DETERMINANTS OF PHYSICAL RESTRAINT USE AMONG NURSES: A REGRESSION ANALYSIS OF KNOWLEDGE, ATTITUDES, AND PERSPECTIVES AT MATHARI HOSPITAL

Abstract

Introduction: This study investigated factors influencing physical restraint use among nurses at Mathari Hospital, Kenya, focusing on knowledge, attitudes, and perspectives as potential determinants. Method: A descriptive cross-sectional study was conducted among 52 nurses directly involved in patient care. Data were collected using a self-administered semi-structured questionnaire assessing knowledge, attitudes, perspectives, and physical restraint use. Descriptive statistics summarized participant characteristics and study variables, while bivariate analysis and linear regression examined relationships between predictors and restraint use. Results: Most nurses demonstrated knowledge of physical restraints and their purpose (92.3%), and 78.8% knew different restraint types. However, only 11.5% reported knowledge of formal necessity assessment before applying restraints. Regression findings indicated that knowledge did not significantly predict physical restraint use (p = 0.059). Attitudes, however, significantly predicted restraint use (p = 0.044). The positive regression coefficient showed that nurses with more favorable attitudes toward restraints were more likely to report higher restraint use scores. Conclusions: Attitudes, rather than knowledge, emerged as the key determinant of physical restraint use among nurses at Mathari Hospital. The findings suggest that increasing knowledge alone may not reduce restraint use. Instead, interventions should address underlying attitudes and decision-making processes. Continuous professional development, targeted training on restraint assessment, promotion of non-restraint alternatives, and reinforcement of ethical psychiatric nursing practices are recommended. These measures could improve patient safety, support evidence-based care, enhance clinical judgment, and encourage more appropriate restraint-related decisions overall.