Page 82 - Reduction of coercive measures
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                                Chapter 4
caregivers, legal representatives, and sometimes by the residents themselves. When no form was received within three weeks the first author or a research assistant contacted them by phone to provide further explanation. Data collection regarding the current study covered one year. The sample consisted of 50 units during this period. There was an average turnover of 2.3 residents per month. At the start of the study, the response rate was 60.5% (265 residents) and at the end of the study 54.2% (238 residents).
Support staff members were asked to participate by sending an email to one support staff member per unit, requesting them to discuss the study and participation with all staff members in the care unit. Afterwards the staff member were asked to confirm that the invitation was well understood by the full team of support staff, or to request additional email or phone consultation until full comprehension was reached. Whenever there was no response or support staff expressed questions, further explanation was given by phone. When staff members did not confirm participation or expressed questions, further explanation was given by researchers by phone or site visit. No support staff refused to participate.
Coercive measures were registered in a newly implemented mandatory registration system of the health care organization. Therefore, registration was already supported by researchers, and completed and maintained by support staff and professionals.
Information on factors in residents and support staff was collected by electronic questionnaires, an interview, and an observation list. First, all questionnaires were sent to support staff to fill out. Next, the observation list was sent on paper to all support staff members. They had to choose one resident which they observed before filling in the digitalized version of the list. Finally, support staff members were interviewed by psychologists who were part of the team of professionals working with the specific units under study.
Social and Communicative Adaptive behavior
The Dutch version of Vineland Adaptive Behavior Scales (Sparrow, Balla, & Cicchetti, 1984; van Berckelaer-Onnes, Buysse, Dijkxhoorn,

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