Development and psychometric testing of the Mechanical Restraint Questionnaire (MR-Q): a pilot study

Abstract Background The use of mechanical restraints (MR) in acute mental health care can cause unexpected effects on patients, such as physical injury and mental trauma, thus MR requires continuous clinical assessment and decision-making before, during, and after mechanical restraint episodes. Despite the importance of these processes, few validated instruments are available to assess health care professionals’ perceptions of restraint-related assessments during the implementation of mechanical restraints. Therefore, this pilot study aimed to develop the Mechanical Restraint Questionnaire (MR-Q) and examine its psychometric properties. Methods A cross-sectional study was conducted. The MR-Q, a self-report questionnaire designed to assess nurses’and ward staff members’perceptions of assessments related to the use of mechanical restraint, consisted of 61 items. Item development was informed by individual interviews, a clinical guideline, and a literature review. Of the 61 items, 26 addressed the practice environment and 35 addressed the caring process. Data were collected from 69 nurses and word staff working in acute mental health wards in Norway. Parallel analysis (PA), visual inspection of the scree plot and exploratory factor analysis (EFA) were performed to examine the questionnaire’s underlying factor structure. The psychometric properties of the MR-Q were further assessed through face validity, content validity, construct validity, and reliability testing of the identified subscales. Results The PA suggested a possible six-factor solution, whereas the EFA extracted two dimensions with three factors in each dimension, respectively six factors. Three factors covered the practice environment, and three factors covered the caring process. The factors accounted for 69.3% of the total variance in the practice environment and 52.0% of the total variance in the caring process. Conclusion The findings indicate evidence of an acceptable factor structure and acceptable to high internal consistency of the MR-Q as a measure of the perceptions of MR assessment. Some improvements and further investigation of the reliability and validity in a larger and heterogenous sample are needed.