某市養護機構住民身體被約束之狀況及相關因素之研究

黃惠璣; 李中一

doi:10.6288/TJPH2009-28-02-06

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P132 - 143

医药卫生 > 预防保健与卫生学
医药卫生 > 社会医学

DOI： 10.6288/TJPH

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某市养护机构住民身体被约束之状况及相关因素之研究

A Study on Status and Factors Associated with the Use of Physical Restraints among Residents of long-term Care Institutions in a City

黄惠玑(Hui-Chi Huang) ；李中一(Chung-Yi Li)

台湾公共卫生杂志； 28 卷 2 期 (2009 / 04 / 01) ， P132 - 143

繁体中文 DOI： 10.6288/TJPH2009-28-02-06

机构住民；身体约束；预防跌倒；约束政策； residents ； physical restraint ； preventing fall ； restraint policy

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摘要 │ 参考文献 (30) │ 被引用文献 (3) │ 国际计量

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Objectives: To investigate the rate of and factors associated with the use of physical restraints among residents of long-term care institutions. Methods: This is a cross-sectional study involving 848 residents sampled from 20 residential institutions using probability proportional to size (PPS) across a total of 178 residential institutions in one city. Information on the use of physical restraints and disease history was collected using observation and chart review. Physical functioning, balance and leg muscle power were also measured and recorded. Χ^2 and simple t test were used to compare differences in characteristics between residents who were and were not physically restrained. A logistic regression model was used to identify factors significantly associated with odds of any type of physical restraint use or multiple physical restraint use. Results: The rate of any physical restraint use and multiple physical restraint use was estimated at 74.1% (95% confidence interval, CI=71.2-77.0%) and 47.8% (95% CI=39.9%-55.6%). Compared to those not physically restrained, residents who were physically restrained had a higher rate of cerebrovascular disease, dementia and pressure sores, and had been resident in the institution for longer. Restrained residents had a significant deficit in their scores for activity of daily living (ADL), Mini Mental State Examination (MMSE) and muscle power of both legs. The leading reason given for using physical restraints was ”preventing a fall” (79.8%). Multivariate analysis showed that an increased ADL score was significantly associated with reduced odds of the use of any physical restraint (Adjusted Odds Ratio, AOR=0.98, 95% CI=0.97-0.99) or the use of multiple physical restraints (AOR=0.95, 95% CI=0.93-0.97). Residents from institutions with a second grade by accreditation, whose families had signed an agreement for physical restraints, also showed a significantly increased AOR for the use of physical restraints. Conclusions: The use rate of physical restraint was higher in this Taiwanese residential sample compared to rates found in Europe and United States. Use rate varied within the institution and was associated with signed agreement and poorer physical functioning as indicated by the residents' ADL scores.

参考文献 ( 30 ) 〈TOP〉

Yeh S,Hsiao C,Ho T(2004).The effects of continuing education in restraint reduction on novice nurses in intensive care units.J Nurs Res,12,32-45.
连结：
曾明月、徐亚瑛、史丽珠、陈献宗(2001)。家人照顾者於失能老人出院过渡时期之需求与需求满足变化探讨。护理研究，9，311-321。
连结：
杨嘉玲、徐亚瑛(2001)。护理之家照护品质指标－以老年住民的观点探讨。护理研究，9，53-63。
连结：
Castle NG,Mor V.(1989).Physical restraints in nursing home: a review of the literature since the Nursing Home Reform Act of 1987.Med Care Res Rev,55,139-170.
Correa-Villaseñor A,Stewart WF,Franco-Marina F,Seacat H.(1995).Bias from non-differential misclassification in case-control studies with three exposure levels.Epidemiology,6,276-281.

被引用文献 ( 3 ) 〈TOP〉

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