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An Application of the Theory of Planned Behavior to Predict the Intention and Practice of Nursing Staff Toward Physical Restraint Use in Long-Term Care Facilities: Structural Equation Modeling

Authors Wang J, Liu W, Zhao Q, Xiao M, Peng D

Received 25 November 2020

Accepted for publication 11 February 2021

Published 2 March 2021 Volume 2021:14 Pages 275—287

DOI https://doi.org/10.2147/PRBM.S293759

Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 2

Editor who approved publication: Professor Igor Elman


Jun Wang,1 Weichu Liu,2 Qinghua Zhao,1 Mingzhao Xiao,3 Daomei Peng4

1Department of Nursing, The First Affiliated Hospital of Chongqing Medical University, Chongqing, People’s Republic of China; 2Department of Gynecology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, People’s Republic of China; 3Department of Urology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, People’s Republic of China; 4The First Social Welfare Home of Chongqing, Chongqing, People’s Republic of China

Correspondence: Qinghua Zhao 1 Youyi Road, Chongqing, 400016, People’s Republic of China
Tel +8618602308866
Fax +023-89012206
Email [email protected]

Purpose: Understanding the factors that affect nursing staffs’ intention and practice of physical restraint (PR) on older adults help develop restraint-reduction programs. This study aimed to identify the relationship between the Theory of Planned Behavior (TPB) constructs and nursing staffs’ practice to use PR in long-term care (LTC) facilities.
Patients and Methods: A cross-sectional survey was conducted via convenience sampling among 316 nursing staff in six Chinese LTC facilities. PR-TPB questionnaire and the practice subscale of the Chinese version of the Staff Knowledge, Attitudes and Practices Questionnaire regarding PR were used to collect the data. Structural equation modeling (SEM) was used to examine the relationship between variables.
Results: The SEM fit well with the data (χ2/df =1.639, RMSEA = 0.045, CFI= 0.955, GFI=0.945). Attitude (β=0.536, P< 0.001) and perceived behavioral control (PBC) (β=0.139, P< 0.05) predicted intention (R2=0.359). PBC was a significant predictor of practice, with R2 accounting for 0.151.
Conclusion: TPB provided useful insight into better understanding nursing staffs’ PR practices, although it did not support all the TPB principles significantly. Prospective studies may be conducted to design and implement multi-component interventions based on TPB and explore the effectiveness of PR reduction in LTC facilities in-depth.

Keywords: physical restraints, nursing home, aged, the theory of planned behavior, nursing, China

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