Page 27 - Reduction of coercive measures

not only contribute to better registrations but also to data that can be combined and compared, providing better guidance for efforts focused on reducing the use of coercive measures.
Webber et al. (2011) indicated several difficulties in the registration of coercive measure in their analysis of reports of mechanical and chemical restraint and seclusion made by support staff over a 12-month period in the State of Victoria, Australia. They concluded that the utility of support staff reports was hampered by their confusion over definitions of coercive measures, limitations to the types of measures that were reported, and by the absence of important information such as frequency of use. Matson and Boisjoli (2009) reported a wide variation in prevalence numbers among the studies they reviewed, from 14% to 53%. The studies differed with respect to the time frame investigated (3 months versus 1 month), and the sample sizes (300-500). They proposed that standardized definitions could lead to more information on actual reliability of measurements of the use of coercive measures. To be useful, these standardized definitions should include qualitative aspects, such as the aim of a specific measure or the context in which a specific measure is applied. Qualitative aspects complicate the design of reliable registrations, however.
Niemeijer, Depla, Frederiks, Franke, and Hertogh (2014) studied the use of surveillance technology and found that support staff members weighed safety as more important than self-determination. As coercive measures often serve multiple purposes, this priority for security might also influence the extent to which workers recognize that a particular measure limits the possibilities for residents to do what they want. Staff may assume that residents find the goal of security as important as they do, and therefore would view coercive measures to be aligned with the implied will of residents to be safe. Also, differences of opinion on the right to self-determination among professionals can cause confusion in determining coercive measures. Whenever a resident resists the use of a coercive measure and staff ignores this resistance, the right of self-determination is in peril. However, some residents, as a consequence of their disabilities, are not able to show resistance or, as a consequence of prolonged use of coercive measures, have resigned themselves to the measure.
Measurement of coercive measures
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