Nurses' perceptions of the use of restraint in pediatric somatic care.
BACKGROUND
The interest in the children's role in pediatric care is connected to children's health-related autonomy and informed consent in care. Despite the strong history of children's rights, nurses' role in the everyday nursing phenomenon, that is, restraint in somatic pediatric care, is still relatively seldom reported.


OBJECTIVE
The aim of this study is to describe nurses' perceptions of the use of restraint in somatic pediatric care. The ultimate aim is to deepen the understanding of the phenomenon of restraint, whose previous study has been fragmented.


METHODS
Qualitative approach was selected because of the lack of previous information. Due to the sensitivity of the research question, individual interviewees were selected among voluntary nurses (n = 8). All participants were registered nurses with general work experience as nurses of 5-16 years on average and specifically 1.5-10 years in pediatric nursing. Inductive content analysis was used for aiming to produce a synthesis of the research phenomenon.


METHODS
The research received organizational approval by the university hospital, and informed consent and confidentiality were ensured.


RESULTS
Restraint in pediatric nursing was process-like, but occurred without advanced planning. The restraint-related process included five categories: (a) identification of the situations where restraint may occur, (b) finding preventive methods, (c) identification of different forms of restraint, (d) rationing the use of restraint, and (e) post-restraint acts. Restraint was seen as a part of pediatric nursing which occurred daily and involved several professionals. According to the nurses' illustrations, restraint means doing things even when a child is not agreeable.


CONCLUSIONS
Restraint is part of somatic pediatric nursing, described as the last, but in some cases, the only resort for carrying out care or treatment. Restraint is not a goal in itself, but an instrumental tool and procedure in carrying out care. In the future, more information about nurses' role and the use of restraint in pediatric nursing is still needed.
University of Eastern Finland, Finland mari.kangasniemi@uef.fi.
Mari
M
Kangasniemi
Oulu University Hospital, Finland.
Oili
O
Papinaho
Oulu University Hospital, Finland.
Anne
A
Korhonen
D001291:Attitude of Health Personnel; D003219:Confidentiality; D006801:Humans; D007258:Informed Consent; D007407:Interviews as Topic; D028701:Patient Rights; D010371:Pediatric Nursing / Q000941:ethics*; D026684:Personal Autonomy; D036301:Qualitative Research; D012149:Restraint, Physical / Q000941:ethics*
Adolescent; child; pediatric nursing; qualitative research; restraint; right to autonomy