Using restraint with nursing home residents: a qualitative study of nursing staff perceptions and decision-making

The study reported in this paper applied a qualitative and interpretative a pproach to nursing staff perceptions of the use of restraint with elderly n ursing home residents, and into nurses' decision-making on restraint use. T he data were collected using unstructured interviews with a purposive sampl e of 20 trained and untrained nursing staff from two Swiss nursing homes. D ata analysis was based on Colaizzi's phenomenological method. Three main th emes were extracted from the data: (1) understanding the term restraint, (2 ) situations in which the decision to apply restraint is considered justifi ed and (3) situations in which nursing staff are uncertain about the use of restraint. The underlying bases with respect to decision-making were: unde rstanding restraint, the rights and responsibilities of both residents and staff, and the duties of staff. Staff members were ambiguous in their under standing of restraint and they showed positive as well as confused attitude s towards its use. Their behaviour was defensive and protective rather than challenging. Further research is required on what is meant by safety in ca re of the elderly nursing today. In nursing practice, as far as issues of r estraint are concerned, greater attention should be devoted to the relation ship between elderly residents' self-determination and responsibility for t heir actions.