Nurses’ decision-making in cases of physical restraint: a synthesis of qualitative evidence
Article first published online: 28 DEC 2011
© 2011 Blackwell Publishing Ltd
Journal of Advanced Nursing
Volume 68, Issue 6, pages 1198–1210, June 2012
How to Cite
Goethals, S., Dierckx de Casterlé, B. and Gastmans, C. (2012), Nurses’ decision-making in cases of physical restraint: a synthesis of qualitative evidence. Journal of Advanced Nursing, 68: 1198–1210. doi: 10.1111/j.1365-2648.2011.05909.x
- Issue published online: 26 APR 2012
- Article first published online: 28 DEC 2011
- Accepted for publication 12 November 2011
- physical restraint;
- qualitative meta-synthesis
goethals s., dierckx de casterlé b. & gastmans c. (2012) Nurses’ decision-making in cases of physical restraint: a synthesis of qualitative evidence. Journal of Advanced Nursing68(6), 1198–1210.
Aim. This article is a report of a review that aimed to synthesize the available qualitative evidence on nurses’ decision-making in cases of physical restraint.
Background. The use of physical restraint in acute and residential healthcare facilities is a widespread practice in many countries. Decisions about the use of physical restraints are complex and ethically laden. The lack of evidence supporting the use of physical restraints, the negative consequences of restraint for patients, and the low availability of alternatives obviously complicate the decision-making.
Data sources. Research papers published between January 1990 and January 2010 were identified in Cinahl, Embase, Medline, PsycInfo and Web of Science.
Review methods. A systematic review was carried out to obtain a meta-synthesis of qualitative evidence. The process of meta-synthesis was supported by the Joanna Briggs Institute’s guidelines.
Findings. The decision-making of nurses dealing with the use of physical restraints is a complex trajectory primarily focused on safety. However, thoughtful decision-making requires nurses to carefully balance different options and associated ethical values. The decision-making process of nurses is influenced by both nurse- and context-related factors.
Conclusions. This review provides a deeper understanding of nurses’ decision-making process on the use of physical restraints. Context- and nurse-related factors can hinder nurses from making an ethical decision on the appropriate use of physical restraints. There is an urgent need to stimulate and educate nurses to arrive at an appropriate decision about the use of physical restraints.