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題名:機構住民使用身體約束之芻議
書刊名:臺灣老人保健學刊
作者:黃惠璣吳森琪 引用關係蘇秀娟林季宜 引用關係馬霏菲
作者(外文):Huang, Hui-chiWu, Sung-chiSu, Hsiu-chuanLin, Chi-yiMa, Fei-fei
出版日期:2008
卷期:4:1
頁次:頁23-38
主題關鍵詞:身體約束自我效能教育課程約束政策Physical restraintSelf efficacyEducation programRestraint policy
原始連結:連回原系統網址new window
相關次數:
  • 被引用次數被引用次數:期刊(2) 博士論文(0) 專書(0) 專書論文(0)
  • 排除自我引用排除自我引用:2
  • 共同引用共同引用:79
  • 點閱點閱:104
臨床上,護理人員為避免病人因拔管、跌倒及跌倒復引發合併症的醫療疏失,導致家屬對照護人員的興訟糾紛,通常會對病人使用身體約束;其次,部分機構因照護人力不足,而默許身體約束為合理措施。依據臨床研究顯示,約束住民不僅未能預防跌倒或縮減照護人力,反易徒增住民跌倒、受傷、死亡的危險;但身體約束迄今仍被廣泛使用於急、慢性醫療與長期照護機構。相較於美國28%、澳洲25.5%及挪威17%之約束使用率,台灣機構住民身體被約束比率達46.6%明顯偏高。研究文獻指出護理人員的知識、態度、工作壓力、自我效能,在在影響其照護行為。綜觀目前長期照護機構之教育課程,大多侷限於如何改良約束帶、強調合理約束住民、簽署家屬同意書等議題,攸關無約束照護環境的規劃與設計,則付諸闕如。事實上,歐美各國為營造無約束的長期照護環境、減少照護人員使用身體約束,執行教育課程之作法已行之多年,可提供爾後國內長期照護職司部門擬訂約束政策參考,期冀有效降低機構住民身體約束使用率。
In clinical settings, nursing staff and other health professionals may use the physical restraints to prevent patients attempting to remove their tubes and to prevent falls. In addition, some facilities may allow caregivers to use physical restraints because of lack of manpower. They believe that their use may prevent families to sue these facilities and health professionals for injuries alleged resulting from falls. A great deal of research has shown that use of physical restraints may not only fail to prevent but actually increase the rate of falls, injuries, and even deaths., Even so, use of physical restraints continues in patient care facilities everywhere. The prevalence of physical restraint use in Taiwan is 46.6% is relatively high while compared to use rates found in the United States, Australia, and Norway with 28%, 25.5%, and 17%, respectively. Some published research has pointed out that the knowledge, attitudes, working stress, and self efficacy have had important effects on nursing staff behaviors. However, educational programs directed toward nursing home patient care in Taiwan have not promoted a restraint free environment, but rather have emphasized improving the quality of restraint materials, creating reasonable restraint protocols reasons, and for getting informed consent from families and those legally responsible. No restraint environment in many other advanced industrialized countries by giving education. The question of whether the same criteria should be applied to Taiwan's long term care facilities and this question has important policy as well as clinical implications.
期刊論文
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2.Castle, N. G.(2000)。Differences in nursing homes with increasing and decreasing use of physical restraints。Medical Care,38,1154-1163。  new window
3.Castle, N. G.(2002)。Nursing homes with persistent deficiency citations for physical restraint use。Medical Care,40(10),868-878。  new window
4.Dunbar, J.、Neufeld, R.、White, H.C.、Libow, L.(1996)。Retrain, don’t restrain: The educational intervention of the National Nursing Home Restraint Removal Project.。Gerontologist,36,539-542.。  new window
5.Eller, L. S.、Kleber, E.、Wang, S. L.(2003)。Resaerch knowledge, attitude and practice of health professional。Nursing Outlook,51,165-170。  new window
6.Evans, D.、Wood, J.、Lambert, L.(2003)。Patient injury and physical restraint devices: a systematic review。Journal of Advanced Nursing,41(3),274-282。  new window
7.Gallinagh, R.、Nevin, R.、Mcllroy, D.(2002)。The use of physical restraints as a safety measure in the care of older people in four rehabilitation ward: Findings from an exploratory study。International Journal of Nursing Studies,39,147-156。  new window
8.Idel, M.、Melamed, S.、Merlo, P.、Yahav, J.、Hendel, T.、Kaplan, B.(2003)。Influence of a merger on nurses, emotional well-being: the importance of self-efficacy and emotional reactivity。Journal of Nursing Management,11,59-63。  new window
9.Janelli, L. M.、Stamps, D.、Delies, L.(2006)。Physical restraint use: A nursing perspective。Medical Surgical Nursing,15,163-167。  new window
10.Kirkevold, 0.、Engedal, K.(2004)。A study into the use of restraint in nursing homes in Norway。British Journal of Nursing,8,902-906。  new window
11.Meehan, T.、Bergen, H.、Fjeidsoe, K.(2004)。Staff and patient perceptions of seclusion: Has anything changed。Journal of Advanced Nursing,47,33-38。  new window
12.Rogers, L. Q.、Matevey, C.、Hopkins-Price, P.、Shah, P.、Dunnington, G.、Coumeya, K. S.(2004)。Exploring social cognitive theory constructs for promoting exercise among breast cancer patients。Cancer Nursing,27,402-473。  new window
13.Smith, N.、Timms, J.、Parker, V.、Reimels, E.、Hamlin, A.、Hamlin, A.(2003)。The impact of education on the use of physical restraints in the acute care tetting。Journal of Continuing Education in Nursing,34,26-33。  new window
14.黃耀榮(20040100)。失智症照護空間之現況問題與建構趨勢。長期照護雜誌,7(4),352-354。  延伸查詢new window
15.吳秋燕、吳肖琪、劉文良、林麗嬋(19991200)。機構正式照顧者之約束知識、態度和使用理由之關係。護理研究,7(6),518-530。new window  延伸查詢new window
16.張惠甄(20030900)。護理人員對使用身體約束於長期照護機構的看法。長期照護雜誌,7(3),265-272。  延伸查詢new window
17.黃惠子、莊宇慧、陳秋燕、李碧娥、藺寶珍(20050600)。住院老人對身體約束的經驗感受。實證護理,1(2),123-131。new window  延伸查詢new window
18.林秀蓉、邱啟潤(20040400)。護理人員對失能病患主要照顧者出院需求處理自信及其相關因素探討。護理雜誌,51(2),48-56。new window  延伸查詢new window
19.黃惠子、馬鳳歧、陳清惠(20030600)。護理人員對身體約束的知識、態度、行為及其相關性探討。慈濟護理雜誌,2(2),32-41。  延伸查詢new window
20.葉淑惠、林麗味、王興耀、吳淑如、林昭宏、蔡富棉(20010400)。護理之家施行約束縮減方案之成效。護理研究,9(2),183-193。new window  延伸查詢new window
21.楊嘉玲、徐亞瑛(20010200)。護理之家照護品質指標--以老年住民的觀點探討。護理研究,9(1),53-64。new window  延伸查詢new window
22.曾明月、徐亞瑛、史麗珠、陳獻宗(20010600)。家人照顧者於失能老人出院過渡期之需求、需求滿足變化探討。護理研究,9(3),311-321。new window  延伸查詢new window
23.蔣立琦、郭雅雯、林綽娟(20040400)。自我效能之概念分析。護理雜誌,51(2),67-72。new window  延伸查詢new window
24.Evans, L. K.、Strumpf, N. E.(1989)。Tying down the elderly: A review of the literature on physical restraint。Journal of the American Geriatrics Society,37,65-74。  new window
25.Pennington, K.、Magiluy, K.、Scott, J.(2003)。The role of certified nursing assistants in nursing homes。Journal of Nursing Adiministration,33(11),578-584。  new window
26.Hamers, J. P. H.、Gulpers, M. J. M.、Strik, W.(2004)。Use of physical restraints with cognitively impaired nursing home residents。J Adv Nurs,45,246-251。  new window
27.Karlsson, S.、Bucht, G.、Eriksson, S.、Sandman, P.(2001)。Factors relating to the use of physical restraints in geriatric settings。J Am Geriatr Soc,49,1722-1728。  new window
28.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。  new window
29.Castle, N. G.、Mor, V.(1987)。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。  new window
30.Retsas, A. P.(1998)。Survey findings describing the use of physical restraints in nursing homes in Victoria, Australia。International Journal of Nursing studies,35(3),184-191。  new window
31.Koch, S.、Lyon, C.(2001)。Case study approach to removing physical restraint。In J Nurs Pract,7,156-161。  new window
32.Mion, L.、Minnick, A.、Palm, R.、Marshall, B.、Lamb, K.(1996)。Physical restraint use in the hospital setting: unresolved issues and directions for research。Milbank Q,74,411-429。  new window
學位論文
1.張毓珊(2000)。長期照護機構住民身體約束之使用(碩士論文)。國立臺灣大學。  延伸查詢new window
圖書
1.Bandura, Albert(1977)。Social Learning Theory。Prentice-Hall, Inc.。  new window
2.Bandura, Albert(1986)。Social Foundations of Thought and Action: A Social Cognitive Theory。Prentice-Hall, Inc.。  new window
其他
1.吳世鐘(2002)。指標推行之成效分享,http://mail.tjcha.org.tw/tjcha_data/TQIP, 2002/12/08。  延伸查詢new window
2.Tilly, J.,Reed, P.(2007)。Falls, wandering, and physical restraints: intervention for residents with dementia in assisted living and nursing homes,www.semorshousing.org/OutsideOfStore/Interactiveiolders., 2007/01/07。  new window
3.World Health Organization(2005)。Abuse of the elderly: World report on violence and health,http://www.who.int/violence iniury_prevention/chap5.pdf, 2005/10/13。  new window
 
 
 
 
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