School of Nursing, Department of Medicine, Qingdao University, Qingdao, China.
Department of Thoracic surgery, Qingdao Municipal Hospital, Qingdao, China.
Int J Nurs Pract. 2021 Feb;27(1):e12868. doi: 10.1111/ijn.12868. Epub 2020 Jul 1.
The study aims to explore and describe nurses' behaviours towards physical restraint (PR) use in intensive care units (ICUs) and identify key characteristics of these experiences.
Patients within the ICU are always vulnerable, which requires a thoughtful deliberation when employing PR in ethically laden situations. Considering that the qualitative study on nurses' behaviours towards PR use in ICUs is limited, a deep understanding of how nurses reason and restrict patients is necessary before developing a minimizing programme in hospitals.
A descriptive qualitative study was conducted in this paper. Data were collected by 24 semistructured, in-depth and individual interviews about PR, where 24 nurses were drawn from six ICUs of four hospital settings from a comprehensive tertiary care hospital in Qingdao. The QSR NVivo 11.0 software program was used to manage the interview data, and data analysis was guided by the Qualitative Analysis Guide of Leuven. The checklist of Consolidated Criteria for Reporting Qualitative Studies was followed as a guideline in reporting the study.
Regarding PR, nurses' behaviours start with a hazard perception, followed by hesitation about whether to restrict the patient. They would usually decide to apply PR when they think that no other choice to control the situation is available. Then, they would reflect on and rationalize their behaviours. Nurses, intensivists, patients and their families participate in and affect this process directly or indirectly.
Nurses' behaviours towards PR use comprise a series of complex processes centred on safety. Nurses' decision making should be performed with the participation of intensivists, patients and family caregivers.
本研究旨在探索和描述护士在重症监护病房（ICU）中使用身体约束（PR）的行为，并确定这些经验的关键特征。
ICU 中的患者始终处于脆弱状态，因此在伦理问题情况下使用 PR 时需要深思熟虑。考虑到 ICU 护士使用 PR 的定性研究有限，在医院制定减少 PR 计划之前，有必要深入了解护士如何对患者进行推理和限制。
本文进行了描述性定性研究。通过 24 次关于 PR 的半结构化、深入和个人访谈收集数据，从青岛市一家综合性三级保健医院的六个 ICU 中抽取了 24 名护士。使用 QSR NVivo 11.0 软件程序管理访谈数据，数据分析由鲁汶定性分析指南指导。研究报告遵循了定性研究报告的综合标准清单（CONSORT）准则。
关于 PR，护士的行为始于对危险的感知，然后对是否限制患者感到犹豫。当他们认为没有其他控制情况的选择时，通常会决定使用 PR。然后，他们会反思并合理化自己的行为。护士、重症监护医生、患者及其家属直接或间接地参与并影响这一过程。
护士使用 PR 的行为包括一系列以安全为中心的复杂过程。护士的决策应该在重症监护医生、患者和家属的参与下进行。
