18.1.12

Oversiktsartikkel: Pasientopplevelser av fysisk maktbruk

Negative psychological impact
While participant reports of positive restraint experiences were rare, all the studies reviewed included a discussion of the negative psychological impact the experience of being physically restrained had on the participants.

Common themes included anger, fear, humiliation, demoralization, dehumanization, degradation, powerlessness, distress, embarrassment, and feeling that their integrity as a person had been violated. 

Retraumatization
Several authors reported retraumatization as a consequence of physical restraint. Many participants reported that the experience of being restrained brought back memories of previous violent attacks against them, including experiences of being raped and having been abused as a child.

Perceptions of unethical practices
Participants in six of the 12 studies included descriptions of incidents that they felt were punitive, abusive, or unethical practices undertaken by clinicians during their restraint experiences.

Broken spirit
In each article reviewed, there is indication that participants felt helpless, hopeless, and as if their spirits had been broken at some point during their restraint experience. The participants described coming to some place of  acceptance, knowing that there was nothing they could do to get out of the restraints.

Conclusion
Physical restraint is a high-risk procedure that has important implications for the well-being of our patients.

The division between beliefs about the therapeutic benefit of physical restraint and the actual perceptions and experiences of our patients points to a serious gap in our understanding about the potentially harmful effects of this common intervention.

Kilde: http://www.ncbi.nlm.nih.gov/pubmed/21054728

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