Paper
Monday, July 7, 2008
The Impact of Physical Restraint Knowledge on Nursing Practice: A Meta-Analysis
Meichin Huang, RN1, Yu-Chen Lin, RN1, Wanling Chen, RN1, Yi-Jan Wen, RN2, Pei-Chun Li, RN3, and Yueh-Yen Fang, PhD4. (1) Nursing Department, Chung-Ho Memorial Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan, (2) Hospice Care, Pingtung Christion Hospital, Pingtung, Taiwan, (3) Nursing Department, Chang Gung Memorial Hospital, Niaosong, Kaohsiung, Taiwan, (4) School of Nursing, Fooyin University, Ta-liao, Kaohsiung, Taiwan
| Learning Objective #1: realize the relationship between physical restraint knowledge and restraint attitude among nurses. |
| Learning Objective #2: realize the relationship between physical restraint knowledge and restraint behavior among nurses. |
There is an increase use of physical restraint in both longterm care and critical care facilities. Reduction in restraint use has become a quality indicator of critical care. Most studies of physical restraint in nursing had focused on the situations that caused physical restraint and nurses' attitude and behavior toward this practice. However, no literature provides an integrated discussion of these study results. The purpose of this meta-analysis was to integrate research findings on the relationship between knowledge and attitude, as well as knowledge and behavior of physical restraint among nurses. Random effect models were used to calculate combined effect sizes. Six Chinese and English databases were used to systematically locate both published and unpublished physical restraint literature in nursing up to year 2007. English databases used were MEDLINE, CINAHL, and PubMed. Chinese databases used were CEPS, as well as the Chinese Journal Database and the Thesis/Dissertation Database developed by the National Library in Taiwan. The literature search applied key words of ‘restraint', ‘physical restraint', ‘restraint knowledge', ‘restraint attitude', ‘perception', ‘attitude toward restraint', ‘attitude and knowledge of restraint', ‘education', ‘nursing', ‘nurse'. Eight studies, provided 1,416 samples, met inclusion criteria were selected for the meta-analysis. Meta-analysis results showed consistent results amomg studies on the relationship between knowledge and attitude of restraint. Based on six studies (731 subjects), the combined effect presented a positive relationship between knowledge and attitude (r=.39, 95% CI= .24-.51, p<.001). Four studies with a pooled sample size of 765 subjects provided effect sizes for the relationship between knowledge and behavior of restraint. Inconsistent results were found between these studies. The combined effect of this relationship was not significant (r=.11, 95% CI= -.08-.29, p=.27). Results of this meta-analysis suggested that attitude of restraint may not predict actual behavior. In the future, more studies on restraint behavior are suggested.