Carers' Lived Experience of Witnessing the Mechanical Restraint of Their Loved One: A Dialogical Narrative Approach.

BACKGROUND AND AIM: Mechanical restraint is the use of devices or equipment, such as bandages and ropes, to confine patients to a hospital bed, thereby restricting their movement. It is frequently employed in intensive care units to prevent falls and the removal of intravenous cannulas or other medical devices. Despite substantial empirical evidence of its adverse psychological and physiological effects, mechanical restraint remains a common practice, particularly among older adults experiencing delirium. Therefore, this dialogic narrative approach aimed to explore the lived experiences of a granddaughter witnessing the mechanical restraint of her beloved grandfather, who experienced delirium and was mechanically restrained on multiple occasions across two different hospitals.

METHODS: A descriptive qualitative design underpinned by social constructionism was employed, using multiple semi-structured interviews for data collection and a dialogic narrative approach to construct the granddaughter's narrative.

FINDINGS: This lived experience was conceptualised into five narratives: (1) Carers and the loved one, (2) Caring for the person, not the diagnosis, (3) Calling for the humanisation of ICUs, (4) Witnessing the tying up of my grandfather, (5) Exposing the status quo: Mechanical restraint as the first resort, and (6) Shattering the muscular man identity. The study used the Consolidated Criteria for Reporting Qualitative Research checklist.

DISCUSSION: The carer's narrative reveals compelling evidence of the complexity surrounding the use of mechanical restraint to control disturbing behaviours among elderly patients with delirium in ICU environments. Although many carers might relate this study to their lived experiences, the transferability of this dialogic narrative remains limited to Hana and her family context.