{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T07:00:54Z","timestamp":1790060454723,"version":"4.0.1"},"reference-count":57,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T00:00:00Z","timestamp":1787529600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T00:00:00Z","timestamp":1787529600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100023890","name":"Department of Nursing, Emma Eccles Jones College of Education and Human Services","doi-asserted-by":"publisher","award":["KLHL2024AA03"],"award-info":[{"award-number":["KLHL2024AA03"]}],"id":[{"id":"10.13039\/100023890","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Nursing in Critical Care"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Physical restraint is still common in Chinese intensive care units, especially for mechanically ventilated patients and those with invasive devices. Inappropriate use causes considerable physical and psychological harm. Despite global efforts to minimise restraint, systematic research on standardised assessment and management frameworks for restraint reduction in domestic ICUs is lacking.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>This study aimed to explore the influencing factors of nurses' implementation of minimising physical restraint and identify key pathways for optimising clinical restraint management practices.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Design<\/jats:title>\n                    <jats:p>This exploratory sequential mixed\u2010methods study (Qualitative\u2192Quantitative) was conducted from July to November 2024 and recruited ICU nurses from three Grade 3 Class A tertiary hospitals, the highest hospital tier in southern China. Qualitative data from semi\u2010structured interviews were analysed using Colaizzi's phenomenological method. The core themes identified were then operationalised as antecedent conditions for fuzzy\u2010set qualitative comparative analysis (fsQCA). Only frontline bedside nurses were included in the fsQCA dataset, as they are the staff directly applying physical restraints. All procedures follow the MMARS (JARS\u2010Mixed) and GRAMMS reporting standards for mixed\u2010methods research.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Six key themes emerged across patient, nursing and organisational levels. A single configurational pathway explained higher restraint removal rates (\u2265\u200950%, based on published Chinese ICU data): the synergy of patient cooperation and effective staffing, combined with lower device\u2010related concerns, less clinical experience and limited team communication (consistency\u2009=\u20090.89, coverage\u2009=\u20090.34).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This study proposes the delivery of targeted training in the assessment of patients' level of consciousness, optimised nurse\u2013patient ratio, improved physicians' and nurses' competence, and updated protocols to promote restraint minimisation in the ICU.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Relevance to Clinical Practice<\/jats:title>\n                    <jats:p>Identifying barriers and facilitators to minimal restraint enables nurses to develop targeted strategies that ensure a safer work environment and promote patient\u2010centred care.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/nicc.70628","type":"journal-article","created":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T04:36:39Z","timestamp":1787632599000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["<scp>ICU<\/scp>\n                    Nurse Perspectives on Influences of Minimal Physical Restraint Practices: A Mixed\u2010Methods Study"],"prefix":"10.1111","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-8159-2727","authenticated-orcid":false,"given":"Hui","family":"He","sequence":"first","affiliation":[{"name":"Intensive Care Unit 1 The First Affiliated Hospital of Sun Yat\u2010Sen University  Guangzhou China"},{"name":"School of Public Health Sun Yat\u2010Sen University  Guangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-2249-5811","authenticated-orcid":false,"given":"Jing","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Occupational and Environmental Health, School of Public Health Sun Yat\u2010Sen University  Guangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liping","family":"Bai","sequence":"additional","affiliation":[{"name":"Intensive Care Unit 1 The First Affiliated Hospital of Sun Yat\u2010Sen University  Guangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mengdi","family":"Zhang","sequence":"additional","affiliation":[{"name":"Intensive Care Unit 1 The First Affiliated Hospital of Sun Yat\u2010Sen University  Guangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-4464-8194","authenticated-orcid":false,"given":"Yu Chan","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Maternal and Child Health, School of Public Health Sun Yat\u2010Sen University  Guangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6370-3430","authenticated-orcid":false,"given":"Jing","family":"Liao","sequence":"additional","affiliation":[{"name":"Department of Medical Statistics and Epidemiology Sun Yat\u2010Sen University  Guangzhou China"},{"name":"Global Health Institute, School of Public Health, Institute of State Governance Sun Yat\u2010Sen University  Guangzhou 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