Physical Restraint in Chinese Mental Health Settings: A Multi-Perspective Interpretative Phenomenological Analysis of Patients' and Healthcare Professionals' Experiences

Abstract

Physical restraint is a highly controversial intervention in psychiatric nursing. While the prevalence and policies of physical restraint vary significantly worldwide and across China's diverse regional healthcare systems, the overall rate in Chinese mental health settings remains notably higher. However, the lived experiences and cognition of both patients with mental disorders and healthcare professionals remain underexplored in existing literature. This study adopted a multi-perspective interpretative phenomenological analysis to investigate the experiences, perceptions, and relational tensions regarding physical restraints among inpatients and healthcare professionals in Chinese mental health settings. A total of 21 participants were recruited from a mental health hospital in Shanghai, comprising nine patients with mental disorders in the recovery phase, seven mental health nurses, and five psychiatrists. In-depth semi-structured interviews were conducted individually with all participants to explore their lived experiences, perceptions, and perspectives related to physical restraint. The interview transcripts were analysed using multi-perspective interpretative phenomenological analysis (IPA). Three themes were extracted: (1) embodied experiences during physical restraint, (2) cognitive biases arising from diverse perspectives, and (3) the trust crisis and reconstruction between healthcare professionals and patients. Physical restraint in Chinese mental health settings is shaped by a complex interplay of power, culture and resource factors. To achieve a balance between safety and patient dignity, it is imperative to enhance communication, implement trauma-informed care and establish support systems.