Department of Nursing, the First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
Department of Gynecology, the First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
J Adv Nurs. 2020 Oct;76(10):2597-2609. doi: 10.1111/jan.14486. Epub 2020 Aug 17.
To investigate the use of physical restraints among Chinese long-term care facilities older adults and to identify its risk factors.
Observational and cross-sectional study.
A total of 1,026 older adults from six long-term care facilities in Chongqing were recruited by cluster sampling method from July - November 2019. Data on physical restraint use and older adults' characteristics were collected using physical restraints observation forms and older adults' records. Organizational data were collected by questionnaires asking nursing managers. The independent risk factors for physical restraints use were assessed using chi-square test and binary logistic regression.
The study found that the prevalence of physical restraints in six long-term care facilities in China was 25.83%. Waist belt (55.47%) and wrist restraint (52.83%) were most frequently used. Only 61.51% of physical restraints were signed with informed consent. 71.70% of physical restraints were caused by the prevention of falls, 89.06% of physical restraints were without nursing documentation, and 13.58% restrained older adults were observed to have physical complications. According to the binary logistic regression analysis, facility type and ownership, older adults per nursing assistant, length of residence, cognitive impairment, care dependency, mobility restriction, fall risk, physical agitation, and indwelling tubes emerged as important risk factors for the use of physical restraints.
The use of physical restraints among Chinese long-term care facilities older adults was at a relatively high level and lack standardized and regulated practices. Moreover, Physical restraint use was associated with facility type and ownership, older adults per nursing assistant, length of residence, cognitive impairment, care dependency, mobility restriction, fall risks, physical agitation, and indwelling tube.
This study will provide an effective reference for nursing staff in long-term care facilities to assess high-risk older adults in their use of physical restraints, which can support them to implement effective minimized restraint approaches to targeted people.
调查中国长期护理机构老年人使用身体约束的情况，并确定其危险因素。
观察性和横断面研究。
采用整群抽样法，于 2019 年 7 月至 11 月从重庆市 6 家长期护理机构招募了 1026 名老年人。使用身体约束观察表和老年人记录收集身体约束使用和老年人特征的数据。通过问卷调查护理管理人员收集组织数据。使用卡方检验和二项逻辑回归评估身体约束使用的独立危险因素。
研究发现，中国 6 家长期护理机构的身体约束患病率为 25.83%。腰带（55.47%）和腕部约束（52.83%）最常使用。只有 61.51%的身体约束签署了知情同意书。71.70%的身体约束是为了预防跌倒，89.06%的身体约束没有护理记录，13.58%的受约束老年人出现身体并发症。根据二项逻辑回归分析，机构类型和所有权、每个护理助理的老年人人数、居住时间、认知障碍、护理依赖、活动受限、跌倒风险、身体激越和留置管是身体约束使用的重要危险因素。
中国长期护理机构老年人身体约束的使用处于较高水平，缺乏标准化和规范的实践。此外，身体约束的使用与机构类型和所有权、每个护理助理的老年人人数、居住时间、认知障碍、护理依赖、活动受限、跌倒风险、身体激越和留置管有关。
本研究将为长期护理机构的护理人员评估高风险老年人使用身体约束提供有效参考，有助于他们对目标人群实施有效的最小化约束方法。
