Knowledge, Attitudes, and Practices toward Physical Restraints among Intensive Care Unit Nurses: A Cross-Sectional Study

The present study aims to identify the level of nurses' knowledge, attitudes, and practices toward physical restraints and their associated factors, as well as determine the relationship between the level of nurses' knowledge, attitudes, and practices regarding physical restraint in ICUs in Jordan.

This cross-sectional study was conducted across intensive care units of four hospitals in Jordan during two months (January-February 2025). A cohort of 66 registered nurses was recruited. Participants' knowledge, attitudes, and practices regarding the use of physical restraints were assessed using the validated Acute/Critical Care Nurses' Knowledge of Physical Restraints Questionnaire. A multiple linear regression was conducted to identify factors influencing nurses' knowledge, attitudes, and practices toward physical restraints. Pearson correlation was used to assess the relationships among knowledge, attitude, and practice scores, with statistical significance set at p < 0.05 and a 95% confidence interval.

Nurses demonstrated moderate levels of knowledge (11.2 ± 3), generally positive attitudes (31 ± 3.6), and moderate compliance with recommended physical restraint practices (22.7 ± 0.09). Reading about physical restraints emerged as a significant predictor (B=3.475, SE=1.064, β= 0.392, p = 0.002), indicating that nurses who had read about physical restraints scored higher on the practice scale. Knowledge was positively correlated with attitude scores (r = 0.627, p < 0.001).

The findings underscore the need for targeted, ICU-specific educational interventions designed to enhance nurses’ knowledge and attitudes toward the use of physical restraints.

Key findings reveal moderate knowledge and practice levels, with notable gaps in safety protocols and alternative interventions, reflecting patterns observed across multiple countries worldwide. Notably, we identified a positive relationship between knowledge and attitude, although this finding remains contested in the literature, suggesting that contextual influences require further investigation. The reliance on convenience sampling and the small sample size limit the generalizability of the findings, as the sample may not fully represent the broader population of healthcare professionals. Future research should investigate the effectiveness of targeted educational interventions in enhancing nurses' knowledge, attitudes, and ethical practices related to the use of physical restraints.