Monitoring Knowledge, Attitudes, and Practices on Restraint Use in Adult and Pediatric Intensive Care Units: The Multicenter Development and Validation of the CON-Ti-IT Questionnaire.

Background/Objectives: The use of physical restraints in adult and pediatric intensive care units (ICUs) is common yet controversial. While restraints are intended to prevent treatment interference or self-harm, they pose significant physical, psychological, and ethical risks. Nurses in intensive ca...

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Publicado en:Nursing Reports Vol. 16; no. 1; pp. 10 - 25
Autores principales: Dittura, Loredana, Schreiber, Silvana, Guidi, Valentina, Giangreco, Manuela, Zamagni, Giulia, Venier, Erica, Di Meola, Raffaella, Balestreri, Elisabetta, Toso, Giorgia, Sartorato, Patrizia, Bertocchi, Luca, Buchini, Sara, Dobrina, Raffaella
Formato: research tables/charts Journal Article
Publicado: MDPI Jan2026
Acceso en línea:Ver este registro en EBSCOhost
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        atl: Monitoring Knowledge, Attitudes, and Practices on Restraint Use in Adult and Pediatric Intensive Care Units: The Multicenter Development and Validation of the CON-Ti-IT Questionnaire.
      aug:
        au:
          Dittura, Loredana
          Schreiber, Silvana
          Guidi, Valentina
          Giangreco, Manuela
          Zamagni, Giulia
          Venier, Erica
          Di Meola, Raffaella
          Balestreri, Elisabetta
          Toso, Giorgia
          Sartorato, Patrizia
          Bertocchi, Luca
          Buchini, Sara
          Dobrina, Raffaella
        affil: Institute for Maternal and Child Health IRCCS Burlo Garofolo, Via dell'Istria, 65, 34137 Trieste, Italy
      sug:
        subj:
          Intensive Care Units In Adulthood
          Intensive Care Units, Pediatric
          Nursing Practice Evaluation
          Nursing Knowledge Evaluation
          Nurse Attitudes Evaluation
          Questionnaires
          Instrument Validation
          Restraint, Physical Utilization
          Critical Care Nurses Psychosocial Factors
          Instrument Construction
          Restraint, Chemical Utilization
          Human
          Male
          Female
          Adult
          Middle Age
          Multimethod Studies
          Multicenter Studies
          Funding Source
          Validation Studies
          Psychometrics
          Italy
          Content Validity
          Face Validity
          Reliability and Validity
          Test-Retest Reliability
          Construct Validity
          Factor Analysis
          Internal Consistency
          Convenience Sample
          Professional-Family Relations
          Decision Making, Shared
          Chi Square Test
          Descriptive Statistics
          Data Analysis Software
          Adult: 19-44 years
          Middle Aged: 45-64 years
          Male
          Female
      ab: Background/Objectives: The use of physical restraints in adult and pediatric intensive care units (ICUs) is common yet controversial. While restraints are intended to prevent treatment interference or self-harm, they pose significant physical, psychological, and ethical risks. Nurses in intensive care units play a key role in decisions about restraint application, but there is a global lack of validated tools to assess their knowledge, attitudes, and practices, particularly in non-English-speaking contexts. Aim of this study was to develop and validate a questionnaire for assessing knowledge, attitudes, and practices (KAP) of ICU nurses regarding restraint use in adult and pediatric settings. Materials and Methods: A multi-method psychometric validation study was conducted across both adult and pediatric ICU settings at two hospitals in northern Italy. Questionnaire development included literature review, expert consultation, and iterative content and face validity assessments. Reliability was tested using test–retest methods, and construct validity was explored through exploratory factor analysis. The study followed COSMIN guidelines. Results: The final CON-Ti-IT questionnaire comprised 29 items across three subscales: Practices, Attitudes, and Knowledge. It demonstrated strong content validity (CVI = 0.96) and good internal consistency for the Practices subscale (Cronbach's α = 0.89). Internal consistency for the Attitudes (α = 0.51) and Knowledge (α = 0.47) subscales was lower, reflecting the broader conceptual variability of these domains. Exploratory factor analysis confirmed the structural validity of the tool and led to the removal of three items with low factor loadings. Conclusions: This study presents the first validated tool specifically designed to evaluate ICU nurses' KAP on restraint in adult and pediatric settings. While developed and validated in Italy, it could undergo cross-cultural adaptation and translation for use in other languages and healthcare systems. Its strong psychometric properties support its application in future research, and the data collected through its use can serve both to improve patient care and to provide a foundation for targeted educational initiatives.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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