Julia Belinda Poncela-Díaz 1, 2
Melanie Pacheco-Nunes 3, 4
Elena Giménez-Gironda 5, 6
Lucia Gállová 7

1 Faculty of Health Sciences (Nursing), University of La Laguna (ULL)
2 Master´s Degree in ER Critical Care and Emergency Nursing, University of Granada (UGR)
3 Faculty of Philosophy and Letters (Philosophy), University of Granada (UGR)
4 Master’s Degree in Bioethics, Valencian International University (VIU)
5 Faculty of Medicine, University of Valencia (UV)
6 San Cecilio Clinical University Hospital (Granada)
7 Faculty of Health Sciences (Physiotherapy), University of Granada (UGR)

Translated by:

Sabrina Cherif-Aneche 8
Pablo Tocino-López 8
María Campos-García 8
Mercedes Barrera-Bautista 8
Leila Barakat-Ignacio 8

8 Faculty of Translation and Interpreting, University of Granada (UGR)


Introduction
Mechanical restraint (MR) is a fairly common practice despite the controversy surrounding its negative effects and the bioethical dilemmas it raises. The objective of this review is to determine the prevalence and effects of MR in patients, as well as the ethical dilemmas that its use poses for healthcare professionals, while shedding light on prevention and alternative techniques derived from efforts to reduce its use.

Methodology
A systematic search was performed from 2012 to the present in three databases: PubMed, Web of Science and Scopus. Studies related to the health field and to the effects, prevention and alternatives to MR were selected. Excluded studies were: systematic reviews, qualitative studies, studies tested in animals, studies in a language other than English or Spanish, unfinished studies and studies without online full-text access.

Results
Of 115 records found, 20 studies that met the established eligibility criteria were included. The negative effects go from loss of autonomy to risk of pulmonary thromboembolism. The most commonly used methods of prevention and reduction of MR include professional training, multidisciplinary work and individualized treatment plans. The implementation of new strategies based on the use of electronic systems for early identification of risk factors could contribute to prevent MR, although further studies are needed.

Conclusions
Past studies focused mainly on the effects of MR, whereas more recent studies show a clear focus on MR reduction and prevention. The number of new articles on the use of MR is limited due to emerging topics.

Keywords: mechanical restraint, effects, procedures, therapies.



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