Douglas Lisa, Donohue Gráinne, Morrissey Jean
St. Patrick's Mental Health Services, Dublin, Ireland.
Trinity Centre for Practice and Healthcare Innovation, School of Nursing and Midwifery, Trinity College, University of Dublin, Dublin, Ireland.
Issues Ment Health Nurs. 2022 May;43(5):473-481. doi: 10.1080/01612840.2021.1978597. Epub 2021 Sep 29.
The use of physical restraint is a contentious practice in the acute mental health setting. There are a plethora of guidelines surrounding the safe use of restraint. However, there is a scarcity of literature dedicated specifically from the perspective of the patient. The existing literature suggests that there are serious physical and psychological implications associated with the use of physical restraint for both mental health patients and nurses alike. The debate surrounding this practice has been intensified by the compelling evidence suggesting that the application of restraint is not compatible with the values of recovery in mental health care. To influence clinical practice that governs the use of restraint, it is essential to explore patient experiences of its use. Therefore, this review aims to explore patient experiences of physical restraint in the acute setting. PubMed, CINAHL and PsycINFO were systematically searched using keywords; "physical restraint" and "patient experience" and "acute setting". The search yielded n = 482 papers in total. Following the application of rigorous inclusion and exclusion criteria and data extraction, a total of n = 9 papers were considered suitable for the systematic review. Quality was assessed using the MMAT instrument. Following analysis, three themes were identified: 'the bio-psychosocial impact of restraint on patients', 'the impact of restraint on the therapeutic relationship' and 'patient needs concerning the use of restraint'. Future research opportunities have been identified that will add to the body of evidence in developing appropriate health interventions and supports for this population.
在急性心理健康环境中，使用身体约束是一种有争议的做法。围绕安全使用约束有大量的指导方针。然而，专门从患者角度出发的文献却很匮乏。现有文献表明，对心理健康患者和护士而言，使用身体约束都存在严重的身体和心理影响。有令人信服的证据表明，约束的应用与心理健康护理中的康复价值观不相容，这加剧了围绕这种做法的争论。为了影响管理约束使用的临床实践，探索患者对其使用的体验至关重要。因此，本综述旨在探索急性环境中患者对身体约束的体验。使用关键词“身体约束”“患者体验”和“急性环境”对PubMed、CINAHL和PsycINFO进行了系统检索。检索共得到n = 482篇论文。在应用严格的纳入和排除标准以及数据提取后，共有n = 9篇论文被认为适合进行系统综述。使用MMAT工具评估质量。经过分析，确定了三个主题：“约束对患者的生物心理社会影响”“约束对治疗关系的影响”以及“患者对约束使用的需求”。已确定了未来的研究机会，这将为制定针对该人群的适当健康干预措施和支持提供更多证据。
