La restricción y el aislamiento mostrados a través de imágenes publicadas en Twitter: ¿Cuáles son las implicaciones para los profesionales de la salud?

Objective: To map areas of discussion about use of seclusion and restraint in healthcare, as expressed in motifs posted on Twitter. Materials and method: We adopted a qualitative approach with an archival and cross-sectional observational design. 188 images from Twitter postings were analyzed. Results: Five categories were identified: Informative and educational messages; Equipment as artifacts; Spatiality; The restrained subjects; Sociopolitical connotations of restraint. Conclusions: Based on our results we conclude that La restricción y el aislamiento mostrados a través de imágenes publicadas en Twitter: ¿Cuáles son las implicaciones para los profesionales de la salud?


Healthcare Settings
The working life of healthcare professionals who care for patients with different kinds of cognitive impairments is Documentation on the prescription of and indications for use of restraint was also poor.
A systematic review by Goethals et al. (2013) showed that nurses' decision-making process for use of physical restraint could be

Hidden Settings
During the past decades, social media, e.g., Twitter, have increasingly been used to discuss, reflect on and highlight different kinds of healthcare sector contexts and subject areas (Dyson et al., 2017;Hawkins et al., 2016;Hswen et al., 2017).

MATERIAL AND METHODS
The present study is part of a larger project aimed at theorizing seclusion and restraint in healthcare. In the study, we accessed data that were freely available from Twitter postings, also called tweets. In planning the study, we adopted a qualitative approach with an archival and crosssectional observational design. Based on our inflections. The main keywords were "restraint", "hospital", "nurse", "seclusion", and "coercion", and the full combinations of keywords (N=112) are displayed in (Table   1). We chose to limit the data collection to

Data Analysis
In the first step, we constructed a matrix consisting of several columns to work with the data. The columns in the matrix  (Patton, 2002).

Ethical Considerations
The present study is not considered human subjects research, as only information that was freely accessible on the Internet was collected. Furthermore, no interaction took place between the researchers and the profiles responsible for the tweets. We argue for the ethical responsibility of conducting this research in order to describe how the issues of seclusion and restraint are being discussed in social media.

Manifestation of Equipment as artifacts
The many and varying images within this category show how seclusion and restraint were characterized by objects: handcuffs, beds, chairs, belts, straight jackets, etc. (#28, #30, #85). One feature of the images in this category was that objects were in focus, rather than subjects.
Sometimes an arm could be part of the picture or an ankle, even a torso (#149, #161). One image showed "soft handcuffs" used to restrain self-harming persons (#131).
Although some of the photos included people, the focus was on objects, for  Hence, we view sharing stories of these kinds as a way to support scrutiny of an activity that is often closed to outside observation. These kinds of postings may send signals to healthcare that cases of overuse of restraint or misconducts are being reported and shared globally via social media, as though through a panoptic eye.
When images of equipment were shared, there were several associations with sex.
Initially, we considered these images irrelevant to our purpose and research questions. However, after deciding to analyze these as well and not dismiss them in the first round, we found they should be included. Although professionals who practice restraint do not (or should not) associate it with sexuality, it is apparent from the data that people in general may make that connection. Hence, we believe it is necessary for professionals to bear in mind that those who become the subjects of restraint might make such associations and fear they will also be victims of sexual harassment. We recommend that professionals reflect upon these potential issues, as many people have been sexually There are several methodological issues regarding research on social media, even so it has come to have a tremendous

Declaration of Conflicting Interests
The Authors declares that there is no conflict of interest.

Funding
This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.