Supportive holding or restraint: terminology and practice.

Area of Science:

• Pediatric Nursing
• Childcare Practices
• Healthcare Ethics

Background:

• The distinction between supportive holding and restraint in pediatric nursing is a long-standing debate.
• Definitions vary, with supportive holding aiding therapeutic interventions and restraint used when a child poses a danger.
• Both practices are theoretically based on the child's best interest.

Purpose of the Study:

• To explore the demarcation between supportive holding and restraint in children's nursing.
• To analyze whether current terminology reflects distinct practices or a continuum of force.
• To discuss the implications of interchangeable use of terms like therapeutic holding and restrictive physical intervention.

Main Methods:

• Literature review and conceptual analysis of existing definitions and guidance.
• Examination of the philosophical underpinnings of supportive holding and restraint.
• Discussion of the Royal College of Nursing's suggested terminology (therapeutic holding and restrictive physical intervention).

Main Results:

• The study highlights the ongoing ambiguity in defining and differentiating supportive holding from restraint.
• It questions whether the proposed new terminology (therapeutic holding vs. restrictive physical intervention) clarifies practice or masks a continuum.
• The interchangeable use of terms by authors suggests a lack of clear demarcation in practice.

Conclusions:

• There is a need for clearer definitions and consistent terminology in pediatric nursing regarding physical holds.
• The distinction between therapeutic holding and restrictive physical intervention may be more about the degree of force than a fundamental difference in practice.
• Further research is needed to establish clear guidelines and differentiate practices to ensure child safety and therapeutic effectiveness.