Hamers Jan P H, Gulpers Math J M, Strik Willem
Associate Professor, Department of Health Care Studies, Section of Nursing Science, Universiteit Maastricht, Maastricht, The Netherlands.
J Adv Nurs. 2004 Feb;45(3):246-51. doi: 10.1046/j.1365-2648.2003.02885.x.
The aim of the study was to examine the prevalence of physical restraint use in cognitively impaired nursing home residents, the manner in which restraints are used, reasons for using them, and relationships between residents' characteristics and use of physical restraints.
A point prevalence study was conducted on the use of physical restraints among all residents cared for in two Dutch nursing homes and one nursing home unit (n = 265). Data about the nursing home residents and the use of restraints were collected by means of a questionnaire, which was filled in by the nurses. The response rate was 98%. The mean age of residents was 81 years (sd = 8.6), 74% of whom were female.
One or more restraints were used with 49% of the residents. The most frequently used physical restraints were bed rails, a waist belt, and a chair with a table. In almost all situations (90%), residents were continuously restrained and restraints were used for longer than 3 months. The most common reason (90%) for use of restraints was to prevent falls. Logistic regression analysis revealed that use of restraints was highly associated with poor mobility, care dependency and risk of falling in the opinion of nursing staff.
The results of this study are comparable with those of other studies. However, since recent studies have reported that physical restraints are inadequate to prevent falls, recommendations are made to re-evaluate critically the use of restraints and to conduct future research into a responsible and safe way of decreasing the use of physical restraints.
本研究旨在调查认知受损养老院居民中使用身体约束的患病率、约束的使用方式、使用原因以及居民特征与身体约束使用之间的关系。
对荷兰两家养老院和一个护理单元（n = 265）中所有接受护理的居民进行了身体约束使用的现况研究。关于养老院居民和约束使用情况的数据通过问卷收集，由护士填写。回复率为98%。居民的平均年龄为81岁（标准差 = 8.6），其中74%为女性。
49%的居民使用了一种或多种约束措施。最常用的身体约束措施是床栏、腰带和带桌子的椅子。在几乎所有情况下（90%），居民被持续约束，且约束使用时间超过3个月。使用约束措施最常见的原因（90%）是预防跌倒。逻辑回归分析显示，在护理人员看来，约束措施的使用与行动不便、护理依赖和跌倒风险高度相关。
本研究结果与其他研究结果相当。然而，由于最近的研究报告称身体约束措施不足以预防跌倒，建议对约束措施的使用进行严格重新评估，并开展未来研究，以寻找一种负责且安全的方式来减少身体约束措施的使用。
