An integrative review exploring decision-making factors influencing mental health nurses in the use of restraint

作者：Riahi S^*; Thomson G; Duxbury J

来源：Journal of Psychiatric and Mental Health Nursing, 2016, 23(2): 116-128.

DOI：10.1111/jpm.12285

• containment
• decision-making
• integrative review
• mental health
• psychiatric nursing
• restraint

Introduction While mechanical and manual restraint as an institutional method of control within mental health settings may be perceived to seem necessary at times, there is emergent literature highlighting the potential counter-therapeutic impact of this practice for patients as well as staff. Nurses are the professional group who are most likely to use mechanical and manual restraint methods within mental health settings. In-depth insights to understand what factors influence nurses' decision-making related to restraint use are therefore warranted.
Aim To explore what influences mental health nurses' decision-making in the use of restraint.
Method An integrative review using Cooper's framework was undertaken.
Results Eight emerging themes were identified: safety for all', restraint as a necessary intervention', restraint as a last resort', role conflict', maintaining control', staff composition', knowledge and perception of patient behaviours', and psychological impact'. These themes highlight how mental health nurses' decision-making is influenced by ethical and safety responsibilities, as well as, interpersonal and staff-related factors.
Conclusion Research to further understand the experience and actualization of last resort' in the use of restraint and to provide strategies to prevent restraint use in mental health settings are needed.

• 出版日期2016-3