Résumés
Résumé
Les enfants et les adolescents hébergés en centre de réadaptation (CR) ou en foyer de groupe (FG) constituent une population vulnérable chez qui l’utilisation de mesures restrictives, telles que la contention, l’isolement ou le retrait est préoccupante. L’objectif général de la présente étude est de mieux comprendre l’utilisation de ces mesures afin d’améliorer les pratiques cliniques auprès des jeunes en CR et en FG. Méthode : Des données clinico-administratives ont été extraites sur l’utilisation de mesures restrictives auprès de 324 jeunes (29 unités, 10 centres/régions). Une analyse de profil latent a été utilisée afin d’identifier des sous-groupes de jeunes quant aux mesures restrictives. Afin de déterminer quelles caractéristiques individuelles (âge, sexe, appartenance ethnique, motif de prise en charge) et environnementales (durée du séjour, type d’unité, spécialisation de l’unité, mandat légal de l’unité [LPJ vs. LSJPA]) prédisaient l’appartenance aux profils, des régressions logistiques ont été utilisées. Résultats : Près de la moitié des jeunes (48,1%) n’ont expérimenté aucune mesure restrictive pendant la période de six mois étudiée. Parmi les jeunes qui en ont vécu au moins une, deux profils latents ont été trouvés. Plusieurs caractéristiques individuelles, mais surtout environnementales, prédisent d’une part, le fait d’expérimenter ou non une mesure, et, d’autre part, l’appartenance à l’un des deux profils chez les jeunes qui ont expérimenté au moins une mesure. Conclusion : La présente étude a permis d’identifier des facteurs de risque individuels, mais surtout environnementaux, associés au fait de vivre des mesures restrictives.
Mots-clés :
- contention et isolement,
- retrait,
- enfants et adolescents,
- centre de réadaptation,
- analyse de profil latent
Abstract
Children and youth placed in residential treatment centers or in community group homes represent a very vulnerable population in which the use of restrictive measures, such as restraint, seclusion and time-out, is preoccupying. The aim of this study was to enhance our understanding of the use of restrictive measures as a mean of improving professional practices involving these children and youth. Methods: Administrative data on the use of restrictive measures among 324 children and youth (29 residential units, 10 centers/areas) were extracted. A latent profile analysis was used to identify subgroups of children and youth with distinct restrictive measure profiles. Logistic regressions were used to identify individual (age, sex, ethnicity, reason for services) and environmental (length of stay, unit type, specialized designation, type of services) predictors of the use of restrictive measures. Results: Almost half children and youth (48,1%) did not experience any restrictive measure over the 6-month period studied. Among those who did experience at least one measure, we found two latent profiles. Both individual and environmental factors predicted 1) having experienced at least one measure and 2) classification into distinct restrictive measure profiles. Conclusion: The current study led to the identification of individual and, to a greater extent, environmental risk factors associated with the use of restrictive measures in children and youth in residential care.
Keywords:
- restraint and seclusion,
- time-out,
- children and youth,
- residential care,
- latent profile analysis
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