Nurses’ knowledge, attitude and practices on use of restraints at State Mental health care setting: An impact of in-service education programme


  • Sreevani Rentala Dharwad Institute of Mental Health and Neurosciences
  • Sunanda Govinder Thimmajja Dharwad Institute of Mental Health and Neurosciences
  • Prashant Bevoor Dharwad Institute of Mental Health and Neurosciences
  • Raveesh Bevinahalli Nanjegowda Mysore Medical College



restraint, physical, psychiatric nursing, health knowledge, attitudes, practice


Objective. To evaluate the effectiveness of short-term in-service education program in improving nurse’s knowledge, attitude and self-reported practices related to physical restraint use.

Methods. A quasi-experimental one group pre-post study was conducted involving nurses working at a tertiary mental health care setting, Dharwad, India. We provided 3 consecutive days of intensive restraint management education (total 6 hours-two hours per day) with a follow-up assessment after one month. The standard questionnaires on knowledge, attitude and practice regarding physical restraints were used as tools for measuring the impact of in-service education program. The program was conducted for a group of five to six nurses at a time. Teaching was done using lecture method, group discussion and demonstrations.

Results. Of the 52 nurses who participated in the study, 52% were male, 58.5% had a baccalaureate degree. The mean age of respondents was 33.3 years, the mean work experience was 6.7 years. The findings of the study revealed that the mean scores on the knowledge regarding physical restraints increased after the in-service education from 6.4 to 8.2 (p<0.001). The mean attitude scores improved from 18.5 to 23.1 (p<0.001). There was a significant difference in mean practice scores between pre and post-intervention phases (23.7 versus 25.4; p<0.001). There was a significant correlation between post-test knowledge, attitude and practice scores.

Conclusion. The in-service education program improved nurse’s knowledge, attitude and self-reported practice scores. This may lead to more effective restraints management by psychiatric nurses.

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Author Biographies

Sreevani Rentala, Dharwad Institute of Mental Health and Neurosciences

Ph.D. in Nursing, Nursing professor. Email: Corresponding author

Sunanda Govinder Thimmajja, Dharwad Institute of Mental Health and Neurosciences

Ph.D. in Nursing, Assistant Professor. Email:

Prashant Bevoor, Dharwad Institute of Mental Health and Neurosciences

RN.RM. Nursing officer. Email:

Raveesh Bevinahalli Nanjegowda, Mysore Medical College

MD. Psychiatry. Professor and Head. Dept. of Psychiatry, Mysore Medical College, Mysore, India Email:


Çelik S, Kavrazlı S, Demircan E, Güven N, Durmuş Ö, Duran S. Information, attitudes and practices of intensive care nurses on the use of physical restrain. Acıbadem Univ. J. Health Sci. 2012; 3(3):176-83.

Tel H, Tel H. Application of physical retrain and nursing approach in patient safety-II. J. Intensive Care Nurs. 2002; 6(2):69-74.

Hendryx M, Trusevich Y, Coyle F, Short R, Roll J. The distribution and frequency of seclusion and/or restraint amongpsychiatric inpatients. J. Behav. Health Serv. Res. 2010; 37:272‐81.

Khastgir U, Kala A, Goswami U, Kumar S, Behera D. The nature and extent of the use of physical restraint and seclusion in psychiatric practice: Report of a survey. Indian J. Psychiatry. 2003; 45:155‐7.

Steinert T, Lepping P, Bernhardsgrütter R, Conca A, Hatling T, Janssen W, et al. Incidence of seclusion and restraint inpsychiatric hospitals: A literature review and survey of international trends. Soc. Psychiatry Psychiatr. Epidemiol. 2010; 45(9):889‐97.

Lai CK, Chow SK, Suen LK, Wong IY. The effect of a restraint reduction program on physical restraint rates in rehabilitation settings in Hong Kong. Rehabil. Res. Pract. 2011; 2011:284604.

Bowers L, Alexander J, Simpson A, Ryan C, Carr‐Walker P. Cultures of psychiatry and the professional socialization process: The case of containment methods for disturbed patients. Nurse Educ. Today 2004; 24:435‐42.

Almvik R, Rasmussen K, Woods P. Challenging behaviour in the elderly‐monitoring violent incidents. Int. J. Geriatr. Psychiatry. 2006; 21:368‐74.

Kane C. The 2014 Scope and Standards of Practice for Psychiatric Mental Health Nursing: Key Updates. Online J. Issues Nurs. 2015; 20(1):1.

Kalula SZ, Petros SG. Use of physical restraint in hospital patients: A descriptive study in a tertiary hospital in South Africa. Curationis. 2016;39(1):e1-e8. Published 2016 Nov 10. doi:10.4102/curationis.v39i1.1605

Karagözoğlu Ş., Özden D. Knowledge and practices of nurses working ata university hospital related to use of physical restraints. Hemar-G Derg. 2013;1:11–22.

Suen LK, Lai CK, Wong TK. Use of physical restraints in rehabilitation settings: staff knowledge, attitudes and predictors. J. Adv. Nurs. 2006; 55(1):20-8.

Eskandari F, Abdullah KL, Zainal NZ, Wong LP. Use of physical restraint: Nurses’ knowledge, attitude, intention and practice and influencing factors. J. Clin. Nurs. 2017; 26(23-24):4479-88.

Rentala S, Thimmajja SG, Nanjegowda RB, Bevoor P. Restraints practices among psychiatric nurses in state mental health‐care setting, Karnataka, India. Indian J. Psychiatr Nsg. 2019;16(2):98‐104

Mahmoud AS. Psychiatric Nurses’ Attitude and Practice toward Physical Restraint. Arch. Psychiatr. Nurs. 2017; 31(1):2-7.

Hasan AA, Abulattifah A. Psychiatric nurses’ knowledge, attitudes, and practice towards the use of physical restraints. Perspect. Psychiatr. Care. 2019; 55(2):218-24.

Al-Khaled T, Zahran E, El-Soussi A. Nurses’ related factors influencing the use of physical restraint in critical care units. J. Am. Sci. 2011; 7(8):13-22.

Mehrok S, Belsiyal CX, Kamboj P, Mery A. The use of physical restraints- knowledge and attitude of nurses of a tertiary care institute, Uttarakhand, India. J. Educ. Health Promoti. 2020; 9:77.

Koczy P, Becker C, Rapp K, et al. Effectiveness of a multifactorial intervention to reduce physical restraints in nursing home residents. J. Am. Geriatr. Soc. 2011; 59(2):333-9.

Lan SH, Lu LC, Lan SJ, et al. Educational intervention on physical restraint use in long-term care facilities -Systematic review and meta-analysis. Kaohsiung J. Med. Sci. 2017; 33(8):411-21.

Gandhi S, Poreddi V, Nagarajaiah, Palaniappan M, Reddy SSN, BadaMath S. Indian nurses’ Knowledge, Attitude and Practice towards use of physical restraints in psychiatric patients. Invest. Educ. Enferm. 2018; 36(1):e10.

Janelli LM, Scherer YK, Kuhn MM. Acute/critical care nurses’ knowledge of physical restraints--implications for staff development. J. Nurs. Staff Dev. 1994; 10(1):6-11.

Eskandari F, Abdullah KL, Zainal NZ, Wong LP. The effect of educational intervention on nurses’ knowledge, attitude, intention, practice and incidence rate of physical restraint use. Nurse Educ. Pract. 2018; 32:52-7.

Pradhan N, Lama S, Mandal G, Shrestha E. Physical restraining: Nurses knowledge and practice in Tertiary Care Hospital of Eastern Nepal. Nurs. Open. 2019; 6:1029–37

Wang L, Zhu XP, Zeng XT, Xiong P. Nurses’ knowledge, attitudes and practices related to physical restraint: a cross-sectional study. Int. Nurs. Rev. 2019; 66(1):122-9.



How to Cite

Rentala, S., Govinder Thimmajja, S., Bevoor, P., & Bevinahalli Nanjegowda, R. (2021). Nurses’ knowledge, attitude and practices on use of restraints at State Mental health care setting: An impact of in-service education programme. Investigación Y Educación En Enfermería, 39(1).




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