McLean Hospital, 115 Mill St., Belmont, MA 02478, United States of America.
Fairfield University, 1073 N. Benson Road, Fairfield, CT 06825, United States of America.
Arch Psychiatr Nurs. 2020 Feb;34(1):2-6. doi: 10.1016/j.apnu.2019.12.009. Epub 2019 Dec 26.
Restraint and seclusion continues to be a challenging topic in psychiatric nursing care. While there is a movement toward reduction and elimination of restraint, emergency situations still arise that require intervention for the safety of patients and staff. In addition to traditional methods of restraint (physical holds, four-point restraint, seclusion), the restraint chair has been introduced at some hospitals as an alternative to four-point restraint. The restraint chair allows the patient to be upright in a seated position during the restraint process. Little research on the restraint chair currently exists. The purpose of this study was to examine the nurses' experience with the restraint chair compared to four-point restraint. Results indicate nurses feel the restraint chair is easier to use, more humane, less traumatic, comforting, and enhances the therapeutic relationship compared to four-point restraint. Based on the reports of nurses in this study and prior quantitative work on the restraint chair (Castillo, Coyne, Chan, Hall, & Vilke, 2011; Visaggio et al., 2018), the restraint chair appears to be a safe and effective alternative to traditional four-point restraint. More research verifying these results at other hospitals in the United States and abroad is warranted.
约束和隔离在精神科护理中仍然是一个具有挑战性的话题。虽然有减少和消除约束的趋势，但仍会出现紧急情况，需要对患者和工作人员的安全进行干预。除了传统的约束方法（身体固定、四点约束、隔离）外，一些医院还引入了约束椅作为四点约束的替代方法。约束椅允许患者在约束过程中保持坐姿。目前对约束椅的研究很少。本研究的目的是比较护士使用约束椅和四点约束的经验。结果表明，与四点约束相比，护士认为约束椅使用起来更容易、更人道、创伤更小、更舒适，并且能增强治疗关系。基于本研究中护士的报告以及先前关于约束椅的定量研究（Castillo、Coyne、Chan、Hall 和 Vilke，2011 年；Visaggio 等人，2018 年），约束椅似乎是传统四点约束的一种安全有效的替代方法。需要在美国和其他国家的其他医院进行更多的研究来验证这些结果。
