A cross‐sectional study on nurses' attitudes towards physical restraints use in nursing homes in Portugal

Ferrão, Sónia; Bleijlevens, Michel H. C.; Nogueira, Paulo; Henriques, Maria Adriana

doi:10.1002/nop2.769

Cited by 11 publications

(17 citation statements)

References 36 publications

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“…This was contrary to the findings of Hamers et al that age and gender were related to attitudes of nursing staff in nursing homes. 52 A study by Ferrão et al 53 in Portugal displayed that longer professional experience was related to a positive attitude about appropriate restraint use in clinical practice, whereas no significant relationship was found in our study. Nursing assistants who received in-job training on PR performed more positive attitudes toward PR use, although the training was sporadic and not systematic.…”

Section: Discussioncontrasting

confidence: 85%

Difference of Physical Restraint Knowledge, Attitudes and Practice Between Nurses and Nursing Assistants in Long-Term Care Facilities: A Cross-Sectional Study

Wang

Liu

Hou-wei

et al. 2022

RMHP

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Background: Physical restraint (PR) is widespread use among older adults in long-term care (LTC) facilities, which has negative effects on older adults' health and quality of care. Considering that research on PR use in Chinese LTC facilities is rare, assessment of nursing staff's knowledge, attitude, and practice (KAP) is a prerequisite before minimized PR program and staff training project development.Purpose: This study aimed at determining the differentiation of levels and factors of KAP toward PR use between nurses and nursing assistants in LTC facilities. Methods: A cross-sectional study was conducted in six Chinese LTC facilities from November to December in 2019 and May to June in 2020. A total of 316 nursing staff, comprising 69 nurses and 247 nursing assistants were investigated using the Chinese version of the Staff Knowledge, Attitudes and Practices Questionnaire regarding PR. One-way analysis of variance, chi-squared test, Welch test, the Mann-Whitney U-test, and multiple linear regression were performed for data analysis. Results: Mean scores of overall knowledge, attitude, and practice were 5.90±2.27, 31.97±3.01, 30.89±4.82, respectively. PR knowledge and practice of nurses were significantly higher than that of nursing assistants (all P<0.001), whereas PR attitude with no significant difference (P=0.084). In-school training, in-job training, and knowledge on PR significantly affected PR practice of nurses and nursing assistants. Further, nursing assistants' practice was also significantly predicted by education (β=0.131, P=0.019), age (β= −0.140, P=0.034), monthly income (β=−0.184, P=0.002), and attitude (β=0.130, P=0.030). In-job training (β=0.283, P<0.001), age (β= −0.164, P=0.021), and knowledge (β=0.292, P<0.001) significantly affected nursing assistants' attitude, while their knowledge was influenced by monthly income (β=0.153, P=0.019) and work years in LTC (β=0.343, P<0.001). Conclusion: Specific knowledge deficits, negative fields of attitude, and practice were dissimilar between nurses and nursing assistants. The targeted and stratified PR education approaches were suggested to prompt their KAP.

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Section: Discussioncontrasting

confidence: 85%

Difference of Physical Restraint Knowledge, Attitudes and Practice Between Nurses and Nursing Assistants in Long-Term Care Facilities: A Cross-Sectional Study

Wang

Liu

Hou-wei

et al. 2022

RMHP

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“…Differentiating physical restraints according to their intent into restrictive and supportive device categories might have several potential implications: first, this classification differentiating between positive beneficial and negative devices suggests that the accurate measurement of the physical restraints use should not be reduced to the counting of the presence of a device or to the evaluation of movement limitation; therefore, alongside direct observations, the underlying intents and reasons should also be assessed in future studies. Moreover, assessing the intent might increase the accuracy in reporting some devices that apparently might function both as a restraint and as a support (e.g., bed rails, [ 44 ]); second, this classification might overcome available definitions reported in some studies, as in the case of bed rails that have been considered as ‘light restraints’ [ 13 ], as it would be possible to differentiate the degree of restraints as ‘light’ or ‘heavy’ according to the degree of freedom available with the device; third, classifying restraints as restrictive and supportive devices might help in appropriately considering those applied according to the patients’ request that have already been discussed based on their meaning (e.g., bed rails, [ 24 ]) but not truly legitimated in the debate as appropriate restraints or not; fourth, better differentiating the concepts might help inform educators and researchers in an understanding of how to further limit the physical restraint use, targeting the training on those avoidable and illegal restraints such as those used with the purpose of preventing risks. …”

Section: Discussionmentioning

confidence: 99%

“…second, this classification might overcome available definitions reported in some studies, as in the case of bed rails that have been considered as ‘light restraints’ [ 13 ], as it would be possible to differentiate the degree of restraints as ‘light’ or ‘heavy’ according to the degree of freedom available with the device;…”

Section: Discussionmentioning

confidence: 99%

“…In order to identify triggers and alternative interventions, a growing body of research has investigated the underlying nurses’ decision-making process leading to the use of a physical restraint [ 12 , 13 ]. Different tools have also been validated, such as the Staff Knowledge, Attitudes, and Predictors Questionnaire [ 14 ] and the Physical Restraint Use Questionnaire [ 15 ].…”

Section: Introductionmentioning

confidence: 99%

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Between Restrictive and Supportive Devices in the Context of Physical Restraints: Findings from a Large Mixed-Method Study Design

Palese

Longhini

Businarolo

et al. 2021

IJERPH

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Physical restraints are still a common problem across healthcare settings: they are triggered by patient-related factors, nurses, and context-related factors. However, the role of some devices (e.g., bed rails), and those applied according to relatives’/patients’ requests have been little investigated to date. A mixed-method study in 2018, according to the Good Reporting of a Mixed Methods Study criteria was performed. In the quantitative phase, patients with one or more physical restraint(s) as detected through observation of a single index day in 37 Italian facilities (27 long-term, 10 hospital units, =4562 patients) were identified. Then, for each patient with one or more restraint(s), the nurse responsible was interviewed to gather purposes and reasons for physical restraints use. A thematic analysis of the narratives was conducted to (a) clarify the decision-making framework that had been used and (b) to assess the differences, if any, between hospital and long-term settings. The categories ‘Restrictive’ and ‘Supportive’ devices aimed at ‘Preventing risks’ and at ‘Promoting support’, respectively, have emerged. Reasons triggering ‘restrictive devices’ involved patients’ risks, the health professionals’ and/or the relatives’ concerns. In contrast, the ‘supportive’ ones were triggered by patients’ problems/needs. ‘Restrictive’ and ‘Supportive’ devices were applied based on the decision of the team or through a process of shared decision-making involving relatives and patients. According to the framework that emerged, long-term care patients are at increased risk of being treated with ‘restrictive devices’ (Odds Ratio 1.87, Confidence Interval 95% 1.44; 2.43; p < 0.001) as compared to those hospitalized. This study contributes to the improvement in knowledge of the definition, classification and measurement of physical devices across settings.

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“…The Maastricht Attitude Questionnaire (MAQ, German version) was used with the developers’ permission [ 25 , 26 ]. So far, the MAQ has been used solely in long-term care settings and has proven to be valid and reliable [ 27 , 28 , 29 ]. The MAQ includes socio-demographic information (age and gender), work-specific information (workplace, highest professional qualification, and work experience), and three scales dealing with the attitude and perception of nursing staff regarding the use of restraints in health care.…”

Section: Methodsmentioning

confidence: 99%

Attitudes of Nursing Staff in Hospitals towards Restraint Use: A Cross-Sectional Study

Thomann

Gleichner

Hahn

et al. 2022

IJERPH

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The attitude of nursing staff towards restraint use can be decisive for whether restraints are used. So far, nursing staff’s attitudes have been studied primarily in long-term and mental health care settings, while findings from somatic acute care hospital settings are largely lacking. Therefore, we aimed to investigate (a) the attitudes of hospital nursing staff towards restraint use, and (b) the construct validity and reliability of a measurement instrument for use in hospital settings that was developed and validated in long-term care settings (Maastricht Attitude Questionnaire (MAQ)). Using a cross-sectional design, the attitudes of 180 nursing staff towards restraint use were assessed. The data were analysed descriptively and by means of regression analysis and factor analysis. We found that nursing staff in hospitals have a neutral attitude towards restraint use and that the MAQ, with minor adaptations, can be used in hospital settings, although further testing is recommended. Neutral attitudes of nursing staff have also been observed in long-term and mental health care settings, where changing attitudes were found to be challenging. Interventions at the national level (e.g., legal regulations) and management level (e.g., providing alternatives and changing institutional culture) are suggested.

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A cross‐sectional study on nurses' attitudes towards physical restraints use in nursing homes in Portugal

Cited by 11 publications

References 36 publications

Difference of Physical Restraint Knowledge, Attitudes and Practice Between Nurses and Nursing Assistants in Long-Term Care Facilities: A Cross-Sectional Study

Difference of Physical Restraint Knowledge, Attitudes and Practice Between Nurses and Nursing Assistants in Long-Term Care Facilities: A Cross-Sectional Study

Between Restrictive and Supportive Devices in the Context of Physical Restraints: Findings from a Large Mixed-Method Study Design

Attitudes of Nursing Staff in Hospitals towards Restraint Use: A Cross-Sectional Study

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