The Use of Physical Restraints to Psychogeriatric Patients in Hong Kong

Abstract

The use of physical restraint has been a controversial intervention in the nursing management of hospitalized elderly patients in many countries. This ethnographic study was conducted in one psychogeriatric ward in Hong Kong in order to explore what determines psychiatric nurses' decisions to use restraints on their elderly patients. By comparing the findings of three data sources, comprising semistructured interviews, observations, and clinical records, five main themes were identified with regard to the nurses decision of restraint use. They included the rationale of physical restraint, consideration of alternative measures, consideration of adverse consequences, ethical considerations, and policy and documentation of restraint use. The findings of this study demonstrate that nurses must question the established practice myths about restraint use being the best way to maintain patient safety. Most importantly, nurses need cognitive and ethical preparation to face different situations in which physical restraint may be used.

Nurses’ decision‐making in cases of physical restraint: a synthesis of qualitative evidence

“…1995, Janelli & Kanski 1996, Hagan‐Hennessy et al. 1997, Chien 1999, Lee et al. 1999, Hantikainen & Käppeli 2000, Marangos‐Frost & Wells 2000, Hantikainen 2001).…”

Nurses’ feelings and thoughts about using physical restraints on hospitalized older patients

“…In contrast, some studies found that nurses had no manifest ethical dilemmas (Hardin et al. 1994, Chien 2000, Werner & Mendelsson 2001). Studies argue that ethical dilemmas may be intensified by a lack of clear official regulations (Quinn 1993, Thomas et al.…”

The prevalence and correlates of the use of restraint and force on hospitalised older people

“…2006). Similar to western studies, although, qualitative findings on Hong Kong nurses’ perceptions of restraint use have revealed that a major reason nurses give for using restraint is that it protects an older person (Chien 1999, Lee et al. 1999).…”