Nurses' decision-making process in cases of physical restraint in acute elderly care: A qualitative study.

Background: The increasing vulnerability of patients in acute elderly care requires constant critical reflection in ethically charged situations such as when employing physical restraint. Qualitative evidence concerning nurses' decision making in cases of physical restraint is limited and fragmented...

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Publicado en:International Journal of Nursing Studies Vol. 50; no. 5; pp. 603 - 613
Autores principales: Goethals, S., de Casterle, B. Dierckx, Gastmans, C.
Formato: research tables/charts Journal Article
Publicado: Elsevier B.V. 2013
Acceso en línea:Ver este registro en EBSCOhost
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      dt: 2013
      vid: 50
      iid: 5
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      pub: Elsevier B.V.
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        10.1016/j.ijnurstu.2012.10.006
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        atl: Nurses' decision-making process in cases of physical restraint in acute elderly care: A qualitative study.
      aug:
        au:
          Goethals, S.
          de Casterle, B. Dierckx
          Gastmans, C.
        affil: Department of Nursing, Catholic University College Ghent, Belgium
      sug:
        subj:
          Restraint, Physical Utilization
          Decision Making, Clinical
          Acute Care In Old Age
          Gerontologic Nursing
          Human
          Qualitative Studies
          Descriptive Research
          Exploratory Research
          Grounded Theory
          Belgium
          Interviews
          Inpatients
          Purposive Sample
          Theoretical Sample
          Staff Nurses
          Female
          Male
          Adult
          Middle Age
          Aged
          Data Analysis Software
          Constant Comparative Method
          Coding
          Funding Source
          Adult: 19-44 years
          Middle Aged: 45-64 years
          Aged: 65+ years
          Female
          Male
      ab: Background: The increasing vulnerability of patients in acute elderly care requires constant critical reflection in ethically charged situations such as when employing physical restraint. Qualitative evidence concerning nurses' decision making in cases of physical restraint is limited and fragmented. A thorough understanding of nurses' decision-making process could be useful to understand how nurses reason and make decisions in ethically laden situations. Objectives: The aims of this study were to explore and describe nurses' decision-making process in cases of physical restraint. Design: We used a qualitative interview design inspired by the Grounded Theory approach. Data analysis was guided by the Qualitative Analysis Guide of Leuven. Setting: Twelve hospitals geographically spread throughout the five provinces of Flanders, Belgium. Participants: Twenty-one acute geriatric nurses interviewed between October 2009 and April 2011 were purposively and theoretically selected, with the aim of including nurses having a variety of characteristics and experiences concerning decisions on using physical restraint. Results: In cases of physical restraint in acute elderly care, nurses' decision making was never experienced as a fixed decision but rather as a series of decisions. Decision making was mostly reasoned upon and based on rational arguments; however, decisions were also made routinely and intuitively. Some nurses felt very certain about their decisions, while others experienced feelings of uncertainty regarding their decisions. Conclusions: Nurses' decision making is an independent process that requires nurses to obtain a good picture of the patient, to be constantly observant, and to assess and reassess the patient's situation. Coming to thoughtful and individualized decisions requires major commitment and constant critical reflection.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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