The effects of physical restraint education on the knowledge and attitude of nurse interns

Abstract

Objectives: The aim of this study was to determine the effect of training regarding the use of physical restraint of pa- tients on the knowledge and attitude of nurse interns. Methods: This was an experimental study with a pre-test and post-test design. The population consisted of a total of 140 intern students attending the faculty of nursing of a single university in Turkey. Data related to demographic char- acteristics and experience were collected, and the respondents were also asked about alternative methods to physical restraint in an open-ended question during the pre-test phase. The Physical Restraint Knowledge, Attitude, and Prac- tice Scale was used to assess the students before and after a nursing care management class that included physical restraint training. Results: Most of the nurse interns (63.6%) stated that they had experienced the use of physical restraint; most (29.3%) had encountered the practice in a psychiatry clinic. A majority of the students indicated that the content of the under- graduate education regarding physical restraint was not sufficient (65.7%) and that they did not know about alterna- tives to physical restraint (80%). The mean post-test scores in the knowledge, attitude, and practice subdimensions of the scale were significantly higher than the pre-test scores recorded prior to the training (p≤.001). There was a statis- tically significant increase in the following items: “Residents may refuse to be placed in a restraint”(p≤.001; x 2 =0.03), “If physical restraints are to be used, it is required to have signed consent from a member of the patient’s family”(p=0.002; x 2 =7.98), and “Restraints should be released every 2 hours”(p=≤.001; x2 =13.49) in the knowledge subdimension. Higher scores were also seen in many attitude subdimension items, such as “I feel that family members have the right to re- fuse the use of restraints” and “I feel guilty placing a resident in restraints,” and in the practice subdimension, improved scores were seen in items such as “I try alternative measures before restraining a resident” and “When I restrain a resi- dent, I make this decision only with a physician’s order” after the training. Conclusion: Detailed training on the use of physical restraint, including consideration of alternative techniques, rights, and legal aspects, significantly improved the knowledge and attitude the nurse interns. Additional observational stud- ies of practice are recommended.