Karlsson S, Bucht G, Sandman P O
Department of Geriatric Medicine, Umeå University, Sweden.
Scand J Caring Sci. 1998;12(1):48-56.
The aim of the present study was to investigate the use of physical restraints in institutional elder care and staff knowledge about and attitudes toward the use of these restraints. Poor knowledge and negative attitudes toward the use of restraints were found among staff. Significant differences between various staff categories were found concerning knowledge about the use of restraints; nurse aids had the lowest and physicians the highest scores on the knowledge test. Nurse aids demonstrated the least negative attitudes (were most prone to use restraints) and physicians the most negative. Furthermore, there was a significant relation between attitudes and knowledge, i.e. staff with poor knowledge also demonstrated the least negative attitudes toward the use of restraints. Despite these negative attitudes among staff, we found a large proportion of restrained patients in the institutions investigated. Twenty-nine percent of the patients at the investigated clinics were physically restrained. The most common reason given was that restraints were used to prevent falls. No documentation of the observed use of restraints was found in any of the restrained patients' hospital records.
本研究的目的是调查机构养老中身体约束的使用情况以及工作人员对这些约束使用的了解和态度。研究发现工作人员对约束使用的知识掌握不足且态度消极。在不同类别工作人员关于约束使用的知识方面存在显著差异;护理员在知识测试中的得分最低,医生得分最高。护理员表现出最不消极的态度(最倾向于使用约束),而医生态度最消极。此外,态度与知识之间存在显著关系,即知识掌握不足的工作人员对约束使用的消极态度也最少。尽管工作人员存在这些消极态度,但在我们调查的机构中,发现有很大比例的患者受到约束。在所调查诊所中,29%的患者受到身体约束。给出的最常见原因是使用约束是为了防止跌倒。在任何一名受约束患者的医院记录中均未发现关于观察到的约束使用情况的记录。