Exploring the ethics of physical restraints: Students' questioning

Nursing students' experiences regarding physical restraint use in long-term care facilities: A qualitative descriptive study

BACKGROUND

Despite many harmful effects, physical restraints are still used in long-term care facilities. Most existing studies have focused on staff. Nursing students observe staff's use of restraints during gerontological nursing practicums, but there are few studies on nursing students' experiences regarding restraint use in long-term care settings.

OBJECTIVE

This study aimed to explore nursing students' experiences with physical restraint use in order to enhance nursing education and improve care quality in long-term care facilities.

METHODS

Using convenience sampling method, three nursing schools from three provinces were recruited. Twenty-six senior undergraduate nursing students who had taken a gerontological nursing practicum course participated in this study. A qualitative descriptive method was utilized to provide a clear account of the students' experiences. In-depth interviews were conducted using a semi-structured interview guide. Thematic analysis was used for data analysis.

RESULTS

Four themes were identified, which included overuse of restraints, ambivalent response to restraints, becoming accustomed to restraints, and lack of education regarding restraints. Students frequently observed the use of various restraints, which elicited both negative and positive responses, ultimately leading to their desensitization to the overuse of restraints. They expressed a lack of knowledge and educational needs regarding restraint reduction.

CONCLUSION

Nursing students encountered the overuse of various restraints, exhibited ambivalent responses, and became desensitized to this practice in long-term care facilities. They perceived a lack of education and educational needs regarding restraint reduction. This study adds important new knowledge to existing literature and provides important insights into restraint use in long-term care facilities. Future studies need to develop and evaluate educational programs for restraint-free and person-centered care targeting nursing students. Long-term care facilities should offer organizational support and implement continuous mandatory training to promote restraint-free care.

[Nursing Students' Experiences of Observing the Use of Physical Restraints: A Qualitative Study]

PURPOSE

The purpose of this study was to understand the experiences of final-year undergraduate nursing students in observing the use of physical restraints on patients in the course of clinical practice.

METHODS

Three focus group interviews were conducted with 12 Korean nursing students who could provide sufficient information about their observation of physical restraints. The collected data was analyzed through conventional content analysis.

RESULTS

The data were classified into four theme clusters, and nine themes. The four theme clusters included 'recognized as an unavoidable means,' 'experienced problems with the use of physical restraints,' 'realized the importance of the nurse's role and efforts,' and 'aspire to learn about correct use of physical restraints.' While nursing students recognized the necessities and problems of using physical restraints in clinical practice, and the importance of nurses' role and effort, the results found that education related to the use of physical restraints should be more systematic within the nursing curriculum.

CONCLUSION

This study highlights the necessity of educating nursing students to ensure they acquire accurate knowledge and awareness regarding the use of physical restraints, and suggests the inclusion of systematic guidelines through simulation or extracurricular activities.