Nurses' knowledge, attitudes and practices related to physical restraint: the case from Turkey

Main Article Content

Ahu Pınar TURAN


Nurses are primarily for the care of patients and should ensure that physical restraint, which has many negative consequences, be applied according to standard practice. Therefore, they should have knowledge about physical restraint and apply physical restraint by observing existing laws and ethical principles. This study aimed to determine the knowledge level, attitude and practices of pediatric nurses on physical restraint and identify the factors influencing physical restraint use.

A cross-sectional study was conducted involving 150 pediatric nurses working in the pediatric clinic of a training and research hospital. The data were collected with an information form containing the introductory characteristics of the nurses and the Level of Knowledge, Attitudes and Practices of Staff Regarding Physical Restraints Questionnaire. Data were analyzed using the Mann-Whitney U test and the Kruskal-Wallis test.

Overall, nurses had good restraint-related knowledge with positive attitudes, although the physical restraint practices of nurses were not the best and there were some deficiencies. A statistically non-significant difference was found between age, gender, education status, nurses' work unit, and training status regarding physical restraint on the one hand and knowledge, attitude and practice scores relating to the use of physical restraints on the other (p>0.05).

Pediatric nurses' level of knowledge about physical restraint was quite good and their attitudes were positive. However, there were some deficiencies in their practices. Future training should therefore be emphasized to enhance nurses' ethical and sensitive thinking, increase their competence in applying physical restraint and working with patients.

Article Details

How to Cite
OZAKAR AKCA, S. ., & TURAN, A. P. (2023). Nurses’ knowledge, attitudes and practices related to physical restraint: the case from Turkey. Universa Medicina, 42(1), 12–20.
Original Articles


Fariña-López E, Estévez-Guerra GJ, Gandoy-Crego M, LM Polo-Luque, C Gómez-Cantorna, EA Capezuti. Perception of Spanish nursing staff on the use of physical restraints. J Nurs Scholars 2014;46:322-30.

Li X, Fawcett TN. Clinical decision making on the use of physical restraint in intensive care units. Int J Nurs Sci 2014;1:446-50.

Pradhan N, Lama S, Mandal G, Shrestha E. Physical restraining: Nurses knowledge and practice in tertiary care hospital of Eastern Nepal. Nursing Open 2019;6:1029–37.

Gunawardena R, Smithard DG. The attitudes towards the use of restraint and restrictive intervention amongst healthcare staff on acute medical and frailty wards - a brief literature review. Geriatrics 2019;4:50. doi: 10.3390/geriatrics4030050.

Kandeel NA, Attia AK. Physical restraints practice in adult intensive care units in Egypt. Nurs Health Sci 2013;15:79-85.

Canzan F, Mezzalira E, Solato G, et al. Nurses’ views on the use of physical restraints in intensive care: a qualitative study. IJERPH 2021;18:9646.

Goktas A, Buldukoglu K. Determination of psychiatric clinic nurses’ knowledge, attitudes, and practices regarding the use of physical restraints. J Psychiatr Nurs 2018;9:1-10. doi: 10.14744/phd.2017.38247.

Bartlova S, Hajduchova H, Prajsova J. Nurses opinions regarding patient safety in connection with the use of restraints in patients in Czech hospitals. Kontakt 2015;17:e73-e9.

Acevedo-Nuevo M, González-Gil MT, Martin-Arribas MC. Physical restraint use in intensive care units: exploring the decision-making process and new proposals: A multimethod study. IJERPH 2021;18:1826. doi: 10.3390/ijerph182211826.

Duxbury J, Thomson G, Scholes A, et al. Staff experiences and understandings of the REsTRAIN Yourself initiative to minimize the use of physical restraint on mental health wards. Int J Ment Health Nurs 2019;28:845-56.

Salehi Z, Joolaee S, Hajibabaee F, Ghezeljeh TN. The challenges of using physical restraint in intensive care units in Iran: a qualitative study. JICS 2021;22:34-40.

Republic of Turkey Ministry of Health. Health services general directorate. Health quality standarts (sks)- hospital. 1st ed. Ankara: Pozitif Printing; 2015.

Lee TK, Välimäki M, Lantta T. The knowledge, practice and attitudes of nurses regarding physical restraint: survey results from psychiatric inpatient settings. IJERPH 2021;18:6747.

Balci H, Arslan S. Nurses’ information, attýtude and practices towards use of physical restraint in intensive care units. J Caring Sci 2018;7:75-81. doi: 10.15171/jcs.2018.012.

Cusack P, Cusack FP, McAndrew S, McKeown M, Duxbury J. An integrative review exploring the physical and psychological harm inherent in using restraint in mental health inpatient settings. Int J Ment Health Nurs 2018;27:1162-76. doi: 10.1111/inm.12432.

Yont GH, Korhan EA, Dizer B, Gümüs F, Koyuncu R. Examination of ethical dilemmas experienced by adult intensive care unit nurses in physical restraint practices. Holistic Nursing Practice 2014;28:85-90. doi: 10.1097/HNP.0000000000000013.

Karagozoglu S, Ozden D,Yildiz FT. Knowledge, attitudes, and practices of Turkish intern nurses regarding physical restraints. Clin Nurse Spec 2013;27:262-71. doi: 10.1097/NUR.0b013e3182a0baec.

Kisacik OG, Sonmez M, Cosgun T. Use of physical restraints in critical care units: nurses’ knowledge, attitudes, and practices. Crit Care Nurse 2020;40:37-47.

Nielson S, Bray L, Carter B, Kiernan J. Physical restraint of children and adolescents in mental health inpatient services: a systematic review and narrative synthesis. J Child Health Care 2021;25:342-67.

Preisz A, Preisz P. Restraint in paediatrics: a delicate balance. Journal of Paediatrics and Child Health 2019;55:1165-69.

Kaya H, Dogu O. Intensive care unit nurses’ knowledge, attitudes and practices related to using physical restraints. Int J Caring Sci 2018;11:61-70.

Mehrok S, Belsiyal CX, Kamboj P, Mery A. The use of physical restraints- knowledge and attitude of nurses of a tertiary care institute, Uttarakhand, India. J Educ Health Promot 2020;9:77. doi: 10.4103/jehp.jehp_451_19 .

Ye J, Wang C, Xiao A, et al. Physical restraint in mental health nursing: a concept analysis. Int J Nurs Sci 2019;6:343-8.

Abd Elhameed SH, Elemam NI. Nurses knowledge, ýntention and attitude towards the use of physical restraint in geriatric care. IOSR-JNHS 2020;9:30-8. doi: 10.9790/1959-0901063038.

Cui N, Long M, Zhou S, Zhang T, He C, Gan X. Knowledge, attitudes, and practices of Chinese critical care nurses regarding physical restraint. J Contin Educ Nurs 2019;50:121-6.

Kassew T, Tilahun AD, Liyew B. Nurses’ knowledge, attitude, and ýnfluencing factors regarding physical restraint use in the intensive care unit: a multicenter cross-sectional study. Crit Care Res Pract 2020;2:1-10.

Wang L, Zhu XP, Zeng XT, Xiong P. Nurses’ knowledge, attitudes and practices related to physical restraint: a cross sectional study. Int Nurs Rev 2019;66:122-9. .