Page 135 - Reduction of coercive measures

Implications for future research
The standardization and structural registration of coercive measures has contributed to raising awareness in staff of and more reliable information about the use of coercive measures. However, it remains to be determined which concrete care practices should be identified as coercive measures. The context—such as which resident, for what purpose and under what circumstances the measure is applied— affects the identification of coercive measures. For example, a certain care practice, such as taking a walk under the supervision of a support staff member, can be restrictive in one specific situation (if the resident would have rather walked alone or with a non-staff person) and not in another (if the resident desired company and attention from the staff member. For a resident who is physically disabled or disoriented, walking under supervision is probably an opportunity to give more room for self-determination, while for a young person who wants to be independent this is a restriction of autonomy. Further research can focus on the various conditions that determine when care practices are coercive, such as the moods and desires of the resident, resistance from the resident, the extent to which the resident understands the situation, and the purpose for which the measure is deployed. When support staff members and care professionals include these conditions in weighing care practices in order to indicate coercive measures, more reliable and valid registration of coercive measures could be achieved. In addition, clarifying these conditions could also be an addition to, or a practical interpretation of, the legal obligation to register coercive measures. It also increases the chances that the protection of residents’ rights through registration offsets the bureaucratic burden imposed by registration.
In order to advance the state of the art in charting the causes that determine the use of coercive measures, studies using a longitudinal design should be deployed. This also makes it possible to determine the extent to which factors at different levels are interrelated. In addition, further research into such factors offers the possibility to explain certain associations and to investigate the correlation of combinations of factors and the use of coercive measures. Additional
General discussion
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