This thesis reports the outcomes of research into the use of restraint in the care of patients in an acute teaching hospital in Australia. The literature review undertaken for the study revealed much research into restraints showing evidence of the harm they cause, and their ineffectiveness as a safety measure. The literature indicates that the prevalence of restraint use is high - about a third of all hospital patients over the age of eighty-five years may be restrained at some time during the period of their admission.The main emphasis in my investigation was to uncover an understanding of how the use of restraints has remained possible, despite negative reports on their efficacy and questions about their possible abuse of human rights. Primarily, 1 set out to provide vide an understanding of restraint practice, and of how it is maintained and legitimised in a metropolitan teaching hospital.The study was guided by a Foucauldian approach to discourse analysis. The study reports on in depth studies of three patients. The case studies extend beyond observations of the patients to include interviews with members of the multidisciplinary team: nurses, doctors, occupational therapists and physiotherapists. Medical and nursing notes were another source of data.A discursive formation was identified by which restraint use is justified, and legitimised by the health professionals who use it. Five discourses were established, constituting: inability to 'self govern'; an appropriate environment; treatment; duty of care; and marginalisation.The study concludes that restraint use can be understood as a complex discursive practice. Through this discursive practice we can understand how staff maintain a monopoly over the truth and perpetuate claims about the inevitability of restraint use. Knowledge of these discursive practices enables an understanding of how the current ++ / educational approaches to restraint reduction are likely to have little immediate or sustained impact. With these understandings, we are hopefully better placed to change practice in a way that does not substitute one undesirable approach for another. If this is so, the value of this thesis will lie in its influence on practice as much as in its contribution to scholarship.

9th German-Japanese Bridge Symposium, September 10-11, 2012, Kyoto, JAPAN (GJBS09)

Thesis (Ph.D. in Engineering)--Technischen Universität Berlin, 2007. / "Juni 2008"--P. [2]. Includes abstracts in English and German. Includes bibliographical references (p. 127-129). Abstract in English also available online.

Thesis--University of Michigan Law School. / At head of title: Legislative Research Center, the University of Michigan Law School. Includes bibliographical references.

Thesis--University of Michigan Law School. / At head of title: Legislative Research Center, the University of Michigan Law School. Includes bibliographical references.

Thesis (M.Sc.)--York University, 2007. Graduate Programme in Kinesiology and Health Science. / Typescript. Includes bibliographical references (leaves 61-67). Also available on the Internet. MODE OF ACCESS via web browser by entering the following URL: http://gateway.proquest.com/openurl?url_ver=Z39.88-2004&res_dat=xri:pqdiss&rft_val_fmt=info:ofi/fmt:kev:mtx:dissertation&rft_dat=xri:pqdiss:MR31992

Thesis (Ed. D.)--Lehigh University, 2006. / Includes vita. Includes bibliographical references (leaves 84-96).

Agtarap, Wright, Mlynski, Hammad, and Blackledge took an initial step in providing support for the predictive validity of a new conceptual analysis concerned with behavioral restraint - defined as active resistance against a behavioral impulse or urge. The current study was designed to partially replicate and extend findings from their study, employing a common film clip protocol and a procedure for inducing low- and high levels of fatigue. Analyses indicated that key cardiovascular (CV) responses rose with the evocativeness of the film clip among low fatigue participants but fell with the evocativeness of the film clip among high fatigue participants. This is consistent with the prediction that high fatigue participants would put forth more restrain intensity than low fatigue participants when confronted with the less evocative clip, but less restraint intensity than low fatigue participants when confronted with the more evocative clip. Behavioral restraint performance - quantified as duration of facial non-neutrality - was also consistent with predictions, being impaired by fatigue under high- but not low evocativeness conditions. Findings support the broad theoretical suggestion that fatigue influence on behavioral restraint is multifaceted, dependent on the perceived magnitude of the impulse or urge experienced and the importance of resisting it.

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