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Meta-Analysis
. 2020 Sep 16;17(18):6738.
doi: 10.3390/ijerph17186738.

The Effectiveness of Educational Training or Multicomponent Programs to Prevent the Use of Physical Restraints in Nursing Home Settings: A Systematic Review and Meta-Analysis of Experimental Studies

Anna Brugnolli  1 , Federica Canzan  2 , Luigina Mortari  3 , Luisa Saiani  2 , Elisa Ambrosi  2 , Martina Debiasi  1
Affiliations
Meta-Analysis

The Effectiveness of Educational Training or Multicomponent Programs to Prevent the Use of Physical Restraints in Nursing Home Settings: A Systematic Review and Meta-Analysis of Experimental Studies

Anna Brugnolli et al. Int J Environ Res Public Health. .

Abstract

This review assesses the effectiveness of interventions to reduce physical restraint (PR) use in older people living in nursing homes or residential care facilities. A systematic search of studies published in four electronic databases (MEDLINE, CINHAL, PsycINFO, Cochrane Central Register of Controlled Trials). The review included individual and cluster randomized controlled trials that compared educational training and multicomponent programs to avoid PR use. Risk bias of randomized controlled trials (RCTs) was assessed according to the Cochrane Handbook for Systematic Reviews of Interventions. This review includes 16 studies in a qualitative synthesis that met the inclusion criteria, nine of them offered a multicomponent program and seven offered only educational training. The results of the 12 studies included in the meta-analysis showed a significant trend in favor of intervention over time and intensity of PR use tends to decrease. The review indicates that educational programs and other supplementary interventions should be effective, but the heterogeneous operative definition of physical restraints can make difficult data generalization.

Keywords: meta-analysis; nursing homes; older people; physical restraint; systematic review.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
PRISMA Flow Diagram.
Figure 2
Figure 2
Risk of bias summary.
Figure 3
Figure 3
Risk of bias graph: review authors’ judgements about each risk of bias item presented as percentages across all included studies.
Figure 4
Figure 4
(a) Effect of educational program at endpoint study on reducing PR use; (b) Effect of educational program at different follow-up on reducing PR use.
Figure 5
Figure 5
(a) Effect of a multicomponent program at endpoint study on reducing PR use; (b) Effect of a multicomponent program at different follow-up on reducing PR use.
See this image and copyright information in PMC

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