کاهش آموزش کارکنان در نگهداری فیزیکی در خدمات سلامت روان، بازتاب مبتنی بر شواهد برای چین Staff Training Reduces the Use of Physical Restraint in Mental Health Service, Evidence-based Reflection for China

INTRODUCTION Physical restraint was defined as a manual approach to reduce one’s physical movement (Putkonen et al., 2013). To some extent, physical restraint and mechanical restraint would be comprehended interchangeably. In mental health nursing, although physical restraint was an effective approach to manage the immediate risk, the application of physical restraint still resulted in ethical and clinical controversy particularly its requisites and abuse. However, the frequency of physical restraint varied from one study to another. A systematic review reported the incidence of physical restraint in psychiatric wards was 3.8% to 20%, which implicated physical restraint was frequently employed when patients posed critical risk to themselves or others (Putkonen et al., 2013). Furthermore, it was reported that the rate of physical restraint in the United States generally increased from 29.8% to 34.1% between 2007 and 2013, meanwhile, the duration of physical restraint fluctuated between 2 h and 3.7 h (Staggs, 2015). In mainland China (not including Hong Kong, Macao, or Taiwan), the use of physical restraint was even more prevalent. An investigation implemented in a psychiatric hospital of Changsha City asserted the frequency of physical restraint was 51.3% (Zhu et al., 2014). Whereas the frequent application of physical restraint, further studies examined its effect on patients and nurses. Noticeably, various studies verified physical restraint caused adverse effects on patients and nurses. From the patients’ perspective, it was evident that the bodily restraint would cause physical injury and psychological trauma to the patients. For one thing, physical restraint potentially led to a great number of physical injuries including skin injury, pulmonary disease, deep vein thrombosis, nervous system damage, ischemic lesions, or even sudden death (Di Lorenzo, Miani, Formicola, & Ferri, 2014). For another, it was reported the restrained patient undergoes psychological trauma associated with physical restraint, including demoralization, fear, anger, and the loss of dignity(Lancaster, Whittington, Lane, Riley, & Meehan, 2008). From nurses’ perspective, implementing restraint caused an ethical dilemma which was described as an inner conflict in their practice, leaving them the difficulty in coping with this issue (Stewart, Van der Merwe, Bowers, Simpson, & Jones, 2010).