REACTION OF PATIENTS AND PSYCHIATRIC HOSPITAL STAFF ABOUT PHYSICAL RESTRAINT

Abstract

The use of physical restraint in a variety of healthcare settings, has received increased attention in recent years. Physical restraint is used to control the patient who is in danger of harming himself or others and also when less restrictive interventions have been determined to be ineffective. In this emergency situation, patients may be restrained temporarily to receive medication or for longer periods if medication cannot be used. Restraints have deleterious psychological, behavioral and physical effect on patients• and staff. The discussion of patient's perspective on the experience of being restrained, as well as, restraint's alternatives provides powerful testimony. When staff face their attitudes and reactions toward physical restraint; this will help their involvement in the philosophy of using less restrictive intervention, and/or will improve their practice while using restrictive measures, as physical restraint.

The present study aimed to explore the reaction of psychotic inpatients and psychiatric hospital staff about physical restraint. The study was conducted at EI-Maamoura Hospital for Psychiatric Medicine in Alexandria; in ten wards treating psychotic patients.

-r• The subjects of the study comprised three main groups: Group I; which is composed of 80 psychotic patients, either male or female, during the three days following the restraint incident. Group 2; which included I 08 nurses (50 % of the total nursing staff) were selected by stratified random method; who were available at the time of data collection (9 BNSc degree nurses, 90 Secondary nursing school, and 9 Associated nursing degree). Group 3; which consisted of 37 physicians representing also 50% of the medical staff. (8 having a master degree, 17 with a bachelor degree of medicine, and 12 with a diploma degree).

Data of this study were obtained by using the following tools:

1"­ )

Tool 1: Interview schedule to explore reaction of psychotfc in patients about their physical restraint. It was developed by the researcher after review of related literature. It aims to explore the reaction of psychotic inpatients about their physical restraint. It is composed of two parts: (I) Patient's socio-demographic and clinical data sheet; and (2) the patient's reaction about his physical restraint; which was composed of 30 open-ended questions covering patient's reaction to his physical restraint. In addition to 20 statements that measure the patients' psychological reactions to restrain procedure.

Tool II: lnten•iew schedule to explore reaction of medical and nursing staff about physical restraint. It was developed by the researcher after review of related literature.