Castle Nicholas G, Engberg John
Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA 15261, USA.
Med Care. 2009 Nov;47(11):1164-73. doi: 10.1097/MLR.0b013e3181b58a69.
Using a national longitudinal sample of nursing homes residents (N = 264,068), we examine whether physical restraint use contributes to subsequent physical or psychological health decline.
The minimum data set, the on-line survey certification and recording system, and the area resource file were the data sources used. This data represented the period of 2004 and 2005. To control for the difference in characteristics between residents who were subsequently physically restrained and who were not, we use a propensity score matching method.
For all outcomes examined (except depression), that is, behavior issues, cognitive performance, falls, walking dependence, activities of daily living, pressure ulcers, and contractures, were all significantly worse for restrained residents compared with matched residents who were not restrained.
Physical restraint use represents poor clinical practice, and the benefits to residents of further reducing physical restraint use in nursing homes are substantial.
我们使用全国养老院居民纵向样本（N = 264,068），研究使用身体约束措施是否会导致随后的身体或心理健康下降。
使用的数据源包括最小数据集、在线调查认证和记录系统以及区域资源文件。这些数据代表了2004年和2005年期间。为了控制随后受到身体约束的居民与未受约束居民之间的特征差异，我们使用倾向得分匹配方法。
对于所有检查的结果（除抑郁外），即行为问题、认知表现、跌倒、行走依赖、日常生活活动、压疮和挛缩，与未受约束的匹配居民相比，受约束居民的情况均明显更差。
使用身体约束措施代表了不良的临床实践，进一步减少养老院中身体约束措施的使用对居民的益处很大。
