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Staff perceptions of barriers to physical restraint‐reduction in long‐term care: a meta‐synthesis

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  • Eun‐Hi Kong
  • Heeseung Choi
  • Lois K Evans

Abstract

Aims and objectives To critically review the existing qualitative studies to identify, from the perspective of staff, the barriers to physical restraint reduction in long‐term geriatric care facilities. Background Despite the adverse physical and psychosocial effects, physical restraints are still used frequently in many geriatric long‐term care facilities around the world. There is, however, no study that synthesises the existing qualitative literature regarding the barriers to the restraint reduction from the perspective of facility staff. Design/Methods The metastudy research process guided this qualitative synthesis. Five electronic databases were searched, and ten studies were included in this metastudy. Results Five themes were identified through metasynthesis of the findings: concern about and responsibility for safety, unclear and inconsistent definitions of restraint and restraint‐free care, difficulties in the transition from acceptance to removal, noninvolvement in decision‐making to remove restraint and insufficient resources and education. Conclusion A concept analysis of physical restraint is sorely needed, and future studies should explore the prevalence of restraint, the effects of education for staff and family on restraint reduction, and success stories related to restraint‐free care. More research is needed regarding the restraint reduction effectiveness and cost issues. Relevance to clinical practice Physical restraints, commonly used in many geriatric long‐term care facilities, result in many negative effects and ethical issues. To achieve success in reducing physical restraint use, governmental policies and long‐term care institutions should underpin staff efforts with legal, educational and practical support.

Suggested Citation

  • Eun‐Hi Kong & Heeseung Choi & Lois K Evans, 2017. "Staff perceptions of barriers to physical restraint‐reduction in long‐term care: a meta‐synthesis," Journal of Clinical Nursing, John Wiley & Sons, vol. 26(1-2), pages 49-60, January.
  • Handle: RePEc:wly:jocnur:v:26:y:2017:i:1-2:p:49-60
    DOI: 10.1111/jocn.13418
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    References listed on IDEAS

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    1. Phillips, C.D. & Hawes, C. & Fries, B.E., 1993. "Reducing the use of physical restraints in nursing homes: Will it increase costs?," American Journal of Public Health, American Public Health Association, vol. 83(3), pages 342-348.
    2. David Moher & Alessandro Liberati & Jennifer Tetzlaff & Douglas G Altman & The PRISMA Group, 2009. "Preferred Reporting Items for Systematic Reviews and Meta-Analyses: The PRISMA Statement," PLOS Medicine, Public Library of Science, vol. 6(7), pages 1-6, July.
    3. Reetta Saarnio & Arja Isola, 2010. "Nursing staff perceptions of the use of physical restraint in institutional care of older people in Finland," Journal of Clinical Nursing, John Wiley & Sons, vol. 19(21‐22), pages 3197-3207, November.
    4. Cornelia Heinze & Theo Dassen & Ulrike Grittner, 2012. "Use of physical restraints in nursing homes and hospitals and related factors: a cross‐sectional study," Journal of Clinical Nursing, John Wiley & Sons, vol. 21(7‐8), pages 1033-1040, April.
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    1. Eun-Hi Kong & Myoungsuk Kim & Seonho Kim, 2021. "Effects of a Web-Based Educational Program Regarding Physical Restraint Reduction in Long-Term Care Settings on Nursing Students: A Cluster Randomized Controlled Trial," IJERPH, MDPI, vol. 18(13), pages 1-10, June.
    2. Alvisa Palese & Jessica Longhini & Angela Businarolo & Tiziana Piccin & Giuliana Pitacco & Livia Bicego, 2021. "Between Restrictive and Supportive Devices in the Context of Physical Restraints: Findings from a Large Mixed-Method Study Design," IJERPH, MDPI, vol. 18(23), pages 1-14, December.
    3. Carolina Pinazo-Clapés & Sacramento Pinazo-Hernandis & Alicia Sales, 2020. "Effects of an Educational Program for Professional Caregivers on Behavioral Alterations in Nursing Home Residents: Pilot Study," IJERPH, MDPI, vol. 17(23), pages 1-13, November.

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