Nurses' feelings and thoughts about using physical restraints on hospitalized older patients.
OBJECTIVE
To explore nurses' feelings and thoughts about physically restraining older hospitalized patients.


BACKGROUND
The use of physical restraints is still highly prevalent in hospitals; furthermore, older patients are most likely to be so restrained. Studies in acute care settings have focused mainly on nurses' knowledge, attitudes, or practice concerning physical restraints, on physical restraint reduction programmes, on nurses' perceptions about the use of physical restraints, or on elderly patients' experiences with physical restraints. To the best of our knowledge no studies have been conducted on hospital nurses' feelings and thoughts about the use of physical restraints in Taiwan.


METHODS
A qualitative approach was used to understand this phenomenon. Semi-structured interviews were carried out, from August 2002 to March 2003, with 12 nurses working in three hospitals. The interviews were audiotaped and transcribed verbatim; content analysis was used to analyse the data.


RESULTS
Nurses reported a variety of emotional responses regarding the use of physical restraints, including sadness, guilt, conflicts, retribution, absence of feelings, security, and pity for the restrained older people. Rationalization, sharing with colleagues, and compensating behaviours were ways that nurses used to manage their negative feelings.


CONCLUSIONS
Most nurses had negative feelings towards the use of physical restraints. Among these nurses there was a struggle between patients' autonomy and the practice of care. However, other nurses said they had 'no feelings' or 'feeling of security' while using physical restraints.


CONCLUSIONS
The findings of this study may contribute to filling the gaps in nursing knowledge, to improving protocols for physical restraint use in hospitals, and may also assist nurse managers to create a supportive practice environment. It is recommended that in-service training programmes should cover misconceptions regarding physical restraint use, ethical issues and how to cope with feelings while using physical restraints.
Chuang
Yeu-Hui
YH
Lecturer, Department of Nursing, Chung Hwa College of Medical Technology, Tainan, Taiwan. y4.chuang@student.qut.edu.au
Huang
Hui-Tzu
HT
D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D001291:Attitude of Health Personnel; D003220:Conflict, Psychological; D004509:Education, Nursing, Continuing; D004644:Emotions; D005260:Female; D005851:Geriatric Nursing / Q000193:education / Q000941:ethics / Q000379:methods; D006117:Grief; D006167:Guilt; D007722:Health Knowledge, Attitudes, Practice; D006301:Health Services Needs and Demand; D006801:Humans; D007318:Inservice Training; D009341:Negativism; D015404:Nursing Methodology Research; D009741:Nursing Staff, Hospital / Q000193:education / Q000941:ethics / Q000458:organization & administration / Q000523:psychology*; D010344:Patient Advocacy; D036301:Qualitative Research; D012149:Restraint, Physical / Q000009:adverse effects / Q000941:ethics / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires; D013624:Taiwan