The Use of Physical Restraints on Geriatric Patients: Culture and Attitudes among Healthcare Professionals at Intermediate Care Hospitals in Majorca. A Qualitative Study Protocol.

Alba Carrero-Planells,Cristina Moreno-Mulet,Ana Urrutia-Beaskoa

doi:10.3390/ijerph18147509

Abstract

The use of physical restraints is a common practice in the care of hospitalised and institutionalised elderly people. This use is determined by factors related to the patients, their families, the healthcare professionals, the institution, and prevailing social values. Today, however, this practice is often questioned because of its physical, psychological, moral, ethical, and legal repercussions. The present study explores attitudes among healthcare professionals towards the physical restraint of geriatric patients in intermediate care hospitals in Majorca. This study is based on a qualitative design, combining an ethnomethodological approach with critical discourse analysis. The theoretical framework is drawn from Foucault’s work in this field and from Haslam’s theory of mechanisation. Individual interviews will be conducted with physicians, nurses, and nursing assistants at intermediate care hospitals in Majorca. The analysis will focus on these professionals’ knowledge, attitudes, and practices regarding the use of such measures, seeking to identify the factors, especially institutional factors, that determine the use of restraints. It is essential to determine the prevailing culture among healthcare professionals regarding the use of physical restraints on geriatric patients in order to design and propose a more dignified health care model in which such restraints are eliminated.

Highlights

Population ageing is associated with a greater prevalence of cognitive and functional impairment, which increases the number of dependent older people who must be cared for in hospitals and residential centres [1]
We examine the knowledge, attitudes, and practices of these professionals related to the use of physical restraints and describe the institutional factors that influence this question, identifying the similarities and differences in the discourse of the healthcare professionals according to their area and level of work
This study, undertaken from the perspective of the healthcare professionals involved, will contribute to understanding the use of physical restraints in the care of geriatric patients hospitalised in intermediate care units

Summary

Introduction

Population ageing is associated with a greater prevalence of cognitive and functional impairment, which increases the number of dependent older people who must be cared for in hospitals and residential centres [1]. These people are sometimes disoriented, agitated, or wandering, and may present postural alterations and/or an increased risk of falls. An international consensus statement defines physical restraints as “any action or procedure that prevents a person’s free body movement to a position of choice and/or normal access to his/her body by the use of any method, attached or adjacent to a person’s body that he/she cannot control or remove ” [3]. The use of physical restraint is considered a form of involuntary treatment, together with the use of psychotropic medication and non-consensual care [4]

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