A hermeneutic inquiry into adult acute mental health nurses’ experience of physical restraint procedures and their intervention using forced touch with patients

  • Jillian Bailey

Student thesis: Doctoral Thesis


Background: In the UK, adult acute mental health nurses use forced touch during physical restraint interventions. Forced touch refers to the quality of the physical force nurses use to restrict patients’ movement. There are few recent UK studies into nurses’ experiences of physical restraint. In particular, the meanings nurses give to forced touch appears to be missing from the literature.

Aim: The aim was to explore nurses’ experience of physical restraint procedures and specifically, to inquire into nurses’ experience of forced touch during physical restraint interventions. The research also aimed to provide a critical reflection of the notion of ‘physical restraint’ and ‘forced touch.’

Methods: A Heideggerian hermeneutic phenomenological approach was used to collect and analyse data from 14 nurses who engaged in semi-structured interviews with the researcher.

Findings: The overarching interpretation of nurses’ experience of physical restraint procedures was lived inconsistency represented in three major themes: lived moral inconsistency, lived knowledge inconsistency and lived care inconsistency. The nurses’ experience of the procedure included their moral struggles with their role in restraint and a perceived lack of care in the aftermath. Their experience of forced touch illuminated their preference for grasping different parts of the patient’s body and their experience of intimacy. They recalled a complex sequence of touches including forced, gentle, protective and compassionate touches.

Discussion and implications: Implications for practice include the importance of re-orientating restraint training towards a conceptualisation of touch to connect nurses with the meaning of bodily contact during restraint, and the potential influence upon care. The provision of ward-based trainers will also support nurses more effectively in their restraint practice, and develop the nursing discourse of forced touch.

Research implications: Mental health nursing touch demands greater attention because patients are often vulnerable and lack social contact. It is important to understand how nurses learn to touch patients, their reactions to handling the body during physical restraint, and to understand the phenomenon in different cultures. Patients’ perceptions of being touched during physical restraint are essential if the nursing profession is to develop practice in this area.
Date of AwardJul 2015
Original languageEnglish
Awarding Institution
  • University of Portsmouth
SupervisorAnn Dewey (Supervisor), Heather MacKenzie (Supervisor) & Karen Burnell (Supervisor)

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