Department of Diagnostics and Public Health, University of Verona, Strada Le Grazie 8, 37134 Verona, Italy.
Cardiac Surgery Unit, San Bortolo Hospital, Viale Ferdinando Rodolfi, 37, 36100 Vicenza, Italy.
Int J Environ Res Public Health. 2021 Sep 13;18(18):9646. doi: 10.3390/ijerph18189646.
Despite the worldwide promotion of a "restraint-free" model of care due to the questionable ethical and legal issues and the many adverse physical and psychosocial effects of physical restraints, their use remains relatively high, especially in the intensive care setting. Therefore, the aim of the present study was to explore the experiences of nurses using physical restraints in the intensive care setting. Semi-structured interviews with 20 nurses working in intensive care units for at least three years, were conducted, recorded, and transcribed verbatim. Then, the transcripts were analyzed according to the qualitative descriptive approach by Sandelowsky and Barroso (2002). Six main themes emerged: (1) definition of restraint, (2) who decides to restrain? (3) reasons behind the restraint use, (4) physical restraint used as the last option (5) family involvement, (6) nurses' feelings about restraint. Physical restraint evokes different thoughts and feelings. Nurses, which are the professionals most present at the patient's bedside, have been shown to be the main decision-makers regarding the application of physical restraints. Nurses need to balance the ethical principle of beneficence through this practice, ensuring the safety of the patient, and the principle of autonomy of the person.
尽管由于存在伦理和法律问题以及身体和心理社会方面的诸多负面影响，全世界都在提倡“无约束”的护理模式，但身体约束的使用仍然相对较高，尤其是在重症监护环境中。因此，本研究旨在探讨在重症监护环境中使用身体约束的护士的经验。对至少在重症监护病房工作三年的 20 名护士进行了半结构化访谈，对访谈进行了录音，并逐字转录。然后，根据桑德洛斯基和巴罗索（2002 年）的定性描述方法对转录本进行了分析。出现了六个主要主题：（1）约束的定义，（2）谁决定约束？（3）约束使用的原因，（4）约束作为最后手段的使用，（5）家属参与，（6）护士对约束的感受。身体约束会引起不同的想法和感受。护士作为最常在患者床边的专业人员，已被证明是应用身体约束的主要决策者。护士需要通过这种实践平衡有利原则，确保患者的安全，以及尊重个人自主权的原则。
