'It is my turn to raise her' - Decision-making regarding physical restraint in home care in China: A descriptive qualitative study

Abstract

Background: The phenomenon of physical restraint applied to people with dementia in home care is receiving increasing interest from nursing scholars. Although family caregivers play key roles in caring for people with dementia, little is known regarding the ways in which family caregivers make decisions with respect to physical restraint.

Objectives: The aim of this study was to explore Chinese family caregivers' decision-making regarding physical restraint in home care for persons living with dementia.

Design: A descriptive qualitative study was employed.

Methods: Using maximum variation sampling and purposive sampling, 18 family caregivers were recruited. Semistructured interviews were conducted in a memory clinic in northeast China between July 2020 and September 2020; the interviews were transcribed verbatim and analysed via thematic analysis.

Results: 'It is my turn to raise her' is a strong thread, which links three themes: (a) identifying culture-based family and filial ties; (b) maintaining culture-based family and filial ties; and (c) decision-making between belief and reality. The quote reflects the context of a Confucian and filial piety culture, which children care for their parents to repay the kindness of being provided an upbringing. Decisions based on this point are aimed at providing good personal care for people with dementia. Evaluating whether physical restraint is beneficial to people with dementia in general is an important factor in decisions regarding physical restraint. To repay the kindness of being provided an upbringing, children in the context of a Confucian culture cannot bear imposing physical restraint on their parents.

Conclusions: This qualitative study provides new insight into the substantial influence of culture on family caregivers' decision-making. Perpetuating Confucian culture and improving the home care system can help reduce the use of physical restraint for people with dementia at home.

Keywords: Decision-making; Dementia; Family caregiver; Physical restraint; Qualitative research.