ArticleNursing in critical care2026
Physical Restraint in Critically Ill Older Patients: ICU Nurses' Attitudes and Ethical Decision-Making.
Article in Nursing in critical care, 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
2 authors.
Funding
Abstract
backgroundPhysical restraint use in intensive care units (ICUs) raises important ethical, clinical and decisional challenges, particularly among critically ill older patients who are especially vulnerable to its adverse physical and psychological effects. Although nurses play a central role in restraint-related decisions, little qualitative evidence has examined their experiences of using physical restraint with older adults in critical care settings, particularly in Saudi Arabia.
aimTo explore ICU nurses' attitudes toward physical restraint use in critically ill older patients, examine their decision-making processes and understand the ethical dilemmas they encounter in practice. STUDY
designAn exploratory qualitative study was conducted across multiple healthcare settings in the Al-Ahsa region, Saudi Arabia. Semi-structured, in-depth interviews were conducted with ICU nurses who had direct experience with physical restraint use in critically ill older patients. Data were analysed using reflexive thematic analysis following Braun and Clarke's six-phase approach. Reporting was guided by the Consolidated Criteria for Reporting Qualitative Research.
findingsInterviews with 15 ICU nurses identified three interrelated themes: navigating the safety-autonomy tension, the weight of restraint decisions and working within systemic and cultural boundaries. Nurses described restraint as a measure used to protect patients from device removal, falls and self-harm, yet also as a practice that compromised dignity and autonomy. Decision-making was shaped by moral distress, clinical uncertainty, family expectations, staffing constraints, policy gaps and cultural values related to elder respect and family involvement.
conclusionsPhysical restraint decision-making in critically ill older patients is shaped by a complex interplay of clinical urgency, ethical tension, organisational constraints and cultural influences. ICU nurses occupy a central yet under-supported role in these decisions and often experience considerable moral distress. RELEVANCE TO CLINICAL PRACTICE: ICU policy and practice should support restraint minimisation through clear evidence-based guidance, structured ethical decision-making, culturally sensitive family communication and education on alternatives to restraint to protect the safety and dignity of critically ill older patients.
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.