Page 130 - Reduction of coercive measures

Chapter 6
limited to a single factor or selected coercive measures (Fitton & Jones, 2018; Webber, Richardson, & Lambrick, 2014). Factors found in one study were often not replicated in other studies, if the criteria for coercive measures changed or additional factors were included. To contribute to further integration of disparate findings, this study tested the hypothesis that residents’ challenging behavior, communicative adaptive functioning, attachment behavior, and staff’s attributions and self-efficacy were each uniquely associated with residents’ exposure to coercive measures. Also, it was determined to what extent the associated factors varied according to the type of measures that were considered, distinguishing between measures which served a protective function and measures serving operational needs. Chapter four revealed an association between lower scores on communication and socialization functioning on the one hand, and higher number of coercive measures on the other. Challenging behavior such as aggressive and destructive behavior as well as self-injurious and stereotyped behavior was associated with coercive measures applied at direct and unforeseen danger. Against expectations, attachment behavior was not associated with coercive measures. Also, variation of the use of coercive measures across units was only partly explained by staff characteristics as attribution on the stability of CB was associated with the total of coercive measures applied.
In conclusion, this study confirmed the association of resident related factors and the use of coercive measures. Notable was that this association was found in the context of a broad set of other client and staff characteristics that, despite earlier findings and theory, were not associated with coercive measures.
Multidisciplinary reduction of coercive measures for people with intellectual disabilities.
Systematically eliminating or reducing the use of coercive measures is seen as a standard for good care (Deveau & McDonell, 2009). Both practice and scientific studies show encouraging examples of initiatives concerning the reduction of coercive measures (Schreiner et al., 2004; Williams & Grosset, 2011). Nevertheless, systematic information is lacking about the effects of interventions to reduce
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