Experience of mental health nurses regarding mechanical restraint in patients with psychomotor agitation: A qualitative study.
attitude of health personnel
cognitive dissonance
mental health nursing
nurse's role
physical restraint
psychomotor agitation
qualitative methods
Journal
Journal of clinical nursing
ISSN: 1365-2702
Titre abrégé: J Clin Nurs
Pays: England
ID NLM: 9207302
Informations de publication
Date de publication:
Aug 2022
Aug 2022
Historique:
revised:
16
08
2021
received:
26
05
2021
accepted:
18
08
2021
pubmed:
31
8
2021
medline:
6
7
2022
entrez:
30
8
2021
Statut:
ppublish
Résumé
To explore mental health nurses' experiences whilst managing a patient with psychomotor agitation, and the factors that influence the decision to use mechanical restraints. Psychomotor agitation is considered a potentially violent psychiatric emergency. The management of disruptive behaviours includes mechanical restraints as the last resort although its use has consequences for patients, professionals and the therapeutic relationship. A qualitative study design with a hermeneutical approach was developed. A total of 31 nurses were purposively sampled from six short- and medium-stay mental health inpatient units. Data were obtained from semi-structured interviews. A thematic content analysis following the seven steps of Colaizzi's method was performed. Three researchers independently conducted an inductive analysis within a perspective of a hermeneutic paradigm. The COREQ checklist was followed in carrying out this research. Four themes emerged from the analysis: 1) Nurses' perceptions of restraint methods, 2) Factors influencing decision-making, 3) Consequences for professionals of the use of mechanical restraint and 4) Alternatives to mechanical restraint. Aspects such as the importance of teamwork, the issue of cognitive dissonance, ethical conflict and barriers to effecting the withdrawal of these measures affect the mental health nurse's decision-making process. The understanding of these aspects is crucial to further reducing its incidence and negative consequences and achieving the elimination of mechanical restraints. Knowing how nurses feel during the patient's episode of psychomotor agitation and which factors influence the decision on whether to apply coercive methods can guide us on the quality of care offered.
Sections du résumé
AIM
OBJECTIVE
To explore mental health nurses' experiences whilst managing a patient with psychomotor agitation, and the factors that influence the decision to use mechanical restraints.
BACKGROUND
BACKGROUND
Psychomotor agitation is considered a potentially violent psychiatric emergency. The management of disruptive behaviours includes mechanical restraints as the last resort although its use has consequences for patients, professionals and the therapeutic relationship.
DESIGN
METHODS
A qualitative study design with a hermeneutical approach was developed.
METHODS
METHODS
A total of 31 nurses were purposively sampled from six short- and medium-stay mental health inpatient units. Data were obtained from semi-structured interviews. A thematic content analysis following the seven steps of Colaizzi's method was performed. Three researchers independently conducted an inductive analysis within a perspective of a hermeneutic paradigm. The COREQ checklist was followed in carrying out this research.
RESULTS
RESULTS
Four themes emerged from the analysis: 1) Nurses' perceptions of restraint methods, 2) Factors influencing decision-making, 3) Consequences for professionals of the use of mechanical restraint and 4) Alternatives to mechanical restraint.
CONCLUSIONS
CONCLUSIONS
Aspects such as the importance of teamwork, the issue of cognitive dissonance, ethical conflict and barriers to effecting the withdrawal of these measures affect the mental health nurse's decision-making process. The understanding of these aspects is crucial to further reducing its incidence and negative consequences and achieving the elimination of mechanical restraints.
RELEVANCE FOR CLINICAL PRACTICE
CONCLUSIONS
Knowing how nurses feel during the patient's episode of psychomotor agitation and which factors influence the decision on whether to apply coercive methods can guide us on the quality of care offered.
Types de publication
Journal Article
Langues
eng
Pagination
2142-2153Subventions
Organisme : Institut de Recerca Sant Joan de Déu
Commentaires et corrections
Type : CommentIn
Informations de copyright
© 2021 John Wiley & Sons Ltd.
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