Équipements de protection individuelle et outils de sécurisation alternatifs à la contention dans la prise en charge des troubles graves du comportement des personnes avec autisme et déficience intellectuelle (partie 1: perspective des patients)

Translated title of the contribution: Personal protective equipment and restraints alternatives in the management of challenging behaviors in inpatients with autism and intellectual disability (Part 1: Patients’ perspectives)

J. Lefèvre-Utile, V. Guinchat, L. E. Wachtel, D. Cohen, A. Perron, M. Montreuil, F. A. Carnevale, A. Reyre

Research output: Contribution to journalArticle

Abstract

Context: The management of severe behavioral disorders (SBD) in people with autism and intellectual disability (ID) can lead to an escalation of seclusion and restraints, even to abuse. In this context, we offer a literature review regarding the use of personal protective equipment (PPE), as well as the practical experiences associated with their use. Method: An exhaustive review of the literature was conducted as well as an ethnographic study of three specialized units, supplemented by 37 interviews of healthcare professionals. Results: We have distinguished between patients’ PPEs and caregivers’. Their description is correlated with a detailed topography of patients’ and caregivers’ injuries. The functional model underpinning their use makes it possible to better capture, according to clinical targets (self-harm, Pica, hetero-aggression), how PPEs can contribute to the restoration of clinical reasoning useful for the management of SBDs among people with autism and ID. Discussion: PPE appears to be a step forward from a risk-benefit point of view since it leads to fewer injuries and less physical constraints. They reassure caregivers who can better assess and reduce SBDs and foster less restrictive protective measures within the institution. Finally, from an ethical point of view, they contribute to promote the child's best interest and to recognize the concept of shared vulnerability.

Translated title of the contributionPersonal protective equipment and restraints alternatives in the management of challenging behaviors in inpatients with autism and intellectual disability (Part 1: Patients’ perspectives)
Original languageFrench
Pages (from-to)443-459
Number of pages17
JournalNeuropsychiatrie de l'Enfance et de l'Adolescence
Volume66
Issue number7-8
DOIs
StatePublished - Nov 1 2018

Keywords

  • Autism
  • Caregivers
  • Challenging behaviors
  • Intellectual disability (ID)
  • Nursing ethics
  • Personal protective equipment (PPE)
  • Restraints
  • Self-injuries behaviors (SIB)

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Developmental and Educational Psychology
  • Psychiatry and Mental health

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