West Moreton Hospital and Health Service, University of Queensland, Archerfield, Queensland, Australia.
West Moreton Health, Archerfield, Queensland, Australia.
Int J Ment Health Nurs. 2022 Aug;31(4):888-896. doi: 10.1111/inm.12993. Epub 2022 Mar 25.
Despite recent changes to mental health policy in Australia and overseas, physical restraint continues to be widely employed in mental health services. While mental health nurses have a critical role to play in supporting initiatives designed to reduce restraint, it is unclear how they feel about moves to restrict the use of prone restraint. In this qualitative study, focus group interviews were conducted with mental health nursing staff and lived experience workers (LEWs) to gain their perspectives on the use of physical restraint in general and the restrictions being placed on prone ('face down') restraint. Five themes emerged: justifying the need for restraint, reliance on the prone position, the position is not the issue, time limits, and the psychological impact. Although mental health nurses were concerned about the risks associated with physical restraint, they provided strong justification for continued use of the prone position. LEWs raised concerns about the psychological impact of prone restraint and noted the need for a greater emphasis on de-escalation and other restraint avoidance strategies. The findings highlight the complexities and challenges to be considered when developing initiatives to reduce reliance on the use of restraint in general, and prone in particular.
尽管澳大利亚和海外的精神卫生政策最近有所改变，但身体约束仍然在精神卫生服务中广泛使用。虽然精神科护士在支持旨在减少约束的举措方面发挥着关键作用，但他们对限制使用俯卧约束的举措的看法尚不清楚。在这项定性研究中，对精神科护理人员和有生活体验的工作人员（LEW）进行了焦点小组访谈，以了解他们对一般身体约束的使用以及对俯卧（“面朝下”）约束的限制的看法。出现了五个主题：为约束的必要性辩护、依赖俯卧位、位置不是问题、时间限制和心理影响。尽管精神科护士对身体约束相关的风险感到担忧，但他们为继续使用俯卧位提供了强有力的理由。LEW 对俯卧约束的心理影响表示担忧，并指出需要更加重视降级和其他避免约束的策略。研究结果突出了在制定减少对一般约束、特别是对俯卧约束的依赖的举措时需要考虑的复杂性和挑战。
