A Structured Literature Review of Nurses’ Perceptions Concerning the Use of Chemical Restraints Amongst People with Dementia and the Perceived Barriers to Non-Pharmacological Approaches

Abstract

This article aims to critically analyse current literature that explores nurses’ perspectives concerning the use of chemical restraints amongst people with dementia—regarding behavioral and psychological symptoms of dementia (BPSD)—to consolidate existing knowledge on this phenomenon and generate a foundation for further research. This literature review followed the 12-step approach by Kable et al. A total of 17 articles published between 2012 and 2022 were included following critical appraisal. A total of 2,806 participants, primarily consisting of nurses of various levels (44%) were included amongst the 17 included articles. Five themes emerged from the analysis of the findings: (a) nurses’ perceptions of BPSD, (b) perceived effectiveness and safety of chemical restraints, (c) influence of the practice environment, (d) perceptions of non-pharmacological approaches (NPA)s, and (e) barriers to using NPAs. Explicit and implicit pressures to prescribe and utilize chemical restraints exerted by nurses and families promote the use of chemical restraints, amplified by barriers to using alternative approaches. A tentative conceptual model was proposed to explain these emergent concepts and relationships between the themes.