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Abstract

This article is an examination of the impact of phys ical restraints on physical activities of daily living (PADL), walking, and orientation to reality outcomes among nursing home residents. Computerized assess ment data for a cohort of 5073 Virginia Medicaid nurs ing home admissions with complete data for their first and second post-admission assessments were analyzed. Multiple regression analysis was used to compare the outcomes of restrained and nonrestrained residents, after controlling statistically for the influence of case mix variables that might impact outcomes. Restraint use was associated with increased PADL dependence and dis orientation for residents restrained at their first and second assessments, both assessments, and either as sessment. Restraint was associated with increased walk ing dependence for residents restrained at their second assessment and either assessment.

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References

Kane RL , Williams CC , Williams FT , et al. Restraining restraints: Changes in a standard of care. Annu Rev Public Health 1993; 14:545-584.

Wykle M. An overview of restraint use and the movement to reduce the use of restraints . In: Braun JV , Lipson S , eds. Toward a Restraint-free Environment. Baltimore: Health Professions Press, 1993.

Evans LK , Strumpf NE Tying down the elderly: A review of the literature on physical restraint. J Am Geriatr Soc 1989;37:65-74.

Tinetti ME , Liu W. , Marottoli RA , et al. Mechanical restraint use among residents of skilled nursing facilities. JAMA 1991;265:468-471.

Proskauer, Rose, Goetz, and Mendelsohn. Legal and regulatory issues governing the use of restraints. In: Braun JV , Lipson S , eds. Toward a Restraint-free Environment. Baltimore : Health Professions Press, 1993 .

Kapp MB Nursing restraints and legal liability. J Leg Med 13:1-13.

Tinetti ME , Liu W. , Ginter SF Mechanical restraint use and fall-related injuries among residents of skilled nursing facilities. Ann Intern Med 16:369-374.

Ejaz FK , Jones JA , Rose MS Fall s among nursing home residents: an examination of incident reports before and after restraint reduction programs. J Am Geriatr Soc 1994, 42:960-964.

Werner P. , Cohen-Mansfield J. , Braun J. , et al. Physical restraints and agitation in nursing home residents . J Am Geriatr Soc 1989;37:1122-1126.

10.

Folmar S. , Wilson H. Social behavior and physical restraints. Gerontologist 29:650-653.

11.

Miles SH , Irvine P. Deaths caused by physical restraints. Gerontologist 32:762-766.

12.

Burton LC , German PS , Rovner BW , et al. Physical restraint use and cognitive decline among nursing home residents. JAm Geriatr Soc 1992;40:811-816.

13.

Brant LJ , German PS , Rovner BW A longitudinal approach to modeling outcomes in a nursing home study. Gerontologist 32:159-163.

14.

Kane RA , Kane RL Assessing the Elderly. Lexington, MA: Lexington Books, 1981.

15.

Falcone AR Development of a long-term care information system (W. K. Kellogg Grant 5000) . Ann Arbor, MI: Michigan Office of Services to the Aging, 1979.

16.

Spector WD , Takada MA Characteristics of nursing homes that affect outcomes. J Aging Health 1991;3:427-454.

17.

Kane RL , Bell R. , Riegler S. , et al. Predicting the outcomes of nursing home patients. Gerontologist 1983;23:200-206.

18.

Mitchell JB Patient outcomes in alternative long-term care settings. Medical Care 1978;16:439-52.

19.

Statistical Analysis Systems (SAS). SAS System for Regression, 2nd Ed. Cary, NC: SAS Institute, 1985.

20.

Montgomery DC , Peck EA Introduction to Linear Regression Analysis, 2nd Ed. New York: John Wiley & Sons, 1992.

21.

Younger MS A First Course in Linear Regression 2nd Ed. Boston: Duxbury Press, 1985.

22.

Kazis LE , Anderson JJ , Meehan RF Effect sizes for interpreting changes in health status. Med Care 1989;27:S178-189.

The Impact of Restraints on Nursing Home Resident Outcomes

Abstract

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