La contención mecánica en los cuidados del paciente con trastorno mental: Una aproximación conceptual y crítica

Abstract

BACKGROUND: Psychomotor agitation is practically the only emergency in psychiatry. Its psychotherapeutic approach is directed towards the containment of this behaviour through verbal de-escalation, pharmacological containment, isolation and mechanical restraint. This last one consists in restricting the person's movements through marketed straps for this application which objective is to avoid any harm towards himself/herself or towards third parties. Although mechanical restraint requires medical indication, nursing professionals are in many cases the ones who must decide whether they start or not this process. AIM: To describe the concept of mechanical restraint in its context of mental health, to critically analyse its application and to reveal its impact on the nursing professional. METHODS: A concept analysis was carried out through a review of literature on the subject. RESULTS: The utility of a mechanical restraint alone has not been proven as it is a technique that is ultimately used, and it can result in feelings of frustration and guilt in the professional. The decision to contain or not a patient, despite of being taken for the safety of that patient and third parties, is not exempt from generating conflicts in the professional since it can harm the therapeutic relationship established so far. CONCLUSIONS: There exist several interventions aimed at reducing the use of mechanical restraints, but training professionals on handling conflicts and its de-escalation will undoubtedly be key to provide them with the tools to handle these tense situations effectively.