The purpose of this study was to explore the experiences and needs of family caregivers of stroke patients who require physical restraints. The themes and sub-themes that emerged included “the reason for the use of PR” (disruptive behaviors of the patient and personal reasons of caregivers), “the turmoil of having to use PR” (inevitableness, comparing benefits and harms, the emotional effect of PR, and physical effects), and “unmet needs and suggestions” (unmeet needs and suggestions). Nurses should take the experiences of patient relatives into account in the process of PR application, organize training programs, and determine application standards for PR.
AkosileC. O.BanjoT. O.OkoyeE. C.IbikunleP. O.OdoleA. C. (2018). Informal caregiving burden and perceived social support in an acute stroke care facility. Health and Quality of Life Outcomes, 16(1), 57. https://doi.org/10.1186/s12955-018-0885-z
AuslanderG. K. (2011). Family caregivers of hospitalized adults in Israel: A point-prevalence survey and exploration of tasks and motives. Research in Nursing and Health, 34(3), 204–217. https://doi.org/10.1002/nur.20430
4.
BaiX.KwokT. C.IpI. N.WooJ.ChuiM. Y.HoF. K. (2014). Physical restraint use and older patients’ length of hospital stay. Health Psychology and Behavioral Medicine, 2(1), 160–170. https://doi.org/10.1080/21642850.2014.881258
5.
Barton-GoodenA.DawkinsP. E.BennettJ. (2015). Physical restraint usage at a teaching hospital: A pilot study. Clinical Nursing Research, 24(1), 73–90. https://doi.org/10.1177/1054773813493112
6.
BektaşH.CebeciF.KarazeybekE.SucuG.GürsoyE. (2012). Informal caregivers’ experiences during hospitalization in Turkey. HealthMED, 6(9), 3061–3069.
7.
BennettB.BarnstonS.SmithR. (2007). Emotional support after stroke, part 1: Two models from hospital practice. British Journal of Neuroscience Nursing, 3(1), 19–23. https://doi.org/10.12968/bjnn.2007.3.1.22724
8.
BlantonS.ScheibeD. C.RutledgeA. H.ReganB.O’SullivanC. S.ClarkP. C. (2019). Family-centered care during constraint-induced therapy after chronic stroke: A feasibility study. Rehabilitation Nursing, 44(6), 349–357. https://doi.org/10.1097/rnj.0000000000000197
9.
BurlaL.KnierimB.BarthJ.LiewaldK.DuetzM.AbelT. (2008). From text to codings: Intercoder reliability assessment in qualitative content analysis. Nursing Research, 57(2), 113–117. https://doi.org/10.1097/01.NNR.0000313482.33917.7d
10.
ClarkP. C.AycockD. M.ReissA.TannerD.ShenviN. V.EasleyK. A.WolfS. L. (2015). Potential benefits for caregivers of stroke survivors receiving BTX-A and exercise for upper extremity spasticity. Rehabilitation Nursing, 40(3), 188–196. https://doi.org/10.1002/rnj.147
11.
CoutureM.DucharmeF.SassevilleM.BradetteC.GaudetK. (2019). A qualitative systematic review of factors affecting caregivers’ decision-making for care setting placements for individuals with dementia. Geriatric Nursing, 41(2), 172–180.
12.
CreswellJ. W. (2003). Research design: Qualitative, quantitative and mixed methods approaches. Sage Publications.
13.
CreswellJ. W. (2018). Nitel araştirma yöntemleri. Qualitative research methods (BütünM.DemirSB (Eds.), Trans.; 4th ed.). Siyasal Kitapevi.
14.
Department of Health and Human Services. (2006). Centers for Medicare & Medicaid Cervices, hospital conditions of participation: Patients’ rights; final rule. Federal register, 71, 71378–71427.
15.
DoyleL.McCabeC.KeoghB.BradyA.McCannM. (2020). An overview of the qualitative descriptive design within nursing research. Journal of Research in Nursing, 25(5), 443–455. https://doi.org/10.1177/1744987119880234.
16.
EcevitA. Ş.BahçecikN.KarabacakÜ. (2013). Çağdaş Hemşirelikte Etik. (1st ed., pp. 58–59). Tıp Bookstore.
ErlingssonC.BrysiewiczP. (2017). A hands-on guide to doing content analysis. African Journal of Emergency Medicine, 7(3), 93–99. https://doi.org/10.1016/j.afjem.2017.08.001
19.
ErtuğrulB.ÖzdenD. (2020). The effect of physical restraint on neurovascular complications in intensive care units. Australian Critical Care, 33(1), 30–38. https://doi.org/10.1016/j.aucc.2019.03.002
20.
EvansD.FitzGeraldM. (2002). The experience of physical restraint: A systematic review of qualitative research. Contemporary Nurse, 13(2–3), 126–135. https://doi.org/10.5172/conu.13.2-3.126
21.
EvansD.WoodJ.LambertL. (2003). Patient injury and physical restraint devices: A systematic review. Journal of Advanced Nursing, 41(3), 274–282. https://doi.org/10.1046/j.1365-2648.2003.02501.x
22.
Fariña-LópezE.Estévez-GuerraG. J.GonzálezE. N.FernándezM. M.SantanaE. S. (2008). Descriptive study of the attitudes of family caregivers to the use of physical restraints: Preliminary results. Revista Española de Geriatría y Gerontología, 43(4), 201–207. https://doi.org/10.1016/s0211-139x(08)71183-1
GastmansC.MilisenK. (2006). Use of physical restraint in nursing homes: Clinical-ethical considerations. Journal of Medical Ethics, 32(3), 148–152. https://doi.org/10.1136/jme.2005.012708
25.
GoethalsS.DierckxdeCasterléB.GastmansC. (2012). Nurses’ decision making in cases of physical restraint: A synthesis of qualitative evidence. Journal of Advanced Nursing, 68(6), 1198–1210. https://doi.org/10.1111/j.1365-2648.2011.05909.x
26.
HafsteinsdóttirT. B.VergunstM.LindemanE.SchuurmansM. (2011). Educational needs of patients with a stroke and their caregivers: A systematic review of the literature. Patient Education and Counselling, 85(1), 14–25. https://doi.org/10.1016/j.pec.2010.07.046
27.
HautA.KolbeN.StrupeitS.MayerH.MeyerG. (2010). Attitudes of relatives of nursing home residents toward physical restraints. Journal of Nursing Scholarship, 42(4), 448–456. https://doi.org/10.1111/j.1547-5069.2010.01341.x
28.
HesamzadehA.DalvandiA.BagherM. S.FallahiK. M.AhmadiF.MosaviA. N. (2017). Family caregivers’ experience of activities of daily living handling in older adult with stroke: A qualitative research in the Iranian context. Scandinavian Journal of Caring Sciences, 31(3), 515–526. https://doi.org/10.1111/scs.12365
29.
HofmannH.HahnS. (2014). Characteristics of nursing home residents and physical restraint: A systematic literature review. Journal of Clinical Nursing, 23(21–22), 3012–3024. https://doi.org/10.1111/jocn.12384
30.
HolmgrenA. G.JuthN.LindbladA.Von VogelsangA. C. (2020). Restraint in a neurosurgical setting: A mixed-methods study. World Neurosurgery, 133, 104–111. https://doi.org/10.1016/j.wneu.2019.09.105
31.
HsiehH. F.ShannonS. E. (2005). Three approaches to qualitative content analysis. Qualitative Health Research, 15(9), 1277–1288.
32.
HughesR. (2010). Human rights perspectives. In OliverD.MeyerG.IrvingK.HughesC.KopkeS.LapaneK.MadanS.HautA.GoldmanB.GerlachA.GastmansC.DewingJ.WhylieS.WilliamsJ.RoweP.RussellK.TestadI.NymanS. R.WilkinsonH.. . .EllisJ.Rights, risk and restraint-free care of older people: Person-centred approaches in health and social care (pp. 97–104). Jessica Kingsley Publishers.
KahramanB. B.AsiretG. D.YildirimG.AkyarI.AytekinG. K.ÖzA. (2015). Opinions of family caregivers on the use of physical restraints in intensive care unit. Journal of Medical and Surgical Intensive Care Medicine, 6(3), 78.
35.
KaragözoğluŞ.ÖzdenD. (2013). Knowledge and practices of nurses working at a university hospital related to use of physical restraints. Turkish Journal of Research & Development in Nursing, 15(1), 11–22.
36.
KongE. H.ChoiH.EvansL. K. (2017). Staff perceptions of barriers to physical restraint reduction in long term care: A meta synthesis. Journal of Clinical Nurses, 26(1–2), 49–60. https://doi.org/10.1111/jocn.13418
37.
KrügerC.MayerH.HaastertB.MeyerG. (2013). Use of physical restraints in acute hospitals in Germany: A multi-centre cross-sectional study. International Journal of Nursing Studies, 50(12), 1599–1606. https://doi.org/10.1016/j.ijnurstu.2013.05.005
38.
LaiC. K.WongI. Y. (2008). Families’ perspectives on the use of physical restraints. Contemporary Nurse, 27(2), 177–184.
39.
LawsL.RitterL.LoescherL.McEwenM. (2022). Stroke-specific refinements to Naylor’s Transitional Care Model to address the storm of uncertainty and unmet survivor and caregiver Needs. Journal of Neuroscience Nursing, 54(1), 23–29. https://doi.org/10.1097/JNN.0000000000000629
40.
LockwoodC.StannardD.MunnZ.PorrittK.CarrierJ.RittenmeyerL.BjerrumM.SalmondS. (2018). The patient/significant other experience of physical restraint in acute care settings: A qualitative systematic review protocol. JBI Database of Systematic Reviews Implementation Report, 16(3), 622–627. https://doi.org/10.11124/JBISRIR-2017-003457
41.
MackieB. R.MarshallA.MitchellM. (2018). Acute care nurses’ views on family participation and collaboration in fundamental care. Journal of Clinical Nursing, 27(11–12), 2346–2359. https://doi.org/10.1111/jocn.14185
42.
MackieB. R.MitchellM.MarshallA. P. (2019). Patient and family members’ perceptions of family participation in care on acute care wards. Scandinavian Journal of Caring Sciences, 33(2), 359–370. https://doi.org/10.1111/scs.12631
43.
MatanoF.MizunariT.YamadaK.KobayashiS.MuraiY.MoritaA. (2017). Environmental and clinical risk factors for delirium in a neurosurgical center: A prospective study. World Neurosurgery, 103, 424–430. https://doi.org/10.1016/j.wneu.2017.03.139
44.
MatsuzonoK.MashikoT.OzawaT.MiuraK.SuzukiM.FuruyaK.OzawaM.AnanY.ShimazakiH.KoideR.TanakaR.FujimotoS. (2020). Management effort for delirium and insomnia in patients with acute ischemic stroke (MEDIAS) study. Psychiatry and Clinical Neurosciences, 74(4), 279–280. https://doi.org/10.1111/pcn.12979
45.
MengelersA. M.BleijlevensM. H.VerbeekH.CapezutiE.TanF. E.HamersJ. P. (2019). Professional and family caregivers’ attitudes towards involuntary treatment in community-dwelling people with dementia. Journal of Advanced Nursing, 75(1), 96–107. https://doi.org/10.1111/jan.13839
MöhlerR.MeyerG. (2014). Attitudes of nurses towards the use of physical restraints in geriatric care: A systematic review of qualitative and quantitative studies. International Journal of Nursing Studies, 51(2), 274–288. https://doi.org/10.1016/j.ijnurstu.2013.10.004
48.
NakamizoT.KandaT.KudoY.SugawaraE.HashimotoE.OkazakiA.UsudaM.NagaiT.HaraH.JohkuraK. (2021). Effects of uncomfortable care and histamine H2-antagonists on delirium in acute stroke: A propensity score analysis. Journal of the Neurological Sciences, 420, 117251. https://doi.org/10.1016/j.jns.2020.117251
49.
OnwuegbuzieA. J.LeechN. L. (2007). A call for qualitative power analyses. Quality & Quantity, 41(1), 105–121.
50.
PandeyS. C.PatnaikS. (2014). Establishing reliability and validity in qualitative inquiry: A critical examination. Jharkhand Journal of Development and Management Studies XISS, 12(1), 5743–5753.
51.
PivodicL.SmetsT.GambassiG.KylänenM.PasmanH. R.PayneS.SzczerbińskaK.DeliensL.Van den BlockL. (2020). Physical restraining of nursing home residents in the last week of life: An epidemiological study in six European countries. International Journal of Nursing Studies, 104, 103511. https://doi.org/10.1016/j.ijnurstu.2019.103511
52.
QiuX.SitJ. W.KooF. K. (2018). The influence of Chinese culture on family caregivers of stroke survivors: A qualitative study. Journal of Clinical Nursing, 27(1–2), e309–e319. https://doi.org/10.1111/jocn.13947
53.
RaguanB.WolfovitzE.GilE. (2015). Use of physical restraints in a general hospital: A cross-sectional observational study. The Israel Medical Association Journal, 17(10), 633–638.
54.
ReinhardS. C.GivenB.PetlickN. H.BemisA. (2008). Supporting family caregivers in providing care. In HughesR. G. (Ed.), Patient safety and quality: An evidence-based handbook for nurses (chap. 14) Agency for Healthcare Research and Quality (US), from https://www.ncbi.nlm.nih.gov/books/NBK2665/
55.
RolloE.CalleaA.BrunettiV.VollonoC.MarottaJ.Della MarcaG. (2021). Physical restraint precipitates delirium in stroke patients. Journal of the Neurological Sciences, 421(15), 117290. https://doi.org/10.1016/j.jns.2020.117290
56.
RückholdtM.ToflerG. H.BuckleyT. (2017). The impact of hospitalisation on a visiting family member: A case study and discussion. Australian Critical Care, 30(3), 182–185.
57.
RyanT.HarrisonM.GardinerC.JonesA. (2017). Challenges in building interpersonal care in organized hospital stroke units: The perspectives of stroke survivors, family caregivers and the multidisciplinary team. Journal of Advanced Nursing, 73(10), 2351–2360. https://doi.org/10.1111/jan.13313
SandelowskiM. (2010). What’s in a name? Qualitative description revisited. Research in Nursing and Health, 33(1), 77–84. https://doi.org/10.1002/nur.20362
60.
ScheepmansK.Dierckx de CasterléB.PaquayL.Van GansbekeH.MilisenK. (2017). Restraint use in older adults receiving home care. Journal of the American Geriatric Society, 65(8), 1769–1776. https://doi.org/10.1111/jgs.14880
61.
SpezialeH. S.StreubertH. J.CarpenterD. R. (2011). Qualitative research in nursing: Advancing the humanistic imperative. Lippincott Williams & Wilkins.
62.
StevensJ. C. (2012). The use of physical restraints in neurologic patients in the inpatient setting. Continuum: Lifelong Learning in Neurology, 18(6), 1422–1426. https://doi.org/10.1212/01.CON.0000423855.55394.ad
63.
TongA.SainsburyP.CraigJ. (2007). Consolidated criteria for reporting qualitative research (COREQ): A 32- item checklist for interviews and focus group. International Journal for Quality in Health Care, 19(6), 349–357. https://doi.org/10.1093/intqhc/mzm042
64.
UysalN.Gürol ArslanG.MeteS. (2019). The feelings and experiences of hospitalized patients regarding informal caregivers: A qualitative study. Social Work in Health Care, 58(2), 166–181. https://doi.org/10.1080/00981389.2018.1531102
65.
VarugheseT.MontielT. C.EngebretsonJ.SavitzS. I.SharriefA.BeauchampJ. E. (2022). A person-centered approach understanding stroke survivor and family caregiver emotional health. Journal of Neuroscience Nursing, 54(2), 68–73. https://doi.org/10.1097/JNN.0000000000000640
66.
YıldırımA.ŞimşekH. (Eds.). (2016). Qualitative research methods in the social sciences (10th ed.). Seçkin Publishing.
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