias that could have arisen by non-random selection of shifts by the informant and the selection of stakeholders by the researchers. Finally, no specific methods were used to analyze qualitative data on stakeholders’ reflections. A limitation of the entire dissertation concerns the reliability of the information on coercive measures. The broad definition of coercive measures that refers to any measure that is restrictive for a resident in a specific situation is not sufficient to indicate coercive measures. The dissertation established a subset of coercive measures that can be measured with at least reasonable reliability. However, the broad interpretation may lead to differences in interpretation between the assessments of healthcare practices by different staff members, which in turn reduces the reliability of the data. A limitation of the study described in the third chapter was the absence of methodological analyses of the reflections of the experts. As a result, the study is limited to a summary of expert opinion that legislators and policy developers can use to optimize the registration
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