Hopton J
Northern College of Nursing, Midwifery and Health Studies, Greater Manchester, England.
J Adv Nurs. 1995 Jul;22(1):110-5. doi: 10.1046/j.1365-2648.1995.22010110.x.
This paper begins with an exploration of current attitudes towards the use of physical restraint in psychiatric nursing, and the contributions which the 1985 Ritchie Report and the 1991 Report of the Committee Of Inquiry Into Ashworth Hospital have made to the debate on the use of control and restraint within psychiatric institutions. The main focus of the paper, though, is an evaluation of the ethical justifications for and the ethical and political objections to the use of physical restraint techniques as a response to aggressive and self-injurious behaviour in contemporary mental health nursing practice. The author concludes that the number of situations where control and restraint techniques are used might be reduced by the development of new therapeutic approaches. Such approaches should allow for more negotiation regarding care between clients and nurses, and acknowledge the potential benefits of clients resisting supposedly therapeutic interventions which they find unhelpful.
本文首先探讨了当前精神科护理中对使用身体约束的态度,以及1985年的里奇报告和1991年阿什沃思医院调查委员会的报告对精神科机构内控制和约束使用辩论所做的贡献。不过,本文的主要重点是评估在当代精神卫生护理实践中,将身体约束技术作为应对攻击性行为和自我伤害行为的手段的伦理依据以及伦理和政治方面的反对意见。作者得出结论,通过开发新的治疗方法,使用控制和约束技术的情况数量可能会减少。此类方法应允许患者和护士就护理问题进行更多协商,并承认患者抵制他们认为无用的所谓治疗干预措施可能带来的好处。