{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,10]],"date-time":"2026-06-10T06:23:48Z","timestamp":1781072628530,"version":"3.54.1"},"reference-count":43,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2026,1,30]],"date-time":"2026-01-30T00:00:00Z","timestamp":1769731200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,1,30]],"date-time":"2026-01-30T00:00:00Z","timestamp":1769731200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Nursing in Critical Care"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The use of structured decision\u2010making tools is highly important in reducing subjectivity in physical restraint decisions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>The aim of this study was to observationally compare the effectiveness of two decision\u2010making tools in making physical restraint decisions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Design<\/jats:title>\n                    <jats:p>This descriptive, cross\u2010sectional and observational comparative study. The study included patients hospitalised in the intensive care unit (ICU). Each included patient was assessed twice\u2010daily (morning and evening) by one observer using the Restraint Decision Tree (RDT) and another observer using the Restraint Decision Wheel (RDW). Between\u2010group differences were examined using Mann\u2013Whitney U and Kruskal\u2013Wallis H tests, with post hoc comparisons presented through letter\u2010based notations adjacent to medians.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      In total, 105 patients were included. In the morning, patients were assessed with RDT vs. RDW as not restraint: 71% vs. 72.4%, as mitted\/alternative: 20% vs. 21.9% and restraint: 9% vs. 5.7%. In the evening, patients were assessed with RDT vs. RDW as not restraint: 68.6% vs. 72.4%, as mitted\/alternative: 18.1% vs. 22.9%, and restraint: 13.3% vs. 4.8%. Significant differences in total Glasgow Coma Scale scores were observed in both morning and evening assessments of the RDT and in the evening assessment of the RDW (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05). Moreover, a highly significant difference was found between prior restraint history and both morning and evening assessments of the RDT and the RDW (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Both decision\u2010making tools can be implemented by nurses in ICUs. The patient's level of consciousness and previous history of physical restraint are critical parameters affecting the restraint situation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Relevance to Clinical Practice<\/jats:title>\n                    <jats:p>The widespread use of evidence\u2010based, validated and objective decision\u2010making tools can support restraint decisions in ICUs. Considering factors such as delirium and level of consciousness in physical restraint decisions may promote patient\u2010centred clinical practice.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/nicc.70358","type":"journal-article","created":{"date-parts":[[2026,1,30]],"date-time":"2026-01-30T10:11:56Z","timestamp":1769767916000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["A Comparison of Restraint Decision Tools in Intensive Care Unit: An Observational Cross\u2010Sectional Study"],"prefix":"10.1111","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1257-2551","authenticated-orcid":false,"given":"\u00d6zlem","family":"Do\u011fu","sequence":"first","affiliation":[{"name":"Faculty of Health Sciences, Nursing Department, Fundamentals of Nursing Sakarya University  Sakarya Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1214-9625","authenticated-orcid":false,"given":"Ramazan","family":"Bozkurt","sequence":"additional","affiliation":[{"name":"Faculty of Health Sciences, Nursing Department, Fundamentals of Nursing Sakarya University  Sakarya Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0175-2303","authenticated-orcid":false,"given":"Nasibe Ya\u011fmur","family":"Ziyai","sequence":"additional","affiliation":[{"name":"Faculty of Health Sciences, Nursing Department, Fundamentals of Nursing Sakarya University  Sakarya Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-5115-383X","authenticated-orcid":false,"given":"Hatice K\u0131l\u0131\u00e7k\u0131ran","family":"Do\u011fan","sequence":"additional","affiliation":[{"name":"Faculty of Health Sciences, Nursing Department, Fundamentals of Nursing Van Y\u00fcz\u00fcnc\u00fc Y\u0131l University  Van Turkey"},{"name":"Institute of Health Sciences, Fundamentals of Nursing Doctorate Program Ataturk University  Erzurum Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9822-4031","authenticated-orcid":false,"given":"Kezban \u00d6zmen","family":"S\u00fcner","sequence":"additional","affiliation":[{"name":"Department of Intensive Care Sakarya University Training and Research Hospital  Sakarya Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6994-397X","authenticated-orcid":false,"given":"Ali Fuat","family":"Erdem","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology and Reanimation Sakarya University Training and Research Hospital  Sakarya Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,1,30]]},"reference":[{"issue":"1","key":"e_1_2_15_2_1","first-page":"34","article-title":"Chemical and Physical Restraint Use in the Older Person","volume":"3","author":"Agens J. 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