Restraint of adults with intellectual disabilities: A critical review of the prevalence and characteristics associated with its use

Abstract

Background:

As part of their care, adults with intellectual disabilities are often subject to restrictive interventions including restraint.

Method:

A review examining the prevalence of restraint use with people with intellectual disabilities and the characteristics associated with its use.

Results:

The seven papers identified used quantitative methodologies and had cross-sectional designs. Prevalence rates of restraint ranged from 11% to 78%, multiple forms of restraint were common. Most studies focused on characteristics within the person with an intellectual disability, three considered external factors. Challenging behaviour was the most consistent characteristic associated with the use of restraint, but how this was defined varied.

Conclusions:

The review highlights a need for more consistent means of defining and measuring restraint and its associated characteristics. Future research into this area may also want to focus on the context of restraint such as whether it is the least restrictive option used.

Keywords

restraint intellectual disability challenging behaviour

Get full access to this article

View all access options for this article.

References

Acello

Hegner

(2016) Nursing Assistant: A Nursing Process Approach, 11th ed. Boston, MA: Cengage Learning.

Ali

Blickwedel

Hassiotis

(2014) Interventions for challenging behaviour in intellectual disability. Advances in Psychiatric Treatment 20(3): 184–192. DOI: 10.1192/apt.bp.113.011577.

Bonner

Lowe

Rawcliffe

, et al. (2002) Trauma for all: a pilot study of the subjective experience of physical restraint for mental health inpatients and staff in the UK. Journal of Psychiatric and Mental Health Nursing 9(4): 465–473. DOI: 10.1046/j.1365-2850.2002.00504.x.

Department of Health (2012) Transforming care a national response to winterbourne view hospital: Department of health review final report. Available at: https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/213215/final-report.pdf. (accessed 17 February 2016).

Emerson

Robertson

Gregory

, et al. (2000) Treatment and management of challenging behaviours in residential settings. Journal of Applied Research in Intellectual Disabilities 13(4): 197–215. DOI: 10.1046/j.1468-3148.2000.00036.x.

Fish

Culshaw

(2005) The last resort? Staff and client perspectives on physical intervention. Journal of Intellectual Disabilities 9(2): 93–107. DOI: 10.1177/1744629505049726.

Fowkes

FGR

Fulton

(1991) Critical appraisal of published research: introductory guidelines. British Medical Journal 302(6785): 1136–1140. Available at: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1669795/ (accessed 6 January 2016).

Gaskin

McVilly

McGillivray

(2013) Initiatives to reduce the use of seclusion and restraints on people with developmental disabilities: a systematic review and quantitative synthesis. Research in Developmental Disabilities 34(11): 3946–3961. DOI: 10.1016/j.ridd.2013.08.010.

Harris

(1996) Physical restraint procedures for managing challenging behaviours presented by mentally retarded adults and children. Research in Developmental Disabilities 17(2): 99–134. DOI: 10.1016/0891-4222(95)00036-4.

10.

Hawkins

Allen

Jenkins

(2005) The use of physical interventions with people with intellectual disabilities and challenging behaviour the experiences of service users and staff members. Journal of Applied Research in Intellectual Disabilities 18: 19–34. DOI: 10.1111/j.1468-3148.2004.00207.x.

11.

Health and Social Care Information Centre (2015) Learning Disability Census Report. Available at: http://digital.nhs.uk/catalogue/PUB16760. (accessed 4 January 2018).

12.

Karlsson

Bucht

Eriksson

(2001) Factors relating to the use of physical restraints in geriatric care settings. Journal of the American Geriatrics Society 49(12): 1722–1728. DOI: 10.1046/j.1532-5415.2001.49286.x.

13.

Luiselli

(2009) Physical restraint of people with intellectual disability: a review of implementation reduction and elimination procedures. Journal of Applied Research in Intellectual Disabilities 22: 126. DOI: 10.1111/j.1468- 3148.2008.00479.x.

14.

Lundström

Antonsson

Karlsson

, et al. (2011) Use of physical restraints with people with intellectual disabilities living in Sweden’s group homes. Journal of Policy and Practice in Intellectual Disabilities 8(1): 36–41. DOI: 10.1111/j.1741-1130.2011.00285.x.

15.

Matson

Boisjoli

(2009) Restraint procedures and challenging behaviours in intellectual disability: an analysis of causative factors. Journal of Applied Research in Intellectual Disabilities 22(2): 111–117. DOI: 10.1111/j.1468-3148.2008.00477.x.

16.

McGill

Murphy

Kelly-Pike

(2009) Frequency of use and characteristics of people with intellectual disabilities subject to physical interventions. Journal of Applied Research in Intellectual Disabilities 22(2): 152–158. DOI: 10.1111/j.1468-3148.2008.00483.x.

17.

Merineau-Cote

Morin

(2013) Correlates of restraint and seclusion for adults with intellectual disabilities in community services. Journal of Intellectual Disability Research 57(2): 182–190. DOI: 10.1111/j.1365-2788.2012.01601.x.

18.

The National Archives (2007) The Mental Health Act. Available at: https://www.legislation.gov.uk/ukpga/2007/12/contents (accessed 17 February 2016).

19.

National Institute of Health and Care Excellence (2015) Challenging behaviour and learning disabilities: prevention and interventions for people with learning disabilities whose behaviour challenges (NG11). Available at: http://nice.org.uk/guidance/ng11 (accessed 17 January 2016).

20.

Sanderson

Tatt

Higgins

(2007) Tools for assessing quality and susceptibility to bias in observational studies in epidemiology: a systematic review and annotated bibliography. International Journal of Epidemiology 36(3): 666–676. DOI: 10.1093/ije/dym018.

21.

Scheirs

JGM

Blok

Tolhoek

, et al. (2012) Client factors as predictors of restraint and seclusion in people with intellectual disability. Journal of Intellectual and Developmental Disability 37(2): 112–120. DOI: 10.3109/13668250.2012.682357.

22.

Strout

(2010) Perspectives on the experience of being physically restrained: an integrative review of the qualitative literature. International Journal of Mental Health Nursing 19(6): 416–427. DOI: 10.1111/j.1447- 0349.2010.00694.x.

23.

Sturmey

(1999) Correlates of restraint use in an institutional population. Research in Developmental Disabilities 20(5): 339–346. DOI: 10.1016/S0891- 4222(99)00015-3.

24.

Sturmey

(2009) Restraint, seclusion and prn medication in English services for people with learning disabilities administered by the National Health Service: an analysis of the 2007 national audit survey. Journal of Applied Research in Intellectual Disabilities 22(2): 140–144. DOI: 10.1111/j.1468-3148.2008.00481.

25.

Tilli

Spreat

(2009) Restraint safety in a residential setting for persons with intellectual disabilities. Behavioral Interventions 24: 127–136. DOI: 10.1002/bin.28.

26.

United Nations (1945) Charter of the United Nations. Available at: https://www.un.org/development/desa/disabilities/convention-on-the-rights-ofpersons-with-disabilities/article-12-equal-recognition-before-the-law.html (accessed 8 March 2018).

27.

VanVoorhis

CRW

Morgan

(2007) Understanding power and rules of thumb for determining sample sizes. Tutorials in Quantitative Methods for Psychology 3: 43–50. DOI: 10.20982/tqmp.03.2.p043.

28.

Von Elm

Altman

Pocock

, et al. (2007) Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. Lancet 370(9596): 1453–1457. DOI: 10.1136/bmj.39335.541782.AD.

29.

Webber

McVilly

Chan

(2011) Restrictive interventions for people with a disability exhibiting challenging behaviours: analysis of a population database. Journal of Applied Research in Intellectual Disabilities 24: 495–507. DOI: 10.1111/j.1468-3148.2011.00635.x.

30.

Wynn

(2007) Psychiatric inpatients’ experiences with restraint. Journal of Forensic Psychiatry and Psychology 15(1): 124–144. DOI: 10.1080/14789940410001655187.