The Experience of Family Members Who Have Had a Loved One in Physical Restraint in a Critical Care Setting during the COVID-19 Pandemic: A Qualitative Study Using a Phenomenological Design

Abstract

Limited accounts of family members’ experiences with loved ones who have been physically restrained in ICU settings (Ones, 2020; Singer et al., 2020) have left a gap in providing respectful, responsive patient care. One study estimated that physical restraint was being used at the rate of 50 per 1,000 patient days. Currently, it is estimated that approximately 27,000 people are placed in physical restraints each day in U.S. hospitals. ICUs are responsible for 56% of all restraint days, despite accounting for only 16% of all patient days (Mion, 2008). According to Abdeljawad and Mrayyan (2016), patients may experience trauma with the use of these devices. In order to better comprehend the effects following physical restraint use, this dissertation explored the perceptions of family members with loved ones who have been physically restrained, with a focus on their application in critical care settings during the COVID-19 pandemic.

While no scientific evidence of physical restraint efficacy is available, there is much evidence of its risk. Another study reported that in hospitals in the United States, the prevalence of using physical restraints is approximately with 53% of all patients. Further, the prevalence of using restraints on patients in critical care units is 75%. With the increased use of physical restraint, the mortality and morbidity rates are expected to increase, due to serious consequences of physical restraint that can result in confusion, deconditioning, pressure injuries, strangulation, death, and adverse psychological effects (Rakhmatullina et al., 2013). In the extant literature, limited studies have explored family members’ experiences of loved ones being physically restrained (Ones, 2020). The findings from this study included the following themes: Theme 1: Having to Deal with Complications and Difficulties Encountered Preceding, During, and Post Hospitalization; Theme 2: Experiences That Are Identified as Negative; Theme 3: Understanding of Hospital Staff Intentions; Theme 4: The Need for Physical Restraint Intervention (PRI) May Be Justifiable but Stirs up Negative Emotions; and Theme 5: Feelings of Ambivalence Associated with PRI. The study provides an understanding of family members’ perception of these experiences. These insights may help health care clinicians improve the experience of patient care, safety, and quality.