Physical Restraint and Ethical Sensitivity in Intensive Care: From the Physician and Nurse Perspective

Abstract Introduction: The study examined the knowledge, attitudes, and practices of nurses and physicians in the intensive care unit regarding physical restraint and ethical dilemmas. Methods: The study was conducted in four hospitals in Istanbul between February and July 2018 in a descriptive, cross-sectional, and correlational design. The sample consisted of 113 physicians and nurses. The data was collected using a personal information form, a moral sensitivity questionnaire, a nurses' knowledge level, attitudes, and practices scale regarding physical restraints, a Richmond sedation and agitation scale, and a motor activity assessment scale. Results: 89.4% of the nurses and 78.9% of the physicians had used physical restraint before, 98.9% of the nurses and all of the physicians said that physical restraint could be applied when necessary. It was found that the mean practice score of nurses regarding the use of physical restraints (37.01±3.45) was higher than the practice score of physicians (33.57±5.38), while their knowledge and attitude scores were lower. It was determined that nurses had lower moral sensitivity than physicians due to their higher scores on the moral sensitivity questionnaire. It was found that the gender of healthcare workers and the previous use of physical restraint did not affect moral sensitivity. In contrast, the level of education and the status of working in a private hospital negatively affected moral sensitivity. Dıscussıon: Conclusion: It was observed that the rate of physical restraint application was high in healthcare workers; moral sensitivity was affected by occupation, educational status, institution of employment, knowledge, attitudes and practices related to physical restraint.