District nurses’ attitudes toward involuntary treatment in dementia care: a cross-sectional study

Abstract Persons Living with Dementia (PLWD) prefer to live in their home environment, making their own choices and living a self-determined life for as long as possible. However, recent studies have shown that one in two PLWD receives involuntary treatment. Involuntary treatment is care provided that they resist to and/or have not given consent to, such as physical restraints, psychotropic medications. Although district nurses play a key role in the care of PLWD, it is unknown how their attitudes and opinions influence the use of involuntary treatment. This study aims to investigate the attitudes of district nurses towards the use of involuntary treatment in dementia care at home, determinants, and their opinion about its restrictiveness and discomfort. In a cross-sectional study, data were collected in a convenient sample of 296 Belgian district nurses using an online version of the Maastricht Attitude Questionnaire - Home Care. Results show that district nurses perceive involuntary treatment as a regular part of nursing care, having neither positive nor negative attitudes towards its appropriateness. They consider involuntary treatment usage as moderately restrictive to PLWD and feel moderately uncomfortable when using it. Nursing staff with more years of experience in dementia care, perceiving care for PLWD as burdensome, and having a lower educational background were more accepting towards involuntary treatment, rating it as a regular measure in the nursing care repertoire. These findings underscore the need to increase the awareness of district nurses regarding the negative consequences of involuntary treatment use to PLWD.