Effects of a restraint minimization programme on staff’s work environment and the quality of care: a cluster randomized trial
(English)Manuscript (preprint) (Other academic)
Aims and objectives. The aim of the study was to evaluate the effects of a restraint minimization education programme on staff’s work environment and the quality of care in group dwellings for persons with dementia.
Background. Nursing staff in dementia care frequently face ethically difficult situations and have a challenging work environment. The use of physical restraints is one factor found to be associated with an impaired work environment and to evoke negative feelings such as guilt and sadness among the staff.
Design. Cluster randomized controlled trial.
Methods. The intervention and control groups each consisted of 20 group dwellings for persons with dementia. Staff and resident data were gathered by means of questionnaires one month before and after the 6-month education programme. Staff’s work environment was measured using the Stress of Conscience Questionnaire, the Demand–Control–Social Support model, and an assessment of caring climate, while the quality of care was subjectively rated for each resident by the staff.
Results. Analyses showed that nursing staff’s work environment improved in the intervention group, as well as did the quality of care, while there was no significant change in the control group. Subgroup analysis within the intervention group indicated that the largest effect on staff’s work environment occurred in those group dwellings where the use of physical restraints was reduced or stayed constant.
Conclusions. Staff’s work environment and the quality of care can be improved by the implementation of staff education. The findings also indicate that there was a synergistic effect between the education programme and the change in physical restraints use.
Physical restraints, staff education, work environment, dementia care, RCT
Research subject Caring Sciences
IdentifiersURN: urn:nbn:se:umu:diva-31948OAI: oai:DiVA.org:umu-31948DiVA: diva2:300027