THE PROCESS OF PHYSICAL RESTRAINTS: AN ETHNOGRAPHIC STUDY.
Contributors: University of California, Los Angeles.
Published: 1987
Number of pages: 261
Subjects: Education, Health.; Health Sciences, Nursing.; Psychology, Clinical.
Description: The use of external controls in the form of physical restraints on patients in psychiatric settings is a controversial intervention, made so because of historical stigma, legal dogma and the clinical judgment of professionals in urban health care settings in the United States. Previous studies on physical restraints have not addressed the complex issues involved in the decision to physically restrain the patient. This applied anthropological study describes the use of physical restraints, i.e., two point leather restraints, seclusion room and four point leather restraints plus seclusion on one psychiatric emergency ward in a large psychiatric hospital. Qualitative data from observations and interviews of nursing staff and patients was examined using content and thematic analysis. Quantitative data, from patient records and other documents, was tabulated as frequency distributions, as well as subjected to Chi-square analysis, where appropriate.

The concept of control was the unifying theme for the study. Control, a role-expectancy for both patients and staff, was viewed as inner or self and outer or external. Staff applied external controls when the patient was no longer able to control him or her self. A beginning model of control was developed for this study from the social science literature and from the study data.

A major finding not reported by other studies was that staff respond differently to chronic mentally ill patients than to patients who are not chronically mentally ill. This was evidenced by the following results: restrained patients who had longer lengths of stay were also the patients with chronic mental illness; patients who had more than one restraint episode/hospitalization and patients who were restrained for non-violent reason were the chronically mentally ill. The theme of chronicity of patient illness as affecting staff response to the patient was a variable in both the quantitative and qualitative data.
Notes: Source: Dissertation Abstracts International, Volume: 48-06, Section: A, page: 1402.

Thesis (PH.D.)--UNIVERSITY OF CALIFORNIA, LOS ANGELES, 1987.

School code: 0031.