Résumé
The use of physical restraint as an intervention in the care of psychiatric patients dates back to the beginning of psychiatry. Although it is a challenging question, it is still one of the common procedures in psychiatry. Considering that very little research has been done in Iran in relation to physical restraint, this qualitative study aimed to investigate the experiences of nurses working in psychiatric wards regarding physical restraint. This qualitative study was done on 14 nurses working in the psychiatric hospitals of Ahvaz city, southern Iran, during 2011-2012. The participants were selected by purposive sampling. Semistructured interviews were used for data collection, which were continued until data saturation and emergence of themes. Inductive content analysis was used to analyze the data. Four categories emerged: [1] Restraint as a multi-purpose procedure, [2] Processing of physical restraint, [3] Restraint as a challenging subject and [4] The effects of restraint on the spectrum. Each category has several different sub-categories. The participants described using physical restraint as one of the main strategies to control psychiatric patients, and despite having negative consequences, it is extensively used. Given the risks and challenges of using physical restraint, nursing education should find alternative methods.
Résumé
Assessment of patient's needs is the first step for recognizing problems and prevention of complications. Assessment tools are needed in order assess needs, and plan nursing care to prevent complications such as diabetic foot ulcer .The purpose of the present study was to develop self-care requisites assessment tool for prevention of diabetic foot ulcer and examine its validity and reliability. This methodological study consisted of two phases, phrase I was development of the comprehensive assessment form, for which a qualitative study and a literature review was conducted. Phase 2consisted of testing the instrument for validity and reliability. In qualitative study unstructured interviews were conducted with 8 patients with type 2 diabetes. Validity of the instrument was measured by content validity, concurrent validity [criterion related validity] and construct validity. A sample of 153 type two diabetic patients were selected to conduct factor analysis of the tool. Reliability was confirmed by internal consistency. Data were analyzed by SPSS statistical software. The initial form consisted of 103 items. Final version of self-care requisites assessment form for preventing diabetic foot ulcer consisted of 43 items with 5 sub scales. Validity was established for content, construct and concurrent validity. Content validity was assured by a panel of experts .Concurrent validity was measured by comparing the scores from assessment tool with self-care agency and diabetic clients' quality of life scales, which demonstrated an acceptable correlation among the scores. Internal consistency reliability of the tool was demonstrated with Cronbach's a coefficient ranged from 0.70 to 0.89 for subscales, the overall test re test reliability was 0.97. The self-care requisite assessment tool for prevention of diabetic foot ulcer is a reliable and valid instrument to measure self-care needs for prevention of diabetic foot among individuals with type two diabetes mellitus