Physical restraint in mental health nursing: A concept analysis

Objective: Physical restraint is frequently used in medical services,such as in mental health settings,intensive care units and nursing homes,but its nature varies in different institutions.By reviewing related literature,this study aims to clarify the concept of physical restraint in mental health nursing.Method: Three databases (PubMed,PsyclNFO and CINAHL) were retrieved,and Walker and Avant's concept analysis method was used to analyze the concept of physical restraint in mental health nursing.Results: Physical restraint is a coercive approach that enables the administration of necessary treatment by safely reducing the patient's physical movement.It should be the last option used by qualified personnel.Antecedents of physical restraint are improper behavior (violence and disturbance) of patients,medical assessment prior to implementation and legislation governing clinical usage.Consequences of physical restraint are alleviation of conflict,physical injury,mental trauma and invisible impact on the institution.Discussion: This study defined the characteristics of physical restraint in mental health nursing.The proposed concept analysis provided theoretical foundation for future studies.

Physical restraints:An ethical dilemma in mental health services in China

Given that physical restraints cause adverse effects to patients and nurses,their wide and frequent use has resulted in various clinical and ethical controversies in mental health services.The rate of physical restraints is significantly higher in China than in other countries.Some western and domestic media blamed relevant institutions for compromising the basic rights of psychiatric patients.Therefore,this study aims to collect and synthesize the relevant ethical evidence and to provide corresponding guidance for the nursing practice based on the current situation of the mainland of China.This study synthesized the ethical issue according to the ethical principle of autonomy,justice,beneficence,and nonmaleficence.Given the current situation where the nursing workforce is limited and the mental health service is under-developed in China,applying physical restraints in the psychiatric inpatients to guarantee the safety of patients and nurses is crucial.In regard to respect the basic rights of psychiatric patients,it is recommended to protect the their autonomy,and eliminate the adverse effects of physical restraint.This goal would be achieved by ensuring the informed consent,providing humane care,and regulating the implementation of physical restraints.

Clinical decision making on the use of physical restraint in intensive care units

Physical restraint is a common nursing intervention in intensive care units and nurses often use it to ensure patients'safety and to prevent unexpected accidents.However,existing literature indicated that the use of physical restraint is a complex one because of inadequate rationales,the negative physical and emotional effects on patients,but the lack of perceived alternatives.This paper is aimed to interpret the clinical decision-making theories related to the use of physical restraint in intensive care units in order to facilitate our understanding on the use of physical restraint and to evaluate the quality of decisions made by nurses.By reviewing the literature,intuition and heuristics are the main decision-making strategies related to the use of physical restraint in intensive care units because the rapid and reflexive nature of intuition and heuristics allow nurses to have a rapid response to urgent and emergent cases.However,it is problematic if nurses simply count their decision-making on experience rather than incorporate research evidence into clinical practice because of inadequate evidence to support the use of physical restraint.Besides that,such a rapid response may lead nurses to make decisions without adequate assessment and thinking and therefore biases and errors may be generated.Therefore,despite the importance of intuition and heuristics in decision-making in acute settings on the use of physical restraint,it is recommended that nurses should incorporate research evidence with their experience to make decisions and adequate assessment before implementing physical restraint is also necessary.

Development of Nursing Protocol for Preventing Discontinuation of Treatments by Methods Other than Physical Restraint during Acute Exacerbation of Chronic Heart Failure in Patients with Impaired Cognitive Function

The purpose of this study is to prepare a nursing protocol for preventing discontinuation of treatments using a method other than physical restraint during acute exacerbation of chronic heart failure in patients with impaired cognitive function. For the first stage of the study, we prepared a draft of the nursing protocol based on a basic survey. For the second stage, semi-structured interviews were conducted with 5 nurses specialized in chronic heart failure and 10 nurses in dementia case to ensure content validity of the draft protocol. For the third stage, we examined the possibility of clinical application of the revised version of the protocol draft prepared in the second stage of the study. For assessment items, significant points of nursing care, and specific nursing care practice in this revised version, 154 subjects (93.9%) considered effective for patients, in terms of prevention of treatment discontinuation using a method other than physical restraint. All items and contents were considered useful by more than 60% of the nurses. Considering that the nurses working in the clinical setting reported 93.9% of usefulness, we concluded that this nursing protocol remained valid at a certain level. We also received a comment from the certified nurses that we should include the basic contents for newly graduated nurses. We consider that this nursing protocol will be also useful for newly graduated nurses to acquire knowledge. It helped to standardize nursing care in order to predict potential risks for patients with impaired cognitive function.

Ethical Dilemma Factor in Regarding Physical Restraints to Elderly of Female Nurses with the Living Together Experience

Purpose: The aim of this study was to illuminate the connotation of “dilemma” regarding the use of physical restraint on elderly patients as represented by female nurses working in general wards at community hospitals who also live with elderly adults at home. Method: The study used the questionnaire method with an independently prepared questionnaire. Participants: The objective of the study was explained to the persons in charge of nursing in the selected 17 hospitals, and 1929. Finally, this study of participants were 524 female nurses working in general 54 wards (excluding the emergency wards of psychiatry, pediatrics, obstetrics, outpatients, operating rooms, and intensive care units) at community hospitals who also live with elderly adults at home. Results and conclusions: Cronbach’s overall coefficient for the 20 items of dilemma was high (0.78) and the factor analysis extracted four dilemma factors as having a characteristic value of 1 (Kaiser-Meyer-Olkin measure value = 0.81) with a cumulative contribution ratio of 64.5%. The high Cronbach’s for these items (0.86, 0.88, 0.87 and 0.81) confirmed the internal consistencies. With respect to the dilemma where nurses working in general wards at community hospitals who also live with elderly adults at home are faced with the physical restraint of elderly persons, four factors in the clarification of the dilemma were extracted: accomplishment of medical-treatment and accident prevention, characteristic features in nursing for elderly patients with dementia, healthcare professional relationship in nursing for elderly patients with dementia, and priorities on the accident prevention for elderly patients with dementia. Therefore, the construction of four systems to cope with these dilemmas is suggested. These systems would enable practising nurses to: (i) institution of policies to encourage discussion between nurses and other medical staff to reach consensus on treatment;(ii) allocating elderly care specialists to wards to promote alternatives to restraints;(iii) establishment of safety standards to define nurses’ responsibilities;and (iv) institution of continuous ethical education for nurses.

Dilemmas Faced by Nurses Regarding the Physical Restraint of Elderly Patients with Dementia in Japan

This study aimed to clarify the dilemma of nurses working in general wards who face the ethical dilemma of restraining older people with dementia in Midwestern Japan. The study used the questionnaire method with an independently prepared questionnaire. The questionnaire was designed to ensure privacy and anonymity. The privacy and anonymity of study participants was assured. Of the 340 survey questionnaires distributed, 291 (85.6%) completed surveys were eligible number (12 additional surveys were returned without answers). An explanatory factor analysis revealed four dilemma factors among 15 items investigated (KMO value 0.84). These were: factor 1: “Execution of treatment and security,” α = 0.91;factor 2: “approach in the nursing of older people with dementia,” α = 0.93;factor 3: “A cooperative relationship in nursing of older people with dementia,” α = 0.87;and factor 4: “Priorities in nursing,” α = 0.81. The cumulative contribution ratio was 79.1%. We suggest that the program would enable nurses to cope with these dilemmas.

Attitude and practice toward physical restraint among psychiatric nurses in Guangdong,China:a cross-sectional survey

Objective:To explore the correlation between nurses’attitude and practice toward physical restraint(PR)in psychiatric settings and identify the factors that influence the use of PR.Methods:A cross-sectional survey was conducted.A self-designed questionnaire containing a PR scale was used to assess the attitude and practice of registered psychiatric nurses in Guangdong,China,from November 1,2018 to December 31,2018.Descriptive statistics,the Mann–Whitney U test,the Kruskal–Wallis test,and ordinal regression analysis were used to analyze the data.Results:The response rate was 74.6%.The nurses’responses showed neutral attitude and a moderate level of practice regarding the use of PR.Factors such as age,gender,marital status,professional position,nightshift,and the frequency of training programs on PR showed a significant association with nurses’attitude and practice concerning PR(P<0.05).In addition to these factors,this study found that the practice of PR was associated with nurses’attitude toward it(P<0.05).Our results showed that nurses with a largely negative attitude toward PR were more likely to use it(OR=1.91,P<0.001).Conclusions:Clinically,psychiatric nurses with negative attitude are more likely to practice PR.Training and education programs are highly recommended for nursing managers to change the nursing staff’s attitude,since their attitude may have an impact on the PR what they practice.

Evaluation and analysis of the effect of continuing education on nurses’physical restraint knowledge,attitude,and behavior

Objective:The objective of the study is to construct a training course for physical restraint(PR)evidence‑based practice project and apply it to verify its effect.Methods:A total of 162 nurses from five departments of a general hospital in Beijing were trained to compare the PR knowledge,attitudes,and behaviors of nurses before and after training.Results:The nurses were satisfied with the overall curriculum;the total scores of PR’knowledge,attitude and behavior of nurses after training were higher than before,and the difference was statistically significant(P<0.05);the total scores of nurses who received evidence‑related training before this training were higher than those of nurses who did not receive relevant training,and the difference was statistically significant(P<0.05).Conclusion:Continuing education can effectively improve nurses’knowledge,attitude,and behavior level of PR,ensure patient safety,and promote physical and psychological rehabilitation of patients.

Improving ICU Nurses’ Practices of Physical Restraints in Jordan: Effect of an Educational Program

Background: Physical Restraint (PR) has been widely used in the intensive care units, which aims to protect patients and maintain their safety. With all benefits of PR, there are many complications and risks from improper utilization. Further, no Jordanian studies have found to educate nurses regarding the proper PR utilization. Purpose: To evaluate the impact of an educational program on nurses’ knowledge, attitude and practice regarding PR use in ICUs. Methods: A pre-experiment with one-group pretest-posttest design was used among 40 ICU nurses. A self-administered questionnaire was used to evaluate nurses before the education program and two weeks after its completion. Results: After implementation of the program, nurses demonstrated a significant difference in knowledge scores between pretest (M = 10.35 ± 1.73) and posttest (M = 13.30 ± 1.47) (t = 9.92;df = 39;P = 0.000), attitudes scores (M = 27.90 ± 2.79 vs. M = 30.40 ± 2.32) (t = 4.61;df = 39;P = 0.000), and practice scores (M = 36.85 ± 1.98 vs. M = 40.52 ± 1.60) (t = 11.59;df = 39;P = 0.000). Conclusion: Service-education program can improve ICU nurses’ knowledge, and enhance their attitudes and practices towards physical restraint. Such improvement is expected to be reflected in improving the quality of care delivered to the patients, and decreasing complications of malpractice regarding physical restraint.

Development of ethical dilemma scale Japanese nurse faced physical restraints to elderly patients with dementia

Purpose: This study aimed to develop an ethical dilemma scale for nurses faced with the use of physical restraint when caring for elderly patients with dementia. Methods: We used a previously established 20-item dilemma scale. The objective and method of the study were explained to the head of nursing at 17 selected hospitals, and 121 nurses working in the general wards of 14 hospitals (excluding emergency department wards of psychiatry, pediatrics, obstetrics, outpatients, operating rooms and intensive care units) who agreed to participate were enrolled in 2000. Seventy-six nurses from one of the hospitals were selected after eight years (2008) to provide a comparison. Ethical considerations: The study was conducted with the approval of the ethics committee at Meiji University of Integrative Medicine. Results and discussion: Four factors were compared between 2000 and 2008: “execution of treatment and security”, “characteristic features in nursing of elderly patients with dementia”, “cooperative relationship in nursing”, and “priorities in nursing”. The cumulative contribution ratio was 65.3% (KMO = 0.77, p = 0.000) in 2000 and 72.5% (KMO = 0.78, p = 0.000) in 2008. Therefore, the scale dilemma nurse faced physical restraints to elderly patients with dementia in Japan was developed 4 facoters from 17-delremmas items of 20 items.

Physical restraint use rate and total fall and injurious fall rates: An exploratory study in two US acute care hospitals

This exploratory study used archived hospital data to investigate the relationships between the percentage of patients with physical restraints and the total fall rate as well as the injurious fall rate per 1000 patient-days. The two tested research questions were 1) What is the relationship between the restraint use rate and the total fall rate? 2) What is the relationship between the restraint use rate and the injurious fall rate? The results showed that a higher restraint use rate was associated with a higher total fall rate, yet a lower injurious fall rate in adult inpatient acute care settings. In efforts for fall and injurious fall prevention, front-line managers need to balance the frequency and appropriateness of physical restraint use with optimizing patients’ physical activity. Future research should explore the cause–effect relationship between physical restraint use and consequent injurious fall incidents.

Physical restraint using,autonomy,ethics among psychiatric patients in nursing practice in China

The application of physical restraint for patients represents ethical dilemmas for psychiatric nurses in terms of maintaining the safety of all(clients and staff)while at the same time curtailing the individual’s autonomy.This article aimed to provide a sound knowledge of ethical positions and strategies for psychiatric nurses to address ethical issues of physical restraint according to the ethical principles of autonomy,beneficence,nonmaleficence,and ethical theories.Given that nursing workforce was limited and workload among psychiatric nurses was heavy,physical restraint was one of the coercive interventions managing aggressive behavior.In relation to address ethical dilemmas,it was proposed to acquire informed consent of physical restraint from the individuals and provide person‑centered care.Effective communication and negotiation with patients could help to strike a balance between patients’autonomy and nurses’accountability when using physical restraint.In addition,guidelines and targeted intervention strategies need to be developed to regulate and reduce the implementation of restraint.Finally,a collaboration among nurses,psychiatrists,and families is essential to protect patients’autonomy concerning physical restraint use.

The effects of ethical dilemmas regarding the use of physical restraints in eldercare on female nurses who care for their relatives in Japan

Purpose: This study sought to clarify the relationship between a nurse’s exposure to elderly relatives and their perspective in using restraints on the elderly in health care situations. Methods: We approached nursing staff supervisors at 17 general hospital wards and explained the objectives of the study. Supervisors at 14 hospitals agreed to participate, giving us a sampling pool of 1929 nurses. We used a chi square test to compare nurses who had spent time with elderly relatives and those who had not on several variables related to using restraints on elderly patients. Results and Conclusion: This study found that nurses who live with elderly family members were significantly more likely to believe that restraints cause diseases (including chronic diseases) based on a chi square test (p < 0.05). Therefore it would be important that essential was the experiences of individuals with elderly family members when making programs of decreasing nurse’s dilemma to restraining the elderly.

Adverse events related to physical restraint use in intensive care units: A review of the literature

Physical restraints are widely used and accepted as protective measures during treatment in intensive care unit (ICU). This review of the literature summarizes the adverse events and outcomes associated with physical restraint use, and the risk factors associated with their use during treatment in the ICU. The PubMed, Scopus, and Google Scholar databases were screened using predefined search terms to identify studies pertaining to adverse events and/or outcomes associated with physical restraint use, and the factors associated with their use in adult patients admitted to the ICU. A total of 24 articles (including 6126 patients) that were published between 2006 and 2022 were identified. The described adverse events associated with physical restraint use included skin injuries, subsequent delirium, neurofunctional impairment, and a higher rate of post-traumatic stress disorder. Subsequent delirium was the most frequent adverse event to be reported. No alternative measures to physical restraints were discussed, and only one study reported a standardized protocol for their use. Although physical restraint use has been reported to be associated with adverse events (including neurofunctional impairment) in the literature, the available evidence is limited. Although causality cannot be confirmed, a definite association appears to exist. Our findings suggest that it is essential to improve awareness regarding their adverse impact and optimize approaches for their detection, management, and prevention using protocols or checklists.

2024 Adult Compendium of Physical Activities:A third update of the energy costs of human activities

Background:The Compendium of Physical Activities was published in 1993 to improve the comparability of energy expenditure values assigned to self-reported physical activity(PA)across studies.The original version was updated in 2000,and again in 2011,and has been widely used to support PA research,practice,and public health guidelines.Methods:This 2024 update was tailored for adults 19-59 years of age by removing data from those≥60 years.Using a systematic review and supplementary searches,we identified new activities and their associated measured metabolic equivalent(MET)values(using indirect calorimetry)published since 2011.We replaced estimated METs with measured values when possible.Results:We screened 32,173 abstracts and 1507 full-text papers and extracted 2356 PA energy expenditure values from 701 papers.We added303 new PAs and adjusted 176 existing MET values and descriptions to reflect the addition of new data and removal of METs for older adults.We added a Major Heading(Video Games).The 2024 Adult Compendium includes 1114 PAs(912 with measured and 202 with estimated values)across 22 Major Headings.Conclusion:This comprehensive update and refinement led to the creation of The 2024 Adult Compendium,which has utility across research,public health,education,and healthcare domains,as well as in the development of consumer health technologies.The new website with the complete lists of PAs and supporting resources is available at https://pacompendium.com.

Association between physical activity and risk of gastroesophageal reflux disease:A systematic review and meta-analysis

Background:Lifestyle plays an important role in preventing and managing gastroesophageal reflux disease(GERD).In response to the conflicting results in previous studies,we performed a systematic review and meta-analysis to investigate this association.Methods:Relevant studies published until January 2023 were retrieved from 6 databases,and the prevalence of symptomatic gastroesophageal reflux(GER)or GERD was determined from the original studies.A random effects model was employed to meta-analyze the association by computing the pooled relative risk(RR)with 95%confidence intervals(95%CIs).Furthermore,subgroup and dose-response analyses were performed to explore subgroup differences and the association between cumulative physical activity(PA)time and GERD.Results:This meta-analysis included 33 studies comprising 242,850 participants.A significant negative association was observed between PA and the prevalence of symptomatic GER(RR=0.74,95%CI:0.66-0.83;p<0.01)or GERD(RR=0.80,95%CI:0.76-0.84;p<0.01),suggesting that engaging in PA might confer a protective benefit against GERD.Subgroup analyses consistently indicated the presence of this association across nearly all subgroups,particularly among the older individuals(RR_(<40 years):RR_(≥40 years)=0.85:0.69,p<0.01)and smokers(RR_(smoker):RR_(non-smoker)=0.67:0.82,p=0.03).Furthermore,a dose-response analysis revealed that individuals who engaged in 150 min of PA per week had a 72.09%lower risk of developing GERD.Conclusion:Maintaining high levels of PA decreased the risk of GERD,particularly among older adults and smokers.Meeting the recommended PA level of 150 min per week may significantly decrease the prevalence of GERD.

Alexa,let's train now!——A systematic review and classification approach to digital and home-based physical training interventions aiming to support healthy cognitive aging

Background:There is mounting evidence that regular physical activity is an important prerequisite for healthy cognitive aging.Consequently,the finding that almost one-third of the adult population does not reach the recommended level of regular physical activity calls for further public health actions.In this context,digital and home-based physical training interventions might be a promising alternative to center-based intervention programs.Thus,this systematic review aimed to summarize the current state of the literature on the effects of digital and home-based physical training interventions on adult cognitive performance.Methods:In this pre-registered systematic review(PROSPERO;ID:CRD42022320031),5 electronic databases(PubMed,Web of Science,Psyclnfo,SPORTDiscus,and Cochrane Library)were searched by 2 independent researchers(FH and PT)to identify eligible studies investigating the effects of digital and home-based physical training interventions on cognitive performance in adults.The systematic literature search yielded 8258 records(extra17 records from other sources),of which 27 controlled trials were considered relevant.Two reviewers(FH and PT)independently extracted data and assessed the risk of bias using a modified version of the Tool for the assEssment of Study qualiTy and reporting in EXercise(TESTEX scale).Results:Of the 27 reviewed studies,15 reported positive effects on cognitive and motor-cognitive outcomes(i.e.,performance improvements in measures of executive functions,working memory,and choice stepping reaction test),and a considerable heterogeneity concerning study-related,population-related,and intervention-related characteristics was noticed.A more detailed analysis suggests that,in particular,interventions using online classes and technology-based exercise devices(i.e.,step-based exergames)can improve cognitive performance in healthy older adults.Approximately one-half of the reviewed studies were rated as having a high risk of bias with respect to completion adherence(≤85%)and monitoring of the level of regular physical activity in the control group.Conclusion:The current state of evidence concerning the effectiveness of digital and home-based physical training interventions is mixed overall,though there is limited evidence that specific types of digital and home-based physical training interventions(e.g.,online classes and step-based exergames)can be an effective strategy for improving cognitive performance in older adults.However,due to the limited number of available studies,future high-quality studies are needed to buttress this assumption empirically and to allow for more solid and nuanced conclusions.

Association of accelerometer-measured sleep duration and different intensities of physical activity with incident type 2 diabetes in a population-based cohort study

Purpose:The aim of the current study was to investigate the association of accelerometer-measured sleep duration and different intensities of physical activity(PA)with the risk of incident type 2 diabetes in a population-based prospective cohort study.Methods:Altogether,88,000 participants(mean age=62.2±7.9 years,mean±SD)were included from the UK Biobank.Sleep duration(short:<6 h/day;normal:6-8 h/day;long:>8 h/day)and PA of different intensities were measured using a wrist-won accelerometer over a 7-day period between 2013 and 2015.PA was classified according to the median or World Health Organization-recommendation:total volume of PA(high,low),moderate-to-vigorous PA(MVPA)(recommended,not recommended),and light-intensity PA(high,low).Incidence of type 2diabetes was ascertained using hospital records or death registries.Results:During a median follow-up of 7.0 years,1615 incident type 2 diabetes cases were documented.Compared with normal sleep duration,short(hazard ratio(HR)=1.21,95%confidence interval(95%CI):1.03-1.41)but not long sleep duration(HR=1.01,95%CI:0.89-1.15)was associated with excessive type 2 diabetes risk.This increased risk among short sleepers seems to be protected against by PA.Compared with normal sleepers with high or recommended PA,short sleepers with low volume of PA(HR=1.81,95%CI:1.46-2.25),not recommended(below the World Health Organization-recommended level of)MVPA(HR=1.92,95%CI:1.55-2.36),or low light-intensity PA(HR=1.49,95%CI:1.13-1.90)had a higher risk of type 2 diabetes,while short sleepers with a high volume of PA(HR=1.14,95%CI:0.88-1.49),recommended MVPA(HR=1.02,95%CI:0.71-1.48),or high light-intensity PA(HR=1.14,95%CI:0.92-1.41)did not.Conclusion:Accelerometer-measured short but not long sleep duration was associated with a higher risk of incident type 2 diabetes.A higher level of PA,regardless of intensity,potentially ameliorates this excessive risk.

Association of physical activity with risk of chronic kidney disease in China:A population-based cohort study

Background:Information on the association between physical activity(PA)and the risk of chronic kidney disease(CKD)is limited.We aimed to explore the associations of total,domain-specific,and intensity-specific PA with CKD and its subtypes in China.Methods:The study included 475,376 adults from the China Kadoorie Biobank aged 30-79 years during 2004-2008 at baseline.An interviewer-administered questionnaire was used to collect the information about PA,which was quantified as metabolic equivalent of task hours per day(MET-h/day)and categorized into 4 groups based on quartiles.Cox regression was used to analyze the association between PA and CKD risk.Results:During a median follow-up of 12.1 years,5415 incident CKD cases were documented,including 1159 incident diabetic kidney disease(DKD)cases and 362 incident hypertensive nephropathy(HTN)cases.Total PA was inversely associated with CKD risk,with an adjusted hazard ratio(HR,95%confidence interval(95%CI))of 0.83(0.75-0.92)for incident CKD in the highest quartile of total PA as compared with participants in the lowest quartile.Similar results were observed for risk of DKD and HTN,and the corresponding HRs(95%CIs)were 0.75(0.58-0.97)for DKD risk and 0.56(0.37-0.85)for HTN risk.Increased nonoccupational PA,low-intensity PA,and moderate-to-vigorous-intensity PA were significantly associated with a decreased risk of CKD,with HRs(95%CIs)of 0.80(0.73-0.88),0.85(0.77-0.94),and 0.85(0.76-0.95)in the highest quartile,respectively.Conclusion:PA,including nonoccupational PA,low-intensity PA,and moderate-to-vigorous-intensity PA,was inversely associated with the risk of CKD,including DKD,HTN,and other CKD,and such associations were dose dependent.

Displacement field reconstruction in landslide physical modeling by using a terrain laser scanner e Part 2:Application and large strain/displacement and water effect analysis

Deformation analysis is fundamental in geotechnical modeling.Nevertheless,there is still a lack of an effective method to obtain the deformation field under various experimental conditions.In this study,we introduce a processebased physical modeling of a pileereinforced reservoir landslide and present an improved deformation analysis involving large strains and water effects.We collect multieperiod point clouds using a terrain laser scanner and reconstruct its deformation field through a point cloud processing workflow.The results show that this method can accurately describe the landslide surface deformation at any time and area by both scalar and vector fields.The deformation fields in different profiles of the physical model and different stages of the evolutionary process provide adequate and detailed landslide information.We analyze the large strain upstream of the pile caused by the pile installation and the consequent violent deformation during the evolutionary process.Furthermore,our method effectively overcomes the challenges of identifying targets commonly encountered in geotechnical modeling where water effects are considered and targets are polluted,which facilitates the deformation analysis at the wading area in a reservoir landslide.Eventually,combining subsurface deformation as well as numerical modeling,we comprehensively analyze the kinematics and failure mechanisms of this complicated object involving landslides and pile foundations as well as water effects.This method is of great significance for any geotechnical modeling concerning large-strain analysis and water effects.