ORCID
https://orcid.org/https://orcid.org/0000-0002-1384-657X
Date of Award
2026
Document Type
Dissertation
Degree Name
Psychology (Ph.D.)
Department
Psychology
First Advisor
Elizabeth Brondolo
Second Advisor
William Chaplin
Third Advisor
Melissa Peckins
Abstract
Research on the use of physical restraints has revealed high rates of heterogeneity between clinical settings and an array of potential risk factors at both the patient and provider level. This is most evident in general medical hospitals, where patient populations are more heterogenous than other settings and physicians often can rely only on observable characteristics of patients to assess safety risks. More recent work has shown that coherent subgroups of restrained patients can be derived from demographic and clinical indicators. Identification of coherent patient subgroups may aid in understanding both the heterogeneity of the restrained patient population and differences between providers in the decision to use restraints. The current study proceeded in three stages. First, we derived subgroups from a sample of all encounters to a general medical hospital over one year, replicating findings from previous studies. Second, we used these subgroups to populate vignettes which were presented to a sample of 23 physicians, asking them to rate each vignette both in terms of the likelihood that they would use restraints and the likelihood that they assumed others would use restraints. We found evidence for distinct decision-policies between physicians that varied in terms of the knowledge applied in the decision, the consistency of their decisions, and the accuracy of their decisions in determining if the patient described in the vignette had actually been restrained. The results of our study are discussed, along with implications for future research. Major limitations of the current study include a lack of data on nurses, who are vital stakeholders in the decision to restrain, and concerns with missingness of outcome data for 5/23 physicians.
Recommended Citation
Miele, Andrew, "THE LATENT LENS: EXPLORING HETEREOGENEITY IN THE USE OF PHYSICAL RESTRAINTS VIA LATENT CLASS ANALYSIS AND THE LENS MODEL" (2026). Theses and Dissertations. 1052.
https://scholar.stjohns.edu/theses_dissertations/1052