Convergence and divergence: An analysis of mechanical restraints

Nurs Ethics. 2019 Jun;26(4):1009-1026. doi: 10.1177/0969733017736923. Epub 2017 Nov 12.

Abstract

Background: Psychiatric nurses are regularly confronted with the uses and effects of control interventions such as mechanical restraints. Although there are evident tensions in the literature regarding the use of mechanical restraints, very little research has focused on the lived and embodied experience of their use, whether from the patient's perspective or the perspective of nursing staff responsible for their application.

Research aims: (1) to gain access to the bodily phenomenon of being placed in mechanical restraints; (2) to give voice to the intimate experiential understanding of this experience; and (3) through phenomenological interpretation, to understand the subjective processes and meaning-making of this experience.

Research design: For this research, we adopted a distinctly ethics-oriented application of the methodology known as interpretative phenomenological analysis, that is, the interpretive dimension of the research focused on ethical practice in mental healthcare - one that is informed by experiential accounts of the lived body.

Participants and research context: A total of 40 in-depth semi-structured, nondirected interviews with both nurses (n = 21) and patients (n = 19) we conducted to meet the aims of this article. Participants were recruited from an inpatient psychiatric unit of a Canadian general hospital.

Ethical considerations: The research received research ethics board clearance from both the hospital where the study took place and the University of Ottawa.

Findings: The comparative analysis is presented under the following headings: (1) context of care, (2) meaning of quality of care, (3) emotional reactions and nurse-patient relationship, (4) meeting the needs and (5) need for alternatives.

Discussion/conclusions: The research findings are discussed in light of current literature and implications for practice.

Keywords: Mechanical restraints; ethics; phenomenology; psychiatric nursing.

MeSH terms

  • Humans
  • Interviews as Topic / methods
  • Nurses / psychology*
  • Ontario
  • Patients / psychology*
  • Psychiatric Nursing / ethics
  • Psychiatric Nursing / methods
  • Qualitative Research
  • Restraint, Physical / ethics*