ArticleBMC medical ethics2026
A systematic scoping review and interpretive ethical synthesis of ethical decision-making about physical restraints for older adults in Confucian-influenced care contexts.
Article in BMC medical ethics, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
aimThis study aims to map and interpret the evidence on ethical decision-making in the use of physical restraints for older adults, with particular attention to Confucian-influenced family-centred care contexts and comparative international evidence.
designThis study applied a systematic scoping review design combined with an interpretive ethical synthesis.
methodsThe review was guided by the Joanna Briggs Institute approach to scoping reviews and reported with reference to PRISMA principles. Medline/PubMed, CINAHL Plus, CNKI, Google Scholar and ResearchGate were searched for English and Chinese literature published from 1 January 2015 to 30 September 2025. Searches combined terms for physical restraint, older adults, decision-making, ethics, family/proxy decision-making and Confucian or filial-piety contexts. Of 757 records identified, 526 records remained after duplicate removal, 46 full-text reports were assessed, and eight studies were included. Because the evidence base combined qualitative, quantitative and review studies, findings were integrated through a staged interpretive ethical synthesis. Empirical findings were first coded descriptively, then compared across evidence types, and finally interpreted through bioethical concepts including autonomy, relational autonomy, beneficence, non-maleficence, dignity, substituted judgement, vulnerability and culturally situated family responsibility. Primary empirical studies were given greater analytic weight than review articles, which were used mainly for conceptual contextualisation.
resultsFour analytically linked themes were identified: contextual determinants of restraint decisions in care settings; balancing autonomy, relational autonomy, beneficence and non-maleficence; nurses' ethical dilemmas and moral distress; and family or proxy decision-making shaped by substituted judgement, vulnerability, filial responsibility and culturally situated expectations of care.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.