Physical Restraint and Associated Factors in Adult Patients in Intensive Care Units: A Cross-sectional Study in North of Iran.

Critical care Intensive care Intensive care unit Physical restraint

Journal

Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine
ISSN: 0972-5229
Titre abrégé: Indian J Crit Care Med
Pays: India
ID NLM: 101208863

Informations de publication

Date de publication:
Feb 2022
Historique:
entrez: 17 6 2022
pubmed: 18 6 2022
medline: 18 6 2022
Statut: ppublish

Résumé

Patients in the intensive care units (ICUs) are at high risk of developing delirium and agitation. Physical restraint (PR) has increased to control these patients which accompanies by adverse consequences. The aim was to determine the PR use and associated factors in patients hospitalized at the ICUs in the North of Iran. In this cross-sectional study, a total of 272 patients in 3 ICUs of 5 Azar referral hospital affiliated to Golestan University of Medical Sciences (Gorgan, Iran) in 2018 were included. Confusion assessment method for the ICU (CAM-ICU), Richmond Agitation-Sedation Scale (RASS), acute physiology and chronic health evaluation II (APACHE II), and Glasgow Coma Scale (GCS) were used to evaluate delirium, sedation level, disease severity, and level of consciousness, respectively. Analysis was done by STATA version 14.2 (StataCorp LP, College Station, Texas), univariate and multiple analyses. Data from 272 patients were analyzed (mean age of 45.8 ± 21.3 years). PR was used for 74.5% of patients. Restrained patients had more severe disease [mean of APACHE II score, 20.20 (7.5) vs 11.6 (7.1)], longer length of stay [mean of 10 (5.5) vs 5.5 (4.6) days], and lower level of consciousness [mean of GCS score, 8.7 (3.5) vs 13.5 (3.3)] than patients without it. CAM-ICU was positive in majority of patients (79.5 vs 10.4%) and agitation level of RASS score was higher in restrained patients (31.7 vs 3.0%). Associated factors in multiple analysis were use of sedative and psychoactive drugs [odds ratio (OR), 2.85; 95% confidence interval (CI): 1.04-7.82], presence of delirium (OR, 15.13; 95% CI: 4.61-49.65), deep sedation (OR, 0.04; 95% CI: 0.00-0.45), and GCS score (OR, 0.69; 95% CI: 0.53-0.9). This study revealed the high use of PR in the ICUs, and use of sedative and psychoactive drugs, presence of delirium, deep sedation, and GCS score were such associated factors. Nomali M, Ayati A, Yadegari M, Nomali M, Modanloo M. Physical Restraint and Associated Factors in Adult Patients in Intensive Care Units: A Cross-sectional Study in North of Iran. Indian J Crit Care Med 2022;26(2):192-198.

Sections du résumé

Background/aim UNASSIGNED
Patients in the intensive care units (ICUs) are at high risk of developing delirium and agitation. Physical restraint (PR) has increased to control these patients which accompanies by adverse consequences. The aim was to determine the PR use and associated factors in patients hospitalized at the ICUs in the North of Iran.
Materials and methods UNASSIGNED
In this cross-sectional study, a total of 272 patients in 3 ICUs of 5 Azar referral hospital affiliated to Golestan University of Medical Sciences (Gorgan, Iran) in 2018 were included. Confusion assessment method for the ICU (CAM-ICU), Richmond Agitation-Sedation Scale (RASS), acute physiology and chronic health evaluation II (APACHE II), and Glasgow Coma Scale (GCS) were used to evaluate delirium, sedation level, disease severity, and level of consciousness, respectively. Analysis was done by STATA version 14.2 (StataCorp LP, College Station, Texas), univariate and multiple analyses.
Results UNASSIGNED
Data from 272 patients were analyzed (mean age of 45.8 ± 21.3 years). PR was used for 74.5% of patients. Restrained patients had more severe disease [mean of APACHE II score, 20.20 (7.5) vs 11.6 (7.1)], longer length of stay [mean of 10 (5.5) vs 5.5 (4.6) days], and lower level of consciousness [mean of GCS score, 8.7 (3.5) vs 13.5 (3.3)] than patients without it. CAM-ICU was positive in majority of patients (79.5 vs 10.4%) and agitation level of RASS score was higher in restrained patients (31.7 vs 3.0%). Associated factors in multiple analysis were use of sedative and psychoactive drugs [odds ratio (OR), 2.85; 95% confidence interval (CI): 1.04-7.82], presence of delirium (OR, 15.13; 95% CI: 4.61-49.65), deep sedation (OR, 0.04; 95% CI: 0.00-0.45), and GCS score (OR, 0.69; 95% CI: 0.53-0.9).
Conclusion UNASSIGNED
This study revealed the high use of PR in the ICUs, and use of sedative and psychoactive drugs, presence of delirium, deep sedation, and GCS score were such associated factors.
How to cite this article UNASSIGNED
Nomali M, Ayati A, Yadegari M, Nomali M, Modanloo M. Physical Restraint and Associated Factors in Adult Patients in Intensive Care Units: A Cross-sectional Study in North of Iran. Indian J Crit Care Med 2022;26(2):192-198.

Identifiants

DOI: 10.5005/jp-journals-10071-24103 PMID: 35712746 PMC: PMC8857706
pubmed: 35712746
doi: 10.5005/jp-journals-10071-24103
pmc: PMC8857706
doi:

Types de publication

Journal Article

Langues

eng

Pagination

192-198

Informations de copyright

Copyright © 2022; The Author(s).

Déclaration de conflit d'intérêts

Source of support: Nil Conflict of interest: None

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Auteurs

Mahin Nomali (M)

Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran; Student Research Center, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.

Aryan Ayati (A)

School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.

Mohammad Yadegari (M)

Bandar-e gaz Shohada Hospital, Golestan University of Medical Sciences, Gorgan, Iran.

Mahdis Nomali (M)

Alejalil Hospital, Golestan University of Medical Sciences, Gorgan, Iran.

Mahnaz Modanloo (M)

Nursing Research Center, Faculty of Nursing and Midwifery, Golestan University of Medical Sciences, Gorgan, Iran.

Classifications MeSH