Page 107 - Reduction of coercive measures
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                                Multidisciplinary reduction of coercive measures
Design
The target variable of this effectiveness trial was the ending of individual coercive measures that already existed before the trial started or were implemented during the trial period for the participating residents. The sample consisted of 50 randomly selected units. In order to determine the sample size, attention was paid to the clustering of cm, which required the intra-class correlation, and to the variation of cm at the level of residents. Since the intra-class correlation is unknown, the power calculated conservatively with an ICC = .30. The variance is based on a rather high percentage of cm found in prevalence studies, namely 25%. Based on this data and an alpha of .05, the study has a power of .80 for testing a intervention effect of 4.5% on the prevalence of cm. Due to the high turnover of residents, 10 extra units were selected. The 50 recruited care units were randomized into the experimental and care as usual condition, making this a cluster randomized trial of coercive measures nested within residents who were nested within units. Cluster randomization was conducted by an independent researcher using a random number list. Coercive measures were recorded as mandated by the care organization in a register as part of the electronic resident file of the care organization. The register was developed and implemented as part of a wider project in which the trial was included (Schippers, Frederiks, Van Nieuwenhuijzen, & Schuengel, 2018; Chapter 2 this dissertation). Support staff and professionals were supported by researchers to complete and maintain a comprehensive and accurate record of coercive measures. To test whether randomization to the experimental condition in which units participated in the program was effective in reducing coercive measures, dates of onset and dates of termination were recorded for coercive measures from three months preceding the start of the intervention to 18 months after.
Intervention
Multidisciplinary expert team
For the coercive measures subjected to the experimental condition, a multidisciplinary expert team was deployed. The multidisciplinary expert team consisted of Special Education specialists (7), psychologist
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