Joebges Susanne, Mouton-Dorey Corine, Ricou Bara, Biller-Andorno Nikola
Clinic for Anesthesiology, Surgical Intensive Care Medicine and Postoperative Pain Therapy, Dortmund, Germany.
Institute of Biomedical Ethics and History of Medicine, University of Zurich, Zürich, Switzerland.
J Intensive Care Soc. 2023 Feb;24(1):96-103. doi: 10.1177/17511437221091051. Epub 2022 Apr 18.
The use of coercion, in a clinical context as imposing a measure against a patient's opposition or declared will, can occur in various forms in intensive care units (ICU). One prime example of a formal coercive measure in the ICU is the use of restraints, which are applied for patients' own safety. Through a database search, we sought to evaluate patient experiences related to coercive measures.
For this scoping review, clinical databases were searched for qualitative studies. A total of nine were identified that fulfilled the inclusion and the CASP criteria. Common themes emerging from the studies on patient experiences included communication issues, delirium, and emotional reactions. Statements from patients revealed feelings of compromised autonomy and dignity that came with a loss of control. Physical restraints were only one concrete manifestation of formal coercion as perceived by patients in the ICU setting.
There are few qualitative studies focusing on patient experiences of formal coercive measures in the ICU. In addition to the experience of restricted physical movement, the perception of loss of control, loss of dignity, and loss of autonomy suggests that restraining measures are just one element in a setting that may be perceived as informal coercion.
在临床环境中，强制手段是指针对患者的反对或明确意愿采取某种措施，在重症监护病房（ICU）中可能会以各种形式出现。ICU中一种正式强制手段的典型例子是使用约束带，使用约束带是为了患者自身安全。通过数据库检索，我们试图评估与强制手段相关的患者体验。
对于这项范围综述，我们在临床数据库中检索了定性研究。共识别出9项符合纳入标准和CASP标准的研究。关于患者体验的研究中出现的共同主题包括沟通问题、谵妄和情绪反应。患者的陈述揭示了伴随失去控制而来的自主感和尊严受损的感受。在ICU环境中，身体约束只是患者所认为的正式强制手段的一种具体表现形式。
很少有定性研究关注ICU中患者对正式强制手段的体验。除了身体活动受限的体验外，对失去控制、尊严丧失和自主权丧失的感知表明，约束措施只是可能被视为非正式强制手段的环境中的一个因素。
