Page 36 - Reduction of coercive measures
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                                Chapter 2
Results
Part one - Reliability study
During a period of 36 days, 43 out of 55 units registered coercive measures. Registration of coercive measures concerned 231 residents and 554 shifts. Research assistants made 28 independent observations of one shift on 28 units. Within 16 units during a total of 67 shifts, a second support staff member performed registration independent from the first support staff member.
The table in Appendix A shows the kappa and z-scores for the correspondences between the use of coercive measures during a shift as registered by the first support staff members, the independent observers, and the second support staff member. Adequate agreement (i.e. Cohen’s kappa ≥ .50) was found for 25 out of 57 coercive measures concerning registration by support staff members and observers, with the next five measures achieving the highest score: orthosis used in bed, resulting the resident is not being able to move, the use of ‘Swedish belt’ in bed (bed belt), locks on shoes, camera/video surveillance (either within resident’s private room and/or in communal part(s) of the building) and an jump suit which cannot be torn and/or prevents residents taking of their clothes. For 27 coercive measures concerning the agreement between staff members and observers or staff members and second staff members, with the next five measures achieving the highest score: limiting the use of (mobile) phones (having to hand in your phone to the staff at certain (set) times, only being allowed to call someone under supervision or at certain (set) times), closing access to the garden, camera/video surveillance (either within resident’s private room and/or in communal part(s) of the building), physical coercive measure (parts of the body being held down) and limiting visitation (either receiving or visiting) of family friends and others. Adequate agreement for both staff-observer and staff-second staff correspondence was found for 15 coercive measures. An overall kappa of .64 and .70 was found for the staff-observer and staff- second staff correspondence. Both the observer and second staff member more often registered a coercive measure when the staff member did not than vice versa, respectively z= 6.04 and z= 17.42, p ≤.01.
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