ArticleFrontiers in pediatrics2026
Restraint care in the pediatric intensive care unit: a qualitative investigation of nurses' perspectives and experiences.
Article in Frontiers in pediatrics, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Restraint use in pediatric intensive care units (PICUs), while essential for preventing unplanned extubation, presents ethical and practical challenges. Nurses, as primary implementers, often face psychological tensions arising from their dual role as caregivers and enforcers of safety. Yet, their subjective experiences remain underexplored. Methods: A descriptive phenomenological design was employed. Purposive sampling recruited 16 PICU nurses from a tertiary children's hospital in Jiangsu, China, between March and June 2025. Semi-structured, face-to-face interviews (30-60 min) were conducted and analyzed using Colaizzi's method. Ethical approval was obtained, and triangulation ensured rigor. Sample size was determined by data saturation. Results: Sixteen PICU nurses participated. Five core themes emerged: (1) ethical tensions in balancing patient safety with respect for autonomy; (2) practical difficulties due to ill-fitting restraint tools and technical demands; (3) nurse-family communication breakdowns from emotional resistance and information asymmetry; (4) cumulative psychological strain, including vicarious trauma and diminished professional identity; (5) institutional needs for clear protocols, targeted training, and staffing support. Practice gaps included inconsistent emergency assessments, incomplete family consent, poor site-monitoring compliance, and lack of pediatric-specific tools. Conclusion: PICU nurses face multifaceted challenges in restraint care. Improvements require standardized pediatric guidelines, communication-focused training, non-restraint alternatives, and enhanced institutional support.
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