Date of Award
5-2009
Culminating Project Type
Thesis
Degree Name
Social Work: M.S.W
Department
Social Work
College
School of Health and Human Services
First Advisor
Gary Whitford
Second Advisor
Elizabeth Talbot
Third Advisor
Brenda Lenz
Keywords and Subject Headings
Social Work, Perceptions, Physical Restraint, Patients, Hospital Setting
Abstract
To add to empirical social work literature and articulate a social work position on physical restraint use, this hospital social worker examined opinions about physical restraint use among 25 social work colleagues employed on eight acute care units and two mental health units in a central Minnesota hospital. Strumpf and Evans' (1988) Perceptions of Restraint Use Questionnaire (PRUQ) was modified and used to survey St. Cloud Hospital social workers. Good internal consistency was established with the instrument (Cronbach's alpha 0.85).
Top reasons given for the use of physical restraint in this study corroborate with the work of other researchers. Review of the literature reports three most commonly cited rationales for the use of physical restraint with older patients to be to protect from injury, prevent interference with treatment, and control disruptive behavior (Gilbert & Counsell, 1999; Helmuth, 1995; Hendel, 2004; Strumpf & Evans, 1988; Terpstra, 1998; Werner, 2002). In this study, to protect the adult patient from falling out of bed, out of chair, or when ambulating received top rank as rationale for restraint use and to protect staff or other patients from physical abusiveness or combativeness came in second.
Respondents viewed restraint use on a low to moderate level (M = 1.5 to 3.3 on a 4-point Likert scale with "l" denoting "not at all" and "4" denoting "most" likely to restrain). Statistically significant differences were found between social work position (whether medical or mental health), age, experience and the PRUQ score. No statistical differences were found between social work education (whether BSW or MSW) and personal perceptions of restraint use.
Implications for social workers are discussed including ethical considerations and the current move to restraint-free healthcare settings in the United States. Hospital social workers have yet to be utilized to their fullest potential surrounding restraint use with patients. Social workers could play a pivotal role in advocating for patient autonomy, mediating between patients, families, and staff, and engaging the interdisciplinary care team in a dialogue with respect to alternatives, theories, and the ethics surrounding the use of physical restraint with patients.
Recommended Citation
Lund-Reed, Kathryn A., "Social Work Perceptions about Physical Restraint use with the Adult Patient in a Hospital Setting" (2009). Culminating Projects in Social Work. 13.
https://repository.stcloudstate.edu/msw_etds/13
Comments/Acknowledgements
This thesis is dedicated to my family. First, I want to say thank you to my four adult children for their support and patience in waiting for their mother to be a mom again. I love you all and nothing has been more important to me in this world than all of you: T.J., Angie, Joe, and Jeff. Second, I want to say to Sammy, Jace, Sadie, and Sabin: "Grandma has missed you!" I look forward to many sleepless nights having "sleepovers" soon. We will play Trouble, Battleship, Old Maid, and have Tea Parties. Finally, I want to dedicate this thesis to my former husband who died in my arms of cancer midway through the completion of this project. I remember his patiently awaiting my having time to care for him and fondly agreeing to critique the pages of the Introductory and Literature Review chapters of this project. He was utterly amazed and appalled at the lack of governmental oversight of a practice that proved injurious or deadly for many. He was proud of my many discoveries and work, and I will never forget when he said, "Someday I would like to do work like that." Well, here you go, Tom. We did it!
A Hundred Years From Now
...it will not matter what my bank account was,
the sort of house I lived in,
or the kind of car I drove...
but the world may be different
because I was important in the
life of a CHILD
Anonymous