Korean J Adult Nurs.  2013 Apr;25(2):148-156.

Emotional Response of ICU Patients Family toward Physical Restraints

• Kang J
• Lee EN
• Park EY
• Lee Y
• Lee MM

Abstract

PURPOSE
The purpose of this study was to investigate the emotional response of family members of physically restrained patients in the intensive care units (ICUs).
METHODS
The study subjects were 200 family members of ICU patients who had been on physical restraints in two university hospitals. Data were collected using the "Instrument of family's emotional response toward physically restrained patients".
RESULTS
The mean score of familial emotional response was 2.69 out of a possible 5. The subcategory of acceptance was the highest with 3.56 points followed by depression (3.02), helplessness (2.94), anxiety (2.87), shock (2.74), avoidance (2.64), and grudge (2.08). Multiple stepwise regression analysis indicated that the age of family members, side effects of restraints, and information provision were the variables influencing on negative emotional response of family.
CONCLUSION
Family members showed slightly negative emotional response toward the physical restraints. This finding could be influenced by their limited knowledge of the need for the restraints. Educational programs or fact sheets to be given to family members may be helpful.

MeSH Terms

Anxiety
Depression
Hospitals, University
Humans
Intensive Care Units
Restraint, Physical
Shock

Reference

1. Benbenishty J, Adams S, Endacott R. Physical restraint use in intensive care units across Europe: The PRICE study. Intensive and Critical Care Nursing. 2010; 26:241–245. DOI: 10.1016/j.iccn.2010.08.003.

2. Bijttebier P, Vanoost S, Delva D, Ferdinande P, Frans E. Needs of relatives of critical care patients: Perceptions of relatives, physicians and nurses. Intensive Care Medicine. 2001; 27:160–165.

3. Bray K, Hill K, Robson W, Leaver G, Walker N, O'Leary M, et al. British Association of Critical Care Nurses position statement on the use of restraint in adult critical care units. Nursing in Critical Care. 2004; 9:199–212.

4. Cho YA, Kim JS, Kim NR, Choi HJ, Jo JG, Lee HJ, et al. A Study on the use of physical restraints in ICUs. Korean Journal of Adult Nursing. 2006; 18:543–552.

5. Choi E, Song M. Physical restraint use in Korean ICU. Journal of Clinical Nursing. 2003; 12:651–659.

6. Chuang YH, Huang HT. Nurses' feelings and thoughts about using physical restraints on hospitalized older patients. Journal of Clinical Nursing. 2007; 16:486–494.

7. Davidson JE, Jones C, Bienvenu OJ. Family response to critical illness: Postintensive care syndromefamily. Critical Care Medicine. 2012; 40:618–624. DOI: 10.1097/CCM.0b013e318236ebf9.

8. Fariña-López E, Estévez-Guerra GJ, Núñez GE, Montilla FM, Santana SE. Descriptive study of the attitudes of family caregivers to the use of physical restraints: Preliminary results. Revista Espanola de Geriatria y Gerontologia. 2008; 43:201–207.

9. Hardin SB, Magee R, Vinson MH, Owen M, Hyatt E, Stratmann D. Patient and family perceptions of restraints. Journal of Holistic Nursing. 1993; 11:383–397.

10. Haut A, Böther N, Franke N, Hartmann H. Physical restraints in geriatric care: Attitudes of nurses, patients and their families. Pflege Zeitschrift. 2007; 60:206–209.

11. Haut A, Kolbe N, Strupeit S, Mayer H, Meyer G. Attitudes of relatives of nursing home residents toward physical restraints. Journal of Nursing Scholarship. 2010; 42:448–456.

12. Kanski GW, Janelli LM, Jones HM, Kennedy MC. Family reactions to restraints in an acute care setting. Journal of Gerontological Nursing. 1996; 22(6):17–22.

13. Kentish-Barnes N, Lemiale V, Chaize M, Pochard F, Azoulay É. Assessing burden in families of critical care patients. Critical Care Medicine. 2009; 37:10 Suppl. S448–S456. DOI: 10.1097/CCM.0b013e3181b6e145.

14. Kim MY. ICU patients' experience process of physical restraint. Korean Journal of Adult Nursing. 2007; 19:583–592.

15. Kim MY. A study on the use of restraints in ICUs. Daegu: Keimyung University;2009. Unpublished master's thesis.

16. Lai CK, Wong IY. Families' perspectives on the use of physical restraints. Contemporary Nurse. 2008; 27:177–184.

17. Langley G, Schmollgruber S, Egan A. Restraints in intensive care units-a mixed method study. Intensive and Critical Care Nursing. 2011; 27:67–75.

18. Lee EN, Ha SJ, Kang JY. Development and testing of an instrument to measure family's emotional response toward physically restrained patients. Journal of Korean Academy of Nursing. 2008; 38:629–638.

19. Lee MM, Kim KS. Comparison of physical injury, emotional response and unplanned self-removal of medical devices according to use of physical restraint in intensive care unit patients. Journal of Korean Clinical Nursing Research. 2012; 18:296–306.

20. Martin B, Mathisen L. Use of physical restraints in adult critical care: A bicultural study. American Journal of Critical Care. 2005; 14:133–142.

21. McAdam JL, Dracup KA, White DB, Fontaine DK, Puntillo KA. Symptom experiences of family members of intensive care unit patients at high risk for dying. Critical Care Medicine. 2010; 38:1078–1085. DOI: 10.1097/CCM.0b013e3181cf6d94.

22. Minnick A, Leipzig RM, Johnson ME. Elderly patients' reports of physical restraint experiences in intensive care units. American Journal of Critical Care. 2001; 10:168–171.

23. Myhren H, Ekeberg ø, Langen I, Stokland O. Emotional strain, communication, and satisfaction of family members in the intensive care unit compared with expectations of the medical staff: Experiences from a Norwegian university hospital. Intensive Care Medicine. 2004; 30:1791–1798. DOI: 10.1007/s00134-004-2375-5.

24. Newbern VB, Lindsey IH. Attitudes of wives toward having their elderly husbands restrained. Geriatric Nursing. 1994; 15:135–141.

25. Park S. A study of the influences of critically ill patient families' stress on the functional health of the patients: Focused on the moderating effect of family functioning. Seoul: Yonsei University;2005. Unpublished master's thesis.

26. Płaszewska-Żywko L, Gazda D. Emotional reactions and needs of family members of ICU patients. Anaesthesiology Intensive Therapy. 2012; 44:145–149.

27. Schmidt M, Azoulay É. Having a loved one in the ICU: The forgotten family. Current Opinion in Critical Care. 2012; 18:540–547. DOI: 10.1097/MCC.0b013e328357f141.

28. Schwarzkopf D, Behrend S, Skupin H, Westermann I, Riedemann NC, Pfeifer R, et al. Family satisfaction in the intensive care unit: A quantitative and qualitative analysis. Intensive Care Medicine. 2013; Advanced online publication. DOI: 10.1007/s00134-013-2862-7.

29. Vassallo M, Wilkinson C, Stockdale R, Malik N, Baker R, Allen S. Attitudes to restraint for the prevention of falls in hospital. Gerontology. 2005; 51:66–70.

30. Yoo JM. Knowledge and attitudes about the use of the restraints in nurses. Suwon: Ajou University;2011. Unpublished master's thesis.