Research On Nurses' Behavior About Physical Restraint Use And Related Influencing Factors In ICU

ObjectiveThis study was based on related viewpoints of Theory of Planned Behavior,the methods of semi-structured interview and questionnaire survey were used to explore nurses' behavior and psychological journey about physical restraint use,and the main influencing factors were analysed.The results provide theoretical support for the construction of relevant intervention strategies in the future,with a view to promoting the standardized use of physical restraints and reducing the use of physical restraint effectively.Methods1.Semi-structured interview of nurses' behavior about physical restraint use: The study was guided by the Theory of Planned Behavior and the interview outline was developed.Semi-structured in-depth interviews were conducted with 12 ICU nurses.The interview data were imported into QSR NVivo 11.0 qualitative data analysis software,and the method of traditional grounded theory was adopted.The interview data was analyzed and classified,and the specific psychological journey of the ICU nurses' behavior about physical restraint use was discussed.2.Design and evaluation of partial questionnaires: Under the guidance of the Theory of Planned Behavior,combining literature review and previous semi-structured interview results,the first draft of the Subject Norm Questionnaire and the Coping Efficacy Questionnaire were designed,and expert consultation and pilot survey were conducted.The reliability and validity of the questionnaires were tested by content validity index,project analysis,internal consistency coefficient and retest reliability coefficient.3.Questionnaire investigation on nurses' behavior about physical restraint use and analysis of influencing factors: The general information questionnaire,the Practice of Physical Restraint Use Scale,the Attitudes of Physical Restraint Use Scale,the Subject Norm Questionnaire,the Ethical Climate Questionnaire,the Coping Efficacy Questionnaire and the Knowledge of Physical Restraint Use Scale were used to investigate 354 ICU nurses in five tertiary hospitals in Qingdao.The descriptive analysis,univariate analysis,correlation analysis and multiple regression analysis were used to study the physical restraint behavior of ICU nurses and its influencing factors.Results1.The semi-structured interview results showed that the process of physical restraint use can be divided into six stages: risk foresight,physical restraint intention,alternative choice,physical restraint implementation,physical restraint reflection and physical restraint rationalization.Four participants in physical restraint use included nurses,doctors,patients and family members,and the core element was safety.2.The expert consultation and pilot survey results showed that the Subject Norm Questionnaire and the Coping Efficacy Questionnaire had good reliability and validity.The results of content validity analysis showed that the I-CVI was 0.80~1.00 and the S-CVI was 0.93 and 0.92 respectively.The results of project analysis showed that each item had a good degree of discrimination.The Cronbach' s ? coefficients of the two questionnaires were 0.842 and 0.783,the retest reliability coefficients were 0.806 and 0.742,respectively.3.The questionnaire results showed that the total score of nurses' behavior about physical restraint use was(63.09±3.68),the scores of each dimension were ranked from high to low as nursing > evaluation > releasing.The score of nurses' attitude of physical restraint use was(39.22±3.70),the score of nurses' knowledge of physical restraint Use was(12.52±2.11),the score of subject norm was(29.97±1.55),the score of ethical climate cognition was(78.60 ±5.45),and the score of coping efficacy was(30.32±2.40).The results of univariate analysis showed that there was a significant difference(P<0.05)in the scores of physical restraint behavior between different gender,different departments and whether they had participated in continuous education about physical restraint.The results of multiple stepwise regression analysis showed that there were five variables that entered the regression equation in turn: the attitude of physical restraint use,the ethical climate cognition,the subject norm,gender and continuous education of physical restraint,and they can explain 53.7% variation of nurses' behavior about physical restraint use.ConclusionThe Subject Norm Questionnaire and the Coping Efficacy Questionnaire have good reliability and validity,and can be used for related research on ICU nurses' behavior about physical restraint use.The physical restraints of ICU patients are not a simple bundling technique,but a series of complex behavioral processes centered on safety.Although the overall level of ICU nurses' behavior about physical restraint use is high,several behaviors are not performing well.ICU nurses' behavior about physical restraint use can be influenced by a variety of factors,including gender,continuous education about physical restraint,nurses' attitude of physical restraint,the ethical climate cognition and the subject norm.This study suggests that nursing managers should take targeted interventions in the management of physical restraint practice in the future,and guide nursing staff to consider physical restraints critically,as well as to promote the standardized use of physical restraint.