Team Collaboration Experiences of Nurses and Physicians Working in Inpatient Psychiatry Units Related to Physical Restraint Practices: A Qualitative Study

住院精神科病房护士和医生在身体约束实践方面的团队协作经验:一项定性研究

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Abstract

AIM: To investigate team collaboration experiences of the nurses and physicians working in inpatient psychiatry units related to physical restraint practices in Türkiye. METHODS: The present study was conducted in the Adult Psychiatry Inpatient Unit of a university hospital in a province in western Türkiye between May 2022 and January 2023. The study data were collected through 11 individual, face-to-face, semi-structured interviews. The present study has a descriptive qualitative research design. In the analysis of the data obtained from the interviews, the content analysis method was used. RESULTS: Nurses stated that they play a central role in patient observation and initial intervention during escalating behavior. The formal decision to apply physical restraint was legally attributed to physicians. Participants described the physical restraint process as emotionally and physically distressing, emphasizing that clinical experience, clear communication, and teamwork were essential facilitators, while staff shortages and the presence of uninformed patient relatives posed significant barriers. In the study, the following five main themes emerged: "being a part of the process but not taking part in it, staying a step away from it," "another side of psychiatry-an unpleasant practice," "facilitators," "barriers," and "recommendations." CONCLUSION: There are uncertainties in the decision-making and implementation processes of physical restraint. These research results affect patient safety in psychiatric inpatient units providing mental health services.

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