Page 25 - Demo

General introduction 231Although interventions for preventing and reducing physical restraints have been developed for general hospital settings and long-term geriatric care, insufficient information is available about potential effects of these approaches (Abraham et al., 2020; M%u00f6hler et al., 2012). A systematic review found 21 studies reporting positive outcomes in reducing restraints in individuals with intellectual disabilities and autism with treatments such as mindfulness or positive behaviour support (Sturmey, 2018). Most of these approaches were not specifically developed to reduce involuntary care for long-term care settings for people with an intellectual disability. Therefore, in the past decade methods have been developed that may contribute to supporting intellectual disability care organisations to align practices with the Dutch CCA. The research project %u201cFreedom and Safety%u201d which forms the basis for this dissertation, focused on three innovations aiming to reduce involuntary care, which will be discussed next.The e-tool Needs Assessment FrameworkCommissioned by the Ministry of Health, Welfare and Sport, researchers from Tilburg University and VU Medical Centre Amsterdam examined how to take into consideration clients%u2019 perspectives of people with severe intellectual disabilities and people with dementia when thinking about (alternatives to) involuntary care and deciding on its use. This was done with a literature review, a concept mapping study, and a vignette study (de Boer et al., 2019; Embregts et al., 2019; Hertogh, 2015). The results indicated that care staff and family members were able to take into account the perspective of people with moderate to severe intellectual disabilities, as well as people with dementia, in the evaluation and consideration of involuntary care. Based on these studies the online tool Needs Assessment Framework (NAF) (in Dutch: Het Wegingskader) was developed. The aim of NAF was to provide care professionals with guidance in considering clients%u2019 perspectives on involuntary care. The tool serves to increase awareness among care professionals with regard to self-determination of clients with intellectual disabilities. NAF invites users to gather information about clients%u2019 behaviour, possible resistance to care practices, their perception of care, and their experiences. Videos and checklists within the online tool help users to consider clients%u2019 perspectives. The tool is freely available: www.hetwegingskader.nl