Dr Jenny O'neill1
1The Royal Children's Hospital, Parkville, Australia, 2The University of Melbourne, Parkville, Australia
Biography:
Jenny is a Clinical Nurse Consultant at The RCH’s Children’s Bioethics Centre and in Nursing Research. Jenny is a paediatric nurse with over 20 years’ experience in clinical, research and education roles. Her clinical background has largely been in adolescent health and with the Neurodevelopment and Disability department. Her research interests include health equity, difficult decision making in paediatrics, holding children for procedures and adolescent autonomy and consent.
Abstract:
Background:
Young people (YP) with anorexia nervosa (AN) admitted to paediatric hospital services for nutritional rehabilitation, a nasogastric tube (NGT) may be needed, and sometimes restraint is used to enable feeds to be administered. This situation is ethically complex, as this restrictive intervention can be considered medically necessary, but may result in long-term trauma for YP. We have limited understanding of the characteristics of YP requiring restraint in this context, or the lived experience of those involved.
Aim:
The aim of this presentation is to profile two research projects about restraint in YP with AN to generate reflective ethical discussion.
Methods:
The first project is a retrospective audit of the restraint practices and characteristics of YP admitted for the treatment of AN at our service 2021-2023. The second is a qualitative research project designed in collaboration with lived-experience advisors using semi-structured interviews of young adults who were restrained for feeding in adolescence, their parent/carers, and the staff involved.
Results:
The audit found that 11% of YP with AN in this audit were restrained for feeding. Young people restrained were likely to be more complex socially and clinically than those who were not restrained. Additionally, lived experience accounts supported the importance of trauma-informed individualised practice guiding decisions about restraint for feeding in AN.
Conclusion:
These projects prompt deep thinking about restraint in YP with AN, and the findings allow decision making to be evidence-informed, congruent with ethical principles and responsive to the legal structures to promote least restrictive practice in healthcare.