Reducing restrictive measures in complex long-term care for people with intellectual disabilities: Implementation interventions through the lens of normalisation process theory

Esther H. Bisschops*, J. Clasien de Schipper, Baukje Schippers, Petri J.C.M. Embregts, Carlo Schuengel

*Corresponding author for this work

Research output: Contribution to JournalArticleAcademicpeer-review

Abstract

BACKGROUND The multi-disciplinarity of long-term care for people with intellectual disabilities makes organisations seek stability and predictability, complicating implementing innovations. Interventions to implement a method for reducing restrictive measures were analysed through the lens of Normalisation Process Theory to understand the social mechanisms at play.
METHODS Process notes, collected during a trial in which a method to reduce restrictive measures was implemented, were analysed guided by implementation interventions defined by Cochrane Effective Practice and Organisation of Care Review Group. These interventions were mapped to social mechanisms of Normalisation Process Theory.
RESULTS Implementation interventions were widely used in which clients’ perspectives were expressed (client-related-interventions), and consensus processes were held with care professionals. These interventions initiated NPT’s social mechanisms’ Coherence, Cognitive Participation and Collective Action.
CONCLUSIONS The emphasis on consensus and clients’ perspectives when methodically reducing restrictive measures reflects some unique implementation challenges in long-term intellectual disability care.
Original languageEnglish
Pages (from-to)353-364
Number of pages12
JournalJournal of Intellectual & Developmental Disability
Volume47
Issue number4
Early online date15 Mar 2022
DOIs
Publication statusPublished - 2022

Bibliographical note

Funding Information:
This research was supported by ZonMW and Scientific Research Foundation ‘s Heeren Loo. Netherlands Organisation for Health Research and Development.

Publisher Copyright:
© 2022 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.

Keywords

  • Implementation
  • implementation interventions
  • social mechanisms
  • long-term care
  • intellectual disabilities
  • restrictive measures

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