Strumpf N E, Evans L K
J Gerontol Nurs. 1991 Feb;17(2):27-30. doi: 10.3928/0098-9134-19910201-09.
The rising prevalence of physical restraint warrants careful examination of the moral, ethical, and legal dimensions of the practice. For the frail elderly, quality of life, decision making, and informed consent are significant issues. The ethical dilemmas created by the use of physical restraints, and the need to consider restraint as an issue fundamental to the nursing home milieu and beliefs about quality of life, require understanding of and commitment to care that is individualized and person-centered. The elements identified in care settings where restraints are rarely, if ever, used evolve from an awareness of the needs of the individual resident, continuous monitoring of health status, and appropriate adjustments in the care plan.
身体约束使用的日益普遍，使得有必要仔细审视这种做法在道德、伦理和法律层面的问题。对于体弱的老年人来说，生活质量、决策制定和知情同意都是重要问题。使用身体约束所引发的伦理困境，以及将约束视为养老院环境和生活质量观念的基本问题的必要性，都需要理解并致力于提供个性化和以患者为中心的护理。在很少（甚至从未）使用约束措施的护理环境中所确定的要素，源于对每位居民需求的认知、对健康状况的持续监测以及护理计划的适当调整。
