Restraint use in elder care: decision making among registered nurses


Stig Karlsson Geriatric Medicine, Department of Community Medicine and Rehabilitation, Umeå University, S-901 87 Umeå, Sweden (e-mail:


•  This study aimed to illuminate nurses’ reasons for using physical restraint in nursing practice, and in addition, to explore the relationship between nurses’ attitudes and decisions regarding physical restraint use.

•  To provide data about nurses’ reasoning when deciding whether or not to use restraints, 30 registered nurses working in two nursing homes were asked to read a written clinical vignette describing a fall-prone person with dementia who refused to be physically restrained. The association between the decision made and the nurses’ attitudes toward restraint use was measured by Perceptions of Restraint Use Questionnaire (PRUQ).

•  Twenty-one nurses would at first disregard the patient’s wish and use the restraint in the given situation while nine would not. When new relevant facts were provided all nurses except two were ready to change their decision. A significant relationship between nurses’ decisions and their attitudes toward restraint use was also found.

•  The results showed that, although nurses endeavour to decide what they consider to be in the patient’s best interests, this ambition is affected by a variety of variables, especially in relation to the working conditions and the nurses’ willingness to take the risk when not restraining the patient.