Physical Restraint Experience of Patients with Mental Disorders in Mainland China: A Qualitative Study

Abstract

Yue Chong,1 Can Wang,1 Haiying Min,1 Lei Zhang,1 Tingting Zhi,2 Xiaoning Wu,1 Yanbo Wang1 1Clinical Research Center for Mental Disorders, Shanghai Pudong New Area Mental Health Center, School of Medicine, Tongji University, Shanghai, 200124, People’s Republic of China; 2Shanghai Baoshan Mental Health Center, Shanghai, 201900, People’s Republic of ChinaCorrespondence: Yanbo Wang, Clinical Research Center for Mental Disorders, Shanghai Pudong New Area Mental Health Center, School of Medicine, Tongji University, Shanghai, 200124, People’s Republic of China, Tel [phone], Email [email protected]: The use of physical restraint (PR) is considered a controversial practice and research in Western countries has demonstrated negative physical and psychological consequences for patients, as well as staff, family members/carers, organisations and society as a whole. However, there are few research reports on restraint experiences of patients with mental disorders in non-Western countries, especially in mainland China.Aim: This study aims to explore the subjective experiences and perceptions of patients with psychiatric disorders who have experienced PR in mainland China.Methods: Semi-structured interviews were conducted with 8 inpatients with mental disorders in convalescence at a specialized mental health hospital in Shanghai. Interviews were recorded on audiotape and transcribed verbatim. Transcripts were analyzed using thematic analysis.Results: Five themes emerged: “perception and understanding of PR”, “response to PR”, “negative physical and psychological experiences”, “unmet care needs during PR” and “changes after PR”, which together characterize patients’ perceptions, experiences, feelings, and needs in PR.Conclusion: The use of PR involves ethical issues and brings negative experiences to patients with mental disorders that cannot be ignored and should be used as a last resort. Different patients have different attitudes and reactions to PR. During PR, patients’ physical and psychological needs are not adequately met. Medical staff should give more attention to patients in PR, meet their physical and psychological needs, and actively seek PR alternatives and reduction options based on evidence-based resources on restraint reduction available in the West and the national context and culture of China.Keywords: physical restraint, psychiatric nursing, thematic analysis, qualitative research

Keywords

• physical restraint
• psychiatric nursing
• thematic analysis
• qualitative research