The Influence of Physical Restraint on Long Term Care Residents: System Review and Meta-analysis

[[abstract]]Background: " Physical restraint" formerly used as a measure of protection for psychiatric patients is now widely used in acute and chronic medical and long-term care facilities. This study analyzes the impact of "physical restraint" on the health problems, fall prevention, ADL scale and other indicators of the residents in LTCs to emphasize the harm caused by physical restraints. Prompting the government to implement policies to reduce such behavior or help the institutes to seek appropriate alternative care measures for their residents. Methods: A systematic review using the preferred reporting items for systematic reviews and meta-analyses: the PRISMA Statement. The 7 databases included the Cochrane Library, ProQuest, Pubmed, Airiti Library、CINAHL (EBSCO)、Web of Science (OWS), and Medline (Ovid) - were searched to March 2014 by using keywords as physical restraint or physical immobilization combined with long term care facilities or nursing home. Eligible studies were classified by intervention, accessed for quality using the Quality Assessment Tool for Quantitative Studies. Results: Twelve research articles were eligible, 3 in Mandarin and 9 in English. The physical restraint use behavior issues (four articles) of residents and caused them more depression indicator (two articles), days of hospital stay (three articles), besides, as to fall prevention (three articles), the effect estimate d = 0.18, ( 95%【CI】 0.00, 0.36) all were significant differences. No significant differences yielded on MMSE, ADL scale and different staffing levels (three articles) in RN, LPN, and NA. Conclusions Our findings indicate that restraints not only failed to prevent accidents, but also increased falls, morbidity and risk of death, moreover, patients would develop anger, anxiety, withdrawal, and other psychological problems. In the present study, a systematic review and meta-analysis was used to provide evidence for the effects caused by physical restraint executed in long-term care facilities, and to help improve the quality of life of the residents by prompting the government to implement policies to reduce such measure