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.

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. Plain language summary: Purpose: This article aims to critically analyse current literature that explores nurses' perspectives concerning the use of chemical restraints amongst people with dementia. It also aims to consolidate existing knowledge and generate a foundation for further research. Methods: This literature review followed the 12-step approach by Kable et al. A total of 17 articles were included following critical appraisal. Conclusions: Data were analysed to generate five emergent themes describing nurses' approaches to treating behavioural and psychological symptoms of dementia, perceptions and use of chemical restraints and non-pharmacological approaches, and the influence of workplace culture and personal perceptions on their treatment choices. Implications: External and internal pressures to prescribe and utilise chemical restraints exerted by nurses and families promote the use of chemical restraints; amplified by barriers to using alternative approaches. A visual model was proposed to explain these emergent concepts and relationships between them. Limitations: The search limits of English-only articles may have introduced bias into the study, although this allows primarily Western medicine to be analysed, increasing generalisability in this culture. It is also notable that there may be response bias in the results from the respondents conveying perceptions that they believed to be correct rather than what they actually thought. [ABSTRACT FROM AUTHOR]