title: [Therapeutic restraint management in Intensive Care Units: Phenomenological approach to nursing reality].
abstract: OBJECTIVE
  To identify nursing experience on physical restraint management in Critical Care Units. To analyse similarities and differences in nursing experience on physical restraint management according to the clinical context that they are involved in.
  
  
  METHODS
  A multicentre phenomenological study was carried out including 14 Critical Care Units in Madrid, classified according to physical restraint use: Common/systematic use, lacking/personalised use, and mixed use. Five focus groups (23 participants were selected following purposeful sampling) were convened, concluding in data saturation. Data analysis was focused on thematic content analysis following Colaizzi's method.
  
  
  RESULTS
  Six main themes: Physical restraint meaning in Critical Care Units, safety (self-retreat vital devices), contribution factors, feelings, alternatives, and pending issues. Although some themes are common to the 3 Critical Care Unit types, discourse differences are found as regards to indication, feelings, systematic use of pain and sedation measurement tools.
  
  
  CONCLUSIONS
  In order to achieve real physical restraint reduction in Critical Care Units, it is necessary to have a deep understanding of restraints use in the specific clinical context. As self-retreat vital devices emerge as central concept, some interventions proposed in other settings could not be effective, requiring alternatives for critical care patients. Discourse variations laid out in the different Critical Care Unit types could highlight key items that determine the use and different attitudes towards physical restraint.
authors.affiliation: UCI Médica, Hospital Universitario Puerta de Hierro Majadahonda, Majadahonda (Madrid), España; Máster en Cuidados Críticos, Universidad Camilo José Cela, Madrid, España. Electronic address: m.acevedo.nuevo@gmail.com.
authors.forename: M
authors.initials: M
authors.lastname: Acevedo-Nuevo
authors.affiliation: Sección Departamental de Enfermería, Universidad Autónoma de Madrid, Madrid, España.
authors.forename: M T
authors.initials: MT
authors.lastname: González-Gil
authors.affiliation: Departamento de Investigación, Hospital Universitario Puerta de Hierro Majadahonda, Majadahonda (Madrid), España.
authors.forename: M
authors.initials: M
authors.lastname: Solís-Muñoz
authors.affiliation: UCI Médica, Hospital Universitario Puerta de Hierro Majadahonda, Majadahonda (Madrid), España.
authors.forename: N
authors.initials: N
authors.lastname: Láiz-Díez
authors.affiliation: Unidad de Cuidados Cardiacos Postoperatorios, Hospital General Universitario Gregorio Marañón, Madrid, España.
authors.forename: M J
authors.initials: MJ
authors.lastname: Toraño-Olivera
authors.affiliation: UCI Cardiológica, Hospital Universitario 12 de Octubre, Madrid, España.
authors.forename: L F
authors.initials: LF
authors.lastname: Carrasco-Rodríguez-Rey
authors.affiliation: UCI, Hospital Universitario de Móstoles, Móstoles (Madrid), España.
authors.forename: S
authors.initials: S
authors.lastname: García-González
authors.affiliation: UCI, Hospital Universitario Clínico San Carlos, Madrid, España.
authors.forename: T R
authors.initials: TR
authors.lastname: Velasco-Sanz
authors.affiliation: UCI, Hospital Universitario de Móstoles, Móstoles (Madrid), España.
authors.forename: A
authors.initials: A
authors.lastname: Martínez-Álvarez
authors.affiliation: Unidad de Críticos Quirúrgicos, Hospital Universitario Ramón y Cajal, Madrid, España.
authors.forename: B E
authors.initials: BE
authors.lastname: Martin-Rivera
mesh_terms: D064648:Critical Care Nursing; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D012149:Restraint, Physical
keywords: Critical care; Critical care nursing; Enfermería de Cuidados Críticos; Focus group; Grupos de discusión; Hermeneutics; Hermenéutica; Inmovilización terapéutica; Investigación cualitativa; Qualitative research; Restraint physical; Restricción física; Therapeutic immobilization