Page 86 - Reduction of coercive measures

Chapter 4
concerned support staff’s trust, controllability, and satisfaction in handling challenging behavior. An example is ‘how confident are you in handling challenging behavior’. A score was calculated by summing all items and divide them by the number of all items. Scores of support staff within a care unit were aggregated to a mean score. A high score implies a high extent of self-efficacy. Hasting and Brown (2002) found a Cronbach’s alpha of .94 which indicates a high internal consistency. In the present study internal consistency was good as well, indicated by a Cronbach’s alpha of .88.
Coercive measures
Coercive measures were registered in a mandatory registration system of the organization. The registration system is part of the residents’ electronic care records and describes coercive measures in a broad way, irrespective of whether residents resisted the measure or not. Coercive measures were identified by researchers together with professionals responsible for daily care and treatment, using a list of 57 clearly described coercive measures. A recent study by Schippers, Frederiks, Van Nieuwenhuijzen, and Schuengel (2018; Chapter 2 this dissertation) on reliability of the list and registration system showed at least 25 coercive measures to be adequately consistent across informants, either a staff member colleague or a trained observer. In addition, they found 46% of the identified measures to be registered in the system, and 38% in the personal file. Another 16% were described in personal care plans. Therefore, the current study used both sources. Coercive measures regarding medication used to regulate behavior or medication which (side) effects can restrict residents were not recorded in the registration system by physicians and therefore excluded. However, administration of medication under coercion or without informing the resident was included. Additionally, file studies revealed 21 additional coercive measures which were added to the list. This yielded a total available set of 76 coercive measures.
Coercive measures differ in form and function (Dörenberg et al., 2018; Matson & Boisjoli, 2009; Williams, 2010). Four subsets were created. The first subset contained 14 measures applied to protect from direct and mostly unforeseen danger. The second subset contained 46
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