University of Witten/Herdecke, Faculty of Medicine, Institute of Nursing Science, Stockumer Strasse 12, Witten, Germany.
J Nurs Scholarsh. 2010 Dec;42(4):448-56. doi: 10.1111/j.1547-5069.2010.01341.x.
Attitudes of nursing home staff, residents, and their relatives determine the decision-making process about the use of physical restraints. Knowledge of staffs' attitudes toward physical restraints is sparse; even less is known about relatives' attitudes. Therefore, we surveyed relatives' attitudes and opinions toward physical restraints and compared the results to a survey of nursing home staff.
Cross-sectional survey comparing 177 nursing home residents' relatives from 13 German facilities in 2008 to 258 nursing home nurses from 25 German facilities in 2007.
The German version of the Maastricht Attitude Questionnaire was administered. Part I contains 22 items with three subscales (reasons, consequences, and appropriateness of restraints); Part II contains 16 items evaluating restrictiveness and discomfort of restraint measures, respectively. Descriptive and explorative inferential statistics were used for data analyses.
Response rate in both samples was above 90%. Mean age was 62 years (SD 12.60; range 24-93) in relatives and 44 years (SD 11.40; range 19-65) in nurses; 72% and 82% were female, respectively. Relatives assess physical restraints a little more positively compared to nurses, with an average of 3.40 (SD 0.60) versus 3.07 (SD 0.48) on a 5-point scale (5=strongly positive attitude). Relatives assess physical restraints as slightly less restrictive, with 2.11 (SD 0.33), and as less discomforting, with 2.10 (SD 0.38) points, compared to nursing staff, who assess the restraints' restrictiveness with 2.19 (SD 0.29) points and its discomfort with 2.17 (SD 0.32) on a 3-point scale (3=very restrictive/discomforting). Both groups consider wrist and ankle belts as most restrictive and uncomfortable, while sensor mats, infrared systems, and unilateral bedrails were rated as the lowest for restrictiveness and discomfort.
Attitudes of nursing home residents' relatives toward physical restraints are rather positive and generally comparable with nursing home staffs' attitudes.
Interventions aimed to reduce physical restraints need to include education of both staff and relatives of nursing home residents.
养老院工作人员、居民及其亲属的态度决定了使用身体约束的决策过程。工作人员对身体约束的态度知之甚少；亲属的态度更是知之甚少。因此，我们调查了亲属对身体约束的态度和意见，并将结果与对养老院工作人员的调查进行了比较。
2008 年，对来自德国 13 个设施的 177 名养老院居民的亲属进行了横断面调查，2007 年对来自德国 25 个设施的 258 名养老院护士进行了横断面调查。
使用马斯特里赫特态度问卷的德语版。第一部分包含 22 个项目，分为三个分量表（使用约束的原因、后果和适当性）；第二部分包含 16 个项目，分别评估约束措施的限制和不适。采用描述性和探索性推断统计对数据进行分析。
两个样本的应答率均在 90%以上。亲属的平均年龄为 62 岁（标准差 12.60；范围 24-93），护士的平均年龄为 44 岁（标准差 11.40；范围 19-65）；分别有 72%和 82%为女性。与护士相比，亲属对身体约束的评价略为积极，平均得分为 3.40（标准差 0.60），而护士的平均得分为 3.07（标准差 0.48）。亲属评估身体约束的限制程度稍低，为 2.11（标准差 0.33），不适程度稍低，为 2.10（标准差 0.38），而护理人员评估身体约束的限制程度为 2.19（标准差 0.29），不适程度为 2.17（标准差 0.32）。两组人员都认为手腕和脚踝约束带是最具约束性和不舒适的，而传感器垫、红外系统和单侧床栏的限制和不舒适程度最低。
养老院居民亲属对身体约束的态度相当积极，与养老院工作人员的态度大致相同。
旨在减少身体约束的干预措施需要包括对养老院居民的工作人员和亲属进行教育。
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