Nurses' attitudes towards the use of physical restraints on psychogeriatric patients.

Abstract

The aim of this study was to identify nurses' attitudes towards the use of physical restraints on psychogeriatric patients. The objectives of the study sought to examine the reasons for restraint use, to identify nurses' knowledge and attitudes towards restraints, and to consider alternatives to physical restraint. A quantitative, non-experimental, descriptive design was chosen for this study. A purposive sample of 45 nurses working in psychogeriatric wards in a state mental health hospital were selected to participate in completing a 41-item self-administered questionnaire. The questionnaire chosen by the researcher was originally developed by (Janelli et al., 1992), and then adapted by the researcher to meet the needs of this study. The response rate obtained from the purposive sample was that of 89%. The questionnaires were distributed by a link person within the psychogeriatric wards thus ensuring anonymity. Data was analyzed by means of histograms, tables, and thematic analyses for the open-ended question, with a correlation between responses, gender and length of service. Results from the findings showed that nurses had positive attitudes towards restraint use due to the fact that they viewed restraints as a protection from harm for patients. Moreover, inadequate knowledge amongst nurses regarding alternatives to restraints was revealed with males and females disagreeing on these. Also, knowledge on legal issues was lacking due to lack of guidelines in wards. However, participants showed that they were knowledgeable about physical and psychological consequences of restraint use. Several recommendations were made based on the conclusions of the study. These include appropriate training for nurses regarding proper assessment of a psychogeriatric patient before deciding on the use of any kind of restraints, and the provision of information regarding restraint use and alternatives. Furthermore, written clinical practice guidelines should be available in all psychogeriatric wards, hospital policies on restraint use based on the latest research should be reinforced and further research using a larger sample and including nursing aides, relatives and residents themselves should be undertaken.