Patient Experience of Physical Restraint in the Acute Setting: A Systematic Review of the Qualitative Research Evidence

Abstract

The use of physical restraint is a contentious practice in the acute mental health setting. There are a plethora of guidelines surrounding the safe use of restraint. However, there is a scarcity of literature dedicated specifically from the perspective of the patient. The existing literature suggests that there are serious physical and psychological implications associated with the use of physical restraint for both mental health patients and nurses alike. The debate surrounding this practice has been intensified by the compelling evidence suggesting that the application of restraint is not compatible with the values of recovery in mental health care. To influence clinical practice that governs the use of restraint, it is essential to explore patient experiences of its use. Therefore, this review aims to explore patient experiences of physical restraint in the acute setting. PubMed, CINAHL and PsycINFO were systematically searched using keywords; “physical restraint” and “patient experience” and “acute setting”. The search yielded n = 482 papers in total. Following the application of rigorous inclusion and exclusion criteria and data extraction, a total of n = 9 papers were considered suitable for the systematic review. Quality was assessed using the MMAT instrument. Following analysis, three themes were identified: ‘the bio-psychosocial impact of restraint on patients’, ‘the impact of restraint on the therapeutic relationship’ and ‘patient needs concerning the use of restraint’. Future research opportunities have been identified that will add to the body of evidence in developing appropriate health interventions and supports for this population.

Author’s contributions

LD designed and conducted the study, collected and analyzed data, and drafted the manuscript. GD conducted searches, analyzed data and helped to draft the manuscript. JM participated in the drafting of this paper. All authors read and approved the final manuscript.

Disclosure statement

The authors report no conflicts of interest regarding the publication of this paper. All authors have contributed to the preparation of the manuscript, have read, and approved the submitted manuscript. All authors listed are in agreement with the manuscript. The work is original and not under consideration by any other journal.

Funding

The author(s) reported there is no funding associated with the work featured in this article.