荷兰、德国和瑞士护理人员对养老院居民身体约束使用的态度，一项横断面研究。
Attitudes of Dutch, German and Swiss nursing staff towards physical restraint use in nursing home residents, a cross-sectional study.
机构信息
Maastricht University, The Netherlands.
出版信息
Int J Nurs Stud. 2009 Feb;46(2):248-55. doi: 10.1016/j.ijnurstu.2008.06.007. Epub 2008 Jul 25.
OBJECTIVE
To investigate the attitudes of nursing staff towards restraint measures and restraint use in nursing home residents, and to investigate if these attitudes are influenced by country of residence and individual characteristics of nursing staff.
METHODS
A questionnaire on attitudes regarding restraints (subscales: reasons, consequences, and appropriateness of restraint use) and opinions regarding the restrictiveness of restraint measures and discomfort in using them was distributed to a convenience sample of nursing staff in The Netherlands (n=166), Germany (n=258), and Switzerland (n=184).
RESULTS
In general, nursing staff held rather neutral opinions regarding the use of physical restraints, but assessed the use of restraints as an appropriate measure in their clinical practice. Gender and age were not related to attitudes of nursing staff, but we did find some differences in attitudes between nursing staff from the different countries. Dutch nursing staff were most positive regarding the reasons of restraint use (p<0.01), but were less positive than German and Swiss nursing staff regarding the appropriateness of restraint use (p<0.01). Swiss nursing staff were less positive than German nursing staff regarding the appropriateness of restraint use (p<0.01). Nursing staff with longer clinical experience showed a more negative attitude towards restraint use than nursing staff with less experience (p<0.05) and charge nurses had the least positive attitude towards restraint use (p<0.05). Opinions regarding restraint measures differed between the three countries. The use of bilateral bedrails was considered as a moderate restrictive measure; the use of belts was rated as the most restrictive measure and nursing staff expressed pronounced discomfort on the use of these measures.
CONCLUSIONS
Nursing staff from three European countries have different attitudes and opinions regarding the use of physical restraints. The results underline the importance of more tailored, culturally sensitive interventions to reduce physical restraints in nursing homes.
目的
调查护理人员对养老院居民约束措施和约束使用的态度，并调查这些态度是否受到居住国家和护理人员个体特征的影响。
方法
对荷兰（n=166）、德国（n=258）和瑞士（n=184）的护理人员进行了一项关于约束态度的问卷（包括约束原因、后果和使用适当性的子量表）以及对约束措施限制程度和使用约束措施不适的意见的调查。
结果
总体而言，护理人员对使用身体约束持相当中立的态度，但在临床实践中评估使用约束措施是适当的。性别和年龄与护理人员的态度无关，但我们确实发现不同国家的护理人员态度存在一些差异。荷兰护理人员对约束使用原因最积极（p<0.01），但对约束使用适当性的评价不如德国和瑞士护理人员积极（p<0.01）。瑞士护理人员对约束使用适当性的评价不如德国护理人员积极（p<0.01）。临床经验较丰富的护理人员对约束使用的态度比经验较少的护理人员更消极（p<0.05），护士长对约束使用的态度最消极（p<0.05）。护理人员对约束措施的意见在三个国家之间存在差异。双侧床栏的使用被认为是一种中等限制措施；腰带的使用被评为最具限制性的措施，护理人员在使用这些措施时表达了明显的不适。
结论
来自三个欧洲国家的护理人员对身体约束的使用有不同的态度和意见。研究结果强调了采取更具针对性、更具文化敏感性的干预措施来减少养老院身体约束的重要性。
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