Knowledge, Attitudes, and Practices of ICU Nurses Regarding Physical Restraint Use and Associated Factors: A Cross-Sectional Survey in Chongqing, China

Abstract

Abstract Background and Purpose: The care of patients in intensive-care units (ICU) typically involves the use of physical restraints (PR) to ensure patient safety and prevent harm. The levels of ICU nurses’ knowledge, attitude, and practice (KAP) on the use of physical restraints (PR) influence the application of such interventions. However, limited research has been conducted on the KAP of ICU nurses, highlighting the need for further investigation in this area. This study aimed to investigate the KAP levels of ICU nurses on PR use for patients and to analyze influencing factors to enrich this research field of ICU care and to address the research gap in Chongqing, China. Methods: A self-designed questionnaire was developed to assess the levels of ICU nurses' KAP on restraint use, and a total of 1,608 were distributed to readily accessible participants, mostly from secondary or tertiary hospitals, between November and December 2023 using a convenience sampling method. The survey data were processed and analyzed with SPSS 26.0. Linear regression analysis was conducted, with a p-value of less than 0.05 considered indicative of statistical significance. Results: A total of 1,425 questionnaires were collected, resulting in a valid response rate of 88.62%. The KAP scores for PR use differed significantly, with average scores of 8.88 ± 0.90, 31.94 ± 3.58, and 47.18 ± 3.73, respectively. Years of work experience significantly influenced ICU nurses’ knowledge of PR use. Attitudes were affected by work experience, professional title, ICU experience, and PR-related training. Practice was impacted by gender, work experience, and PR training at p-value less than 0.05. Implications for Practice: This study found that ICU nurses exhibited high levels of knowledge and practice, but moderate levels of attitude on PR application in clinical settings with various influencing factors. Increased attention from nursing decision-makers should be given to enhance the management and care practices related to PR use among ICU nurses. [Ethiop. J. Health Dev. 2025; 39(3)] Keywords: Physical restraint; knowledge, attitude, and practice (KAP); ICU nurses; influencing factors