Psychiatric inpatients' perceptions of positive and negative aspects of physical restraint

This qualitative study explored the experiences and feelings of psychiatric inpatients concerning their first encounter with physical restraint. Its purpose was to determine whether restraint has any other effects, other than the intended one of protection. Thirty psychiatric inpatients who had experienced physical restraint in two acute admission wards within the previous two days, were interviewed by the principal researcher. About two-thirds of the participants expressed positive feelings towards staff who had shown concern about their needs and had been willing to help. Positive therapeutic effects, other than physical protection, were largely related to the caring attitudes and behavior demonstrated by the staff. Negative effects were related to the inability of staff to satisfy patients' needs for: concern, empathy, active listening, and information about restraint during and after its use. The conclusion of the study was that physical restraint could be a therapeutic intervention when health professionals were able to provide psychological and informational support to patients throughout the procedure. A perceived unsatisfactory caring attitude and behavior by the restraint provider would cause negative feelings in the patient and would be more likely to result in the patient struggling physically with the restrainer. Additional physical and psychological harm would also be experienced by patients in these circumstances. (c) 2004 Elsevier Ireland Ltd. All rights reserved.