Predicting Critical Care Nurses’ Intention to Use Physical Restraints in Intubated Patients: A Structural Equation Model

Abstract

Aims. To identify the factors influencing critical care nurses’ intention of physical restraint in intubated patients. Background. Physical restraint reduction has been advocated by many international institutions, nurses are the main physical restraint decision-makers, and it is critical to identify the factors influencing physical restraint intention from nurses’ perspective. Methods. A cross-sectional study was conducted among critical care nurses in China from February 2022 to March 2022. Results. The model showed a good model fit (χ2/df = 2.57, RMSEA = 0.07, GFI = 0.94, CFI = 0.89, and AGFI = 0.90). Attitude (β = 0.29, $p<0.05$ ), subjective norm (β = 0.25, $p<0.05$ ), and perceived behavioral control (β = 0.32, $p<0.001$ ) directly influenced the intention to use physical restraint in intubated patients. Ethical conflict (β = 0.04, $p<0.05$ ) indirectly influenced the intention. Conclusions. The study revealed that ethical conflict, attitude, subjective norm, and perceived behavioral control were positive predictors of physical restraint intention among intubated patients from nurses’ perspectives. Implications for Nursing Management. This provides a theoretical perspective to develop effective interventions to reduce physical restraints in critical care settings. Nursing managers should enhance ethical education and physical restraint knowledge and skill training.