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Exploration of Institutional Dementia Care: Social Engagement and the Use of Physical Restraints Open Access

Descriptions

Other title
Subject/Keyword
physical restraints
dementia
social engagement
Type of item
Thesis
Degree grantor
University of Alberta
Author or creator
Wilkie, Jocelyn A
Supervisor and department
Mrazik, Martin (Educational Psychology)
Examining committee member and department
Rinaldi, Christina (Educational Psychology)
Sobsey, Richard (Educational Psychology)
Buck, George (Educational Psychology)
Hunter, Kathleen (Nursing)
Karuza, Jurgis (Psychology)
Department
Department of Educational Psychology
Specialization
Psychological Studies in Education
Date accepted
2012-07-25T15:55:38Z
Graduation date
2012-11
Degree
Doctor of Philosophy
Degree level
Doctoral
Abstract
Social engagement has been established as an important indicator of quality of life. For individuals with dementia, entering an institution can accelerate their exclusion from the social world of their healthy peers (Kitwood, 1997). This study examined social engagement and physical restraint use in 72 elderly individuals diagnosed with dementia (35 males and 37 females) who were being cared for in a psychiatric in-patient setting. The specific research questions were: 1) how frequently are individuals with dementia constructively engaged, passively engaged, self-engaged, or not socially engaged at all with other individuals in their environment; 2) does social engagement differ across the weekday, evening, or weekend nursing shift; and 3) which individual variables uniquely and jointly predict social engagement? Direct observation of social interactions resulted in the following breakdown: 12% constructive engagement, 5% passive engagement, 38% self-engagement, and 46% non-engagement. A repeated measures ANCOVA indicated engagement did not differ across the three shifts. Hierarchical linear regression analyses were used to show that: 1) greater independence in ADLs predicted constructive engagement but restraint use and behavioral disturbances did not; 2) Physical restraint use predicted self-engagement uniquely and jointly with ADL dependency and behavioral disturbances; and 3) Restraint use predicted non-engagement only when combined with ADL dependency. This study showed that physical restraint use contributes to the social exclusion experienced by individuals with dementia. In addition, individuals with dementia who have the greatest care needs are engaged in the least amount of constructive social interactions.
Language
English
DOI
doi:10.7939/R3QW9R
Rights
Permission is hereby granted to the University of Alberta Libraries to reproduce single copies of this thesis and to lend or sell such copies for private, scholarly or scientific research purposes only. Where the thesis is converted to, or otherwise made available in digital form, the University of Alberta will advise potential users of the thesis of these terms. The author reserves all other publication and other rights in association with the copyright in the thesis and, except as herein before provided, neither the thesis nor any substantial portion thereof may be printed or otherwise reproduced in any material form whatsoever without the author's prior written permission.
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File title: Final 2012 Wilkie_prefatory pages
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