养老院中身体约束的使用：临床伦理考量
Use of physical restraint in nursing homes: clinical-ethical considerations.
作者信息
Gastmans C, Milisen K
机构信息
Center for Biomedical Ethics and Law, Catholic University of Leuven, Kapucijnenvoer 35, B-3000 Leuven, Belgium.
出版信息
J Med Ethics. 2006 Mar;32(3):148-52. doi: 10.1136/jme.2005.012708.
Abstract
This article gives a brief overview of the state of the art concerning physical restraint use among older persons in nursing homes. Within this context we identify some essential values and norms that must be observed in an ethical evaluation of physical restraint. These values and norms provide the ethical foundation for a number of concrete recommendations that could give clinical and ethical support to caregivers when they make decisions about physical restraint. Respect for the autonomy and overall wellbeing of older persons, a proportional assessment of the advantages and disadvantages, a priority focus on the alternatives to physical restraint, individualised care, interdisciplinary decision making, and an institutional policy are the central points that make it possible to deal responsibly with the use of physical restraint for older persons in nursing homes.
摘要
本文简要概述了养老院中老年人使用身体约束的现状。在此背景下，我们确定了在对身体约束进行伦理评估时必须遵守的一些基本价值观和规范。这些价值观和规范为一些具体建议提供了伦理基础，这些建议可为护理人员在做出关于身体约束的决策时提供临床和伦理支持。尊重老年人的自主权和整体福祉、对利弊进行相称评估、优先关注身体约束的替代方法、个性化护理、跨学科决策以及机构政策，这些要点使得能够以负责任的方式处理养老院中老年人身体约束的使用问题。
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本文引用的文献
1
Patient autonomy in physical restraint.身体约束中的患者自主权。
J Clin Nurs. 2005 Mar;14 Suppl 1:34-40. doi: 10.1111/j.1365-2702.2005.01145.x.
2
Attitudes to restraint for the prevention of falls in hospital.医院中对预防跌倒的约束措施的态度。
Gerontology. 2005 Jan-Feb;51(1):66-70. doi: 10.1159/000081438.
3
Concealment of drugs in food and beverages in nursing homes: cross sectional study.养老院中食品和饮料藏毒情况：横断面研究
BMJ. 2005 Jan 1;330(7481):20. doi: 10.1136/bmj.38268.579097.55. Epub 2004 Nov 23.
4
Physical restraint use among nursing home residents: A comparison of two data collection methods.养老院居民身体约束的使用情况：两种数据收集方法的比较。
BMC Nurs. 2004 Oct 15;3(1):5. doi: 10.1186/1472-6955-3-5.
5
Differences in period prevalence of the use of physical restraints in elderly inpatients of European hospitals and nursing homes.欧洲医院和养老院老年住院患者使用身体约束措施的期间患病率差异。
J Gerontol A Biol Sci Med Sci. 2004 Sep;59(9):M922-3. doi: 10.1093/gerona/59.9.m922.
6
Use of restraints in long-term residential care facilities in Hong Kong SAR, China: predisposing factors and comparison with other countries.中国香港特别行政区长期住宿护理机构中约束措施的使用：诱发因素及与其他国家的比较。
J Gerontol A Biol Sci Med Sci. 2004 Sep;59(9):M921. doi: 10.1093/gerona/59.9.m921.
7
Use of constraints and their correlates in Norwegian nursing homes.挪威养老院中约束措施及其相关因素的使用情况
Int J Geriatr Psychiatry. 2004 Oct;19(10):980-8. doi: 10.1002/gps.1197.
8
Prevalence of patients subjected to constraint in Norwegian nursing homes.挪威养老院中受到约束的患者患病率。
Scand J Caring Sci. 2004 Sep;18(3):281-6. doi: 10.1111/j.1471-6712.2004.00278.x.
9
Falls and fractures in postmenopausal women: a review.绝经后女性的跌倒与骨折：综述
J Br Menopause Soc. 2003 Sep;9(3):101-6. doi: 10.1258/136218003100322314.
10
Organizational characteristics and restraint use for hospitalized nursing home residents.住院疗养院居民的组织特征与约束使用情况
J Am Geriatr Soc. 2003 Aug;51(8):1079-84. doi: 10.1046/j.1532-5415.2003.51355.x.
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