Physical Restraint Experience of Patients with Mental Disorders in Mainland China: A Qualitative Study

Abstract

Introduction

The use of physical restraint (PR) is considered a controversial practice and research in Western countries has demonstrated negative physical and psychological consequences for patients, as well as staff, family members/carers, organisations and society as a whole. However, there are few research reports on restraint experiences of patients with mental disorders in non-Western countries, especially in mainland China.

Aim

This study aims to explore the subjective experiences and perceptions of patients with psychiatric disorders who have experienced PR in mainland China.

Methods

Semi-structured interviews were conducted with 8 inpatients with mental disorders in convalescence at a specialized mental health hospital in Shanghai. Interviews were recorded on audiotape and transcribed verbatim. Transcripts were analyzed using thematic analysis.

Results

Five themes emerged: “perception and understanding of PR”, “response to PR”, “negative physical and psychological experiences”, “unmet care needs during PR” and “changes after PR”, which together characterize patients’ perceptions, experiences, feelings, and needs in PR.

Conclusion

The use of PR involves ethical issues and brings negative experiences to patients with mental disorders that cannot be ignored and should be used as a last resort. Different patients have different attitudes and reactions to PR. During PR, patients’ physical and psychological needs are not adequately met. Medical staff should give more attention to patients in PR, meet their physical and psychological needs, and actively seek PR alternatives and reduction options based on evidence-based resources on restraint reduction available in the West and the national context and culture of China.

Keywords:

• physical restraint
• psychiatric nursing
• thematic analysis
• qualitative research

Data Sharing Statement

The data are not available due to privacy or ethical restrictions.

Ethical Approval

The study protocol was approved by the Ethics Committee of Pudong New Area Mental Health Center (PDJWLL2022006) and Science and Technology Ethics Committee of Tongji University (2021tjdx065). It was carried out in compliance with the Helsinki Declaration. After being fully informed about the purpose, procedures, and risks of the study, all participants signed an informed consent. And codes rather than personally identifiable information were used in the study.

Acknowledgments

We thank all of the persons who participated in this study and Shanghai Pudong New Area Mental Health Center.

Author Contributions

All authors made a significant contribution to the work reported, whether that is in the conception, study design, execution, acquisition of data, analysis and interpretation, or in all these areas; took part in drafting, revising or critically reviewing the article; gave final approval of the version to be published; have agreed on the journal to which the article has been submitted; and agree to be accountable for all aspects of the work.

Disclosure

All authors declare no conflicts of interest in this work.

Additional information

Funding

This research was funded by the General Project of Shanghai Teaching and Scientific Research (C2021333) and the Outstanding Clinical Discipline Project of Shanghai Pudong (Grant No. PWYgy2021-02).