Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
BMC Geriatrics
Published in: BMC Geriatrics 1/2020

Open Access 01-12-2020 | Research article

Iranian nurses’ perceptions about using physical restraint for hospitalized elderly people: a cross-sectional descriptive-correlational study

Authors: Azam Sharifi, Narges Arsalani, Masoud Fallahi-Khoshknab, Farahnaz Mohammadi-Shahbolaghi, Abbas Ebadi

Published in: BMC Geriatrics | Issue 1/2020

Login to get access

Abstract

Background

Using physical restraint (PR) for hospitalized elderly people is a major nursing challenge. It is associated with different physical and mental complications and ethical dilemmas, though many nurses still use it to ensure patient safety. Nurses’ perceptions are one of the most important factors affecting PR use. This study aimed to evaluate Iranian nurses’ perceptions about PR use for hospitalized elderly people.

Methods

This cross-sectional descriptive-correlational study was conducted from July to December 2019. Participants were 270 hospital nurses who were purposively recruited from intensive care units and medical and surgical wards of three teaching hospitals in Kermanshah, Iran. Data were collected using a demographic questionnaire and the Perceptions of Restraint Use Questionnaire (PRUQ). The SPSS software (v. 23.0) was used for data analysis through the independent-sample t test, the one-way analysis of variance, and the multiple regression analysis.

Results

The total mean score of PRUQ was 4.08 ± 0.12 in the possible range of 1–5. The most important reasons for PR use were to prevent patients from falling out of bed and to prevent them from pulling out catheters. The total mean score of PRUQ had significant relationship with participants’ age, work experience, and history of receiving PR-related educations (P < 0.05), but had no significant relationship with their gender, educational degree, and affiliated hospital ward (P > 0.05).

Conclusion

This study suggests that nurses attach high importance to PR use for hospitalized elderly people. Healthcare policy-makers at national and hospital levels are recommended to provide nurses with PR-related educations in order to reduce the rate of PR-related complications.
Appendix
Available only for authorised users
Literature
1.
Naderi S, Zaboli R, Khalesi N, Nasiripour AA. Factors affecting patient safety: a qualitative content analysis. Ethiop J Health Dev. 2019;33(2):73–80.
2.
Karaka T, Aydin ozkan S, Derya ister E. Physical restraint use in elderly patients: perceptions of nurses in university hospitals. Turk Geriatr Derg. 2018;21(4):588–95.
3.
Goethals S, Casterlé BD, Gastmans C. Nurses’ decision-making process in cases of physical restraint in acute elderly care: a qualitative study. Int J Nurs Stud. 2013;50(5):603–12.PubMed
4.
Penelo E, Estévez-Guerra GJ, Fariña-López E. Validity and measurement invariance of the physical restraint use questionnaire (PRUQ) in nursing staff. J Clin Nurs. 2018;27(5–6):e1179–88.PubMed
5.
Saarnio R, Isola A. Nursing staff perceptions of the use of physical restraint in institutional care of older people in Finland. J Clin Nurs. 2010;19(21–22):3197–207.PubMed
6.
Jiang H, Li C, Gu Y, He Y. Nurses’ perceptions and practice of physical restraint in China. Nurs Ethics. 2015;22(6):652–60.PubMed
7.
Agens JE. Chemical and physical restraint use in the older person. Br J Med Pract. 2010;3(1):302.
8.
Springer G. When and how to use restraints: learn about possible indications for restraint, types of restraints, and how to monitor patients in restraint. Am Nurse Today. 2015;10(1):26–7.
9.
Korczak V, Kirby A, Gunja N. Chemical agents for the sedation of agitated patients in the ED: a systematic review. Am J Emerg Med. 2016;34:2426–31.PubMed
10.
Miller RD, Stoelting RK. Basics of anesthesia. 5th ed. Philadelphia: Churchill Livingstone; 2006.
11.
Bleijlevens MH, Wagner LM, Capezuti E, Hamers JP, Workgroup IPR. Physical restraints: consensus of a research definition using a modified delphi technique. J Am Geriatr Soc. 2016;64(11):2307–10.PubMed
12.
Barton-Gooden A, Dawkins PE, Bennett J. Physical restraint usage at a teaching hospital: a pilot study. Clin Nurs Res. 2015;24(1):73–90.PubMed
13.
Krüger C, Mayer H, Haastert B, Meyer G. Use of physical restraints in acute hospitals in Germany: a multi-centre cross-sectional study. Int J Nurs Stud. 2013;50(12):1599–606.PubMed
14.
Eltaliawi AG, El-Shinawi M, Comer A, Hamazah S, Hirshon JM. Restraint use among selected hospitalized elderly patients in Cairo, Egypt. BMC Res Notes. 2017;10(1):633.PubMedPubMedCentral
15.
Langley G, Schmollgruber S, Egan A. Restraints in intensive care units—a mixed method study. Intensive Crit Care Nurs. 2011;27(2):67–75.PubMed
16.
Park M, Tang JHC, Adams S, Titler MG. Evidence-based guideline: changing the practice of physical restraint use in acute care. J Gerontol Nurs. 2007;33(2):9–16.PubMed
17.
Said AA, Kautz DD. Reducing restraint use for older adults in acute care. Nursing. 2013;43(12):59–61.PubMed
18.
Aseyedali M, Sadeghi-Mahalli N, Norouzi-Tabrizi K. A review on adult daycare centers in the world. Iran J Ageing. 2019;13(4):518–29.
19.
Lim SC, Poon WH. Restraint use in the management of the ederly with dementia in hospital. Intern Med Res Open J. 2016;1(2):1–4.
20.
21.
Dikiciyan J. Australian and New Zealand Society for geriatric medicine position statement abstract: physical restraint use in older people. Aust J Ageing. 2016;35(3):225.
22.
23.
Hazzard WR, Halter JB, Ousander JG, Studenski S, High KP, Asthana S, et al. Hazzard’s geriatric medicine and gerontology. 7th ed. New York: McGraw-Hill Education Medical; 2017.
24.
Fariña-López E, Estévez-Guerra GJ, Polo-Luque ML, Pogrányivá AH, Penelo E. Physical restraint use with elderly patients: perceptions of nurses and nursing assistants in Spanish acute care hospitals. Nurs Res. 2018;67(1):55–9.PubMed
25.
Chaves ES, Cooper RA, Collins DM, Karmarkar A, Cooper R. Review of the use of physical restraints and lap belts with wheelchair users. Assist Technol. 2007;19(2):94–107.PubMed
26.
Möhler R, Nürnberger C, Abraham J, Köpke S, Meyer G. Interventions for preventing and reducing the use of physical restraints of older people in general hospital settings. Cochrane Database Syst Rev. 2016;2016(1212):CD012476.PubMedCentral
27.
Bai X, Kwok TCY, Ip IN, Woo J, Chui MYP, Ho FKY. Physical restraint use and older patients’ length of hospital stay. Health Psychol Behav Med. 2014;2(1):160–70.PubMedPubMedCentral
28.
29.
Strout T. Perspectives on the experience of being physically restrained: an integrative review of the qualitative literature. Int J Ment Health Nurs. 2010;19(6):416–27.PubMed
30.
Rose L, Dale C, Smith OM, Burry L, Enright G, Fergusson D, et al. A mixed-methods systematic review protocol to examine the use of physical restraint with critically ill adults and strategies for minimizing their use. Syst Rev. 2016;5(1):194.PubMedPubMedCentral
31.
Leahy-warren P, Varghese V, Day MR, Curtin M. Physical restraint: perceptions of nurse managers, registered nurses and health care assistants. Int Nurs Rev. 2018;65(3):327–35.PubMed
32.
33.
Crutchfield P, Gibb TS, Redinger MJ, Ferman D, Livingstone J. The conditions for ethical application of restraints. Chest. 2019;155(3):617–25.PubMed
34.
Muir-Cochrane E, Baird J, McCann T. Nurses’ experiences of restraint and seclusion use in short-stay acute old age psychiatry inpatient units: a qualitative study. J Psychiatr Ment Health Nurs. 2015;22(2):109–15.PubMed
35.
Hevener S, Rickabaugh B, Marsh T. Using a decision wheel to reduce use ofrestraints in a medical-surgical intensive care unit. Am J Crit Care. 2016;25(6):479–86.PubMed
36.
Lach HW, Leach KM, Butcher HK. Evidence-based practice guideline. Changing the practice of physical restraint use in acute care. J Gerontol Nurs. 2016;42(2):17–26.PubMed
37.
38.
Guvercin CH, Samur M, Gurkan K. The other side of the coin: nurses’ views and behavior on physical restraint. Acta Bioethica. 2018;24(2):253–64.
39.
Li X, Fawcett T. Clinical decision making on the use of physical restraint in intensive care units. Int J Nurs Sci. 2014;1(4):446–50.
40.
Moradimajd P, Noghabi AA, Zolfaghari M, Mehran A. Physical restraint use in intensive care units. Iran J Crit Care Nurs. 2015;8(3):173–8.
41.
Fariña-López E, Estévez-Guerra GJ, Gandoy-Crego M, Polo-Luque LM, Gómez-Cantorna C, Capezuti EA. Perception of spanish nursing staff on the use of physical restraints. J Nurs Scholarsh. 2014;46(5):322–30.PubMed
42.
McCabe DE, Alvarez CD, McNulty SR, Fitzpatrick JJ. Perceptions of physical restraints use in the elderly among registered nurses and nurse assistants in a single acute care hospital. Geriatr Nurs. 2011;32(1):39–45.PubMed
43.
Aydin ozkan S, Karaka T, Ister E. Validity and reliability of the perceptions of restraint use questionnaire for use in Turkey. Turk Geriatr Derg. 2017;20(1):30–7.
44.
Kurata S, Ojima T. Knowledge, perceptions, and experiences of family caregivers and home care providers of physical restraint use with home-dwelling elders: a cross-sectional study in Japan. BMC Geriatr. 2014;14(1):39.PubMedPubMedCentral
45.
Hofmann H, Schorro E, Haastert B, Meyer G. Use of physical restraints in nursing homes: a multicentre cross-sectional study. BMC Geriatr. 2015;15(1):129.
46.
Mohler R, Meyer G. Attitudes of nurses towards the use of physical restraints in geriatric care: a systematic review of qualitative and quantitative studies. Int J Nurs Stud. 2014;51(2):274–88.PubMed
47.
Saeidi S, Khatiban M, Khazaei A, Soltanian A, Rahimi-Bashar F. Assessment of intensive care unit nurses’ knowledge, attitude, and practice of physical restraint use. Sci J Hamadan Nurs Midwifery Fac. 2015;23(3):40–9.
48.
Ebadi A, Zarshenas L, Rakhshan M, Zareian A, Sharifnia H, Mojahedi M. Principles of scale development in health science. Tehran: Jame-e-negar; 2017.
49.
Strumpf NE, Evans LK. Physical restraint of the hospitalized elderly. Nurs Res. 1988;37(3):132–7.PubMed
50.
Evans LK, Strumpf NE. Frailty and physical restraint. In aging and musculoskeletal disorders. New York: Springer; 1993.
51.
Sharifi A, Arsalani N, Fallahi-Khoshknab F, Mohammadi-Shahboulaghi F, Ebadi A. The psychometric properties of Persian version of the perceptions of physical restraint use questionnaire in the elderly. Salmand: Iranian Journal of Ageing. Forthcoming 2020. In press.
52.
Chang Y, Yu H, Loh E, Chang L. The efficacy of an in-service education program designed to enhance the effectiveness of physical restraints. J Nurs Res. 2016;24(1):79–86.PubMed
53.
Younis GA, Ahmed SE. Physical restraint and maintenance of critically ill patient's safety in intensive care unit: effect of clinical practice guidelines on nurse's practice and attitude. IOSR-JNHS. 2017;6(4):6–21.
54.
Heinze C, Dassen T, Grittner U. Use of physical restraints in nursing homes and hospitals and related factors: a cross-sectional study. J Clin Nurs. 2012;21:1033–40.PubMed
55.
Lee H, Park M, Lee SH, Lee M, Go Y, Kim CG. Factors related to use of physical restraints for older adults with dementia in long-term care settings. J Korean Gerontol Nurs. 2019;21(2):125–34.
56.
Maleho ME. The attitudesand opinions of intensive care nurses on the use of ohysical restraints: thesis for nursing in University of the Witwatersrand: Johannesburg; 2018.
57.
Pretz J, Folse V. Nursing experience and preference for intuition in decision making. J Clin Nurs. 2011;20(19–20):2878–89.PubMed
58.
Traynor M, Boland M, Buus N. Autonomy, evidence and intuition: nurses and decision-making. J Adv Nurs. 2010;66(7):1584–91.PubMed
Metadata
Title
Iranian nurses’ perceptions about using physical restraint for hospitalized elderly people: a cross-sectional descriptive-correlational study
Authors
Azam Sharifi
Narges Arsalani
Masoud Fallahi-Khoshknab
Farahnaz Mohammadi-Shahbolaghi
Abbas Ebadi
Publication date
01-12-2020
Publisher
BioMed Central
Published in
BMC Geriatrics / Issue 1/2020
Electronic ISSN: 1471-2318
DOI
https://doi.org/10.1186/s12877-020-01636-2

Other articles of this Issue 1/2020

BMC Geriatrics 1/2020 Go to the issue

Study protocol

Design of the DYNAMO study: a multi-center randomized controlled trial to investigate the effect of pre-thickened oral nutritional supplements in nursing home residents with dysphagia and malnutrition (risk)

Research article

Development and validation of a screening tool for early identification of bloodstream infection in older patients – a retrospective case-control study

Research article

Screening for domestic abuse and its relationship with demographic variables among elderly individuals referred to primary health care centers of Shiraz in 2018

Research article

The association between cognition and gait in a representative sample of very old people – the influence of dementia and walking aid use

Research article

Physical frailty predicts the development of social frailty: a prospective cohort study

Research article

Spirituality and quality of life in older adults: a path analysis model

ACC 2024 Congress Coverage

Heart Failure Video

Year in Review: Heart failure and cardiomyopathies

Watch now

Watch this official video from ACC.24. Dr. Biykem Bozkurt discuss last year's major advances in heart failure and cardiomyopathies.

Semaglutide benefits people with type 2 diabetes and obesity-related heart failure

16-04-2024 Type 2 Diabetes News

Incentivised to exercise

11-04-2024 Lifestyle Modifications News

New intervention for STEMI-related cardiogenic shock

10-04-2024 Myocardial Infarction News

» View more highlights on the ACC 2024 congress hub page

Image Credits