The decision-making process leading to the use of home physical restraints: A qualitative study

Background Physical restraint is used in residential care despite not being recommended. Decision is influenced by patient characteristics, healthcare provider attitudes, with families often viewing it as a protective tool. Limited research on home care underscores the need for awareness and informed, collaborative decision-making to balance safety, autonomy, and quality of life. Methods . A qualitative descriptive study was conducted in a primary care setting in northern Italy, to explore the use of physical restraint and the decision-making process that led to its use in home care. Twenty-five nurses employing in the involved department were recruited via convenience sampling. Data were gathered through face-to-face interviews using a semi-structured guide. Data were analysed using thematic analysis. Results . Use of physical restraint in home care aims to ensure patient safety, autonomy, and support caregiver respite. Decision to use physical restraint are influenced by 1) meanings and purposes of restraint, (2) patient-related factors, (3) caregiver role and needs, (4) nurse–caregiver negotiation, and (5) balancing risks, benefits, and alternatives. Conclusion . The study highlights the complexity of physical restraint use in home care, where professional responsibility must balance with family roles and patient well-being. Supporting nurses through training, guidelines, and communication is essential to ensure patient safety and family well-being.