Bern University of Applied Sciences, School of Health Professions, Applied Research & Development in Nursing, Bern, Switzerland.
Department of Nursing, Academic-Practice-Partnership, Bern University Hospital, Bern, Switzerland.
Nurs Open. 2023 Nov;10(11):7224-7232. doi: 10.1002/nop2.1975. Epub 2023 Aug 23.
To describe the experiences of patients and relatives with any form of restraints in somatic acute care hospitals.
Qualitative explorative design.
Qualitative research methods were used. Participants were recruited through clinical nursing specialists in participating departments of a university hospital between June and August 2020. Individual interviews were conducted and analysed using content analysis.
Four interviews with patients and five interviews with relatives were conducted with a mean duration of 25 min. The following three topics emerged in the analysis as important: What was perceived as restraints, Assessing the experiences of restraint use on a continuum, and Lack of information about restrictive measures. Patients and relatives defined restraint very broadly and assessed the experiences of restraint on a continuum from positive to negative, with a more critical view from patients. Relatives clearly seemed to approve of the use of restraints in acute care hospitals because it provided them with a sense of security. In general, there seemed to be a lack of information about the use of restraint and its effects on patients and relatives alike.
The involvement of patients and relatives in the decision-making process about restraint use seems to be low. Healthcare professionals need to be better educated to be able to pass on adequate information and to involve patients and their relatives adequately in all processes of restraint use. However, when relatives are involved in decision-making as proxies for patients, it is important to consider that patients' and relatives' opinions on restraints may differ.
Patients and relatives agreed to participate in the study and shared their experiences with us.
描述躯体急症护理医院中患者和家属对任何形式约束的体验。
定性探索性设计。
采用定性研究方法。于 2020 年 6 月至 8 月,通过参与大学医院各科室的临床护理专家招募参与者。对患者和家属分别进行了 4 次和 5 次个人访谈,并使用内容分析法进行分析。
共进行了 4 次患者访谈和 5 次家属访谈,每次访谈平均持续 25 分钟。分析中出现了以下三个重要主题:被视为约束的内容、连续评估约束使用体验,以及缺乏关于限制措施的信息。患者和家属对约束的定义非常广泛,并在连续体上评估约束体验,患者的看法更为批评。家属显然对急症护理医院使用约束表示认可,因为这让他们感到安心。总体而言,对约束的使用及其对患者和家属的影响似乎缺乏信息。
患者和家属参与约束使用决策的程度似乎较低。医疗保健专业人员需要接受更好的教育,以便能够提供充分的信息,并充分让患者及其家属参与约束使用的所有过程。然而,当家属作为患者的代理人参与决策时,重要的是要考虑到患者和家属对约束的看法可能不同。
患者和家属同意参与研究,并与我们分享了他们的经验。