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引文資料
題名:
某市養護機構住民身體被約束之狀況及相關因素之研究
書刊名:
臺灣公共衛生雜誌
作者:
黃惠璣
/
李中一
作者(外文):
Huang, Hui-chi
/
Li, Chung-yi
出版日期:
2009
卷期:
28:2
頁次:
頁132-143
主題關鍵詞:
機構住民
;
身體約束
;
預防跌倒
;
約束政策
;
Residents
;
Physical restraint
;
Preventing fall
;
Restraint policy
原始連結:
連回原系統網址
相關次數:
被引用次數:期刊(
1
) 博士論文(
1
) 專書(0) 專書論文(0)
排除自我引用:
1
共同引用:
30
點閱:263
目標:本研究目的為了解養護機構對住民實施身體約束之比率及其相關因素。方法:本研究為橫斷面研究設計,以抽取機率與機構人數多寡成比例(Probability proportional to size, PPS)的方法從某市178所養護機構中選取20家共848名住民為本研究樣本。住民約束情形與疾病史資料分別以觀察及調閱病歷方式蒐集之,而身體功能、平衡能力、與肌力之資料亦是透過觀察或測量而獲得。本研究利用χ^2與simple t test比較受約束與未受約束住民特性之差異,也利用邏輯斯迴歸模式分析與住民接受約束或多重約束之顯著相關因素。結果:機構住民被約束及多重被約束的比率分別為74.1% (95% confidence interval, CI=71.2-77.0%)和47.8% (95% CI=39.9%-55.6%)。相較於無約束住民,約束住民有顯著較高中風、失智、與壓瘡的比率,入住時間也較久。此外,被約束住民的日常生活功能(Activity of Daily Living, ADL)、認知功能檢查(Mini Mental State Examination, MMSE)、左右腿及腳的肌力得分都顯著地較無約束住民差。住民被約束的原因以預防跌倒佔最多數(79.8%)。多變量分析發現,ADL得分增加與較低的被約束勝算(Adjusted Odds Ratio, AOR=0.98, 95% CI=0.97-0.99)及被多重約束(AOR=0.95, 95% CI=0.93-0.97)有顯著相關;此外,家屬簽署同意書與「甲等」機構住民被約束的勝算比也顯著較高。結論:相較於歐美國家,本研究顯示台灣機構住民身體被約束比率明顯偏高,本研究也發現約束比率高低與家屬簽同意書、機構評鑑等級及住民日常生活身體功能有顯著相關。
以文找文
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.
以文找文
期刊論文
1.
Duncan, P. W.、Weiner, D. K.、Chandler, J.、Studenski, S.(1990)。Functional reach: a new clinical measure of balance。Journal of Gerontology: Medical Sciences,45(6),192-197。
2.
黃惠璣、林季宜、王寶英(200706)。老人或失智老人跌倒危險因子之初探。臺灣老人保健學刊,3(1),1-13。
延伸查詢
3.
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
4.
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。
延伸查詢
5.
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
6.
Correa-Villasenor, A.、Stewart, W. F.、Franco-Marina, F.、Seacat, H.(1995)。Bias from non-differential misclassification in case-control studies with three exposure levels。Epidemiology,6,276-281。
7.
Huang, H. C.、Gau, M. L.、Lin, W. C.、Kernohan, G.(2003)。Assessing risk of falling in older adults。Public Health Nursing,20(5),399-411。
8.
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。
延伸查詢
9.
楊嘉玲、徐亞瑛(2001)。理之家照護品質指標—以老年住民的觀點探討。護理研究,9,53-63。
延伸查詢
10.
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。
11.
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。
12.
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。
13.
Evans LK, Strumpf NE.(1989)。Tying down the elderly: areview of the literature on physical restraint。J Am Geriatr Soc,37,65-74。
14.
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。
15.
Mathias, S.、Nayak, U. S.、Isaacs, B.(1986)。Balance in elderly patients: the "get-up and go" test。Archives of Physical Medicine and Rehabilitation,67(6),387-389。
16.
Rubenstein LZ.(1997)。Preventing falls in the nursing home。.J Am Med Assoc,278,595-596。
17.
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。
18.
Koch, S.、Lyon, C.(2001)。Case study approach to removing physical restraint。In J Nurs Pract,7,156-161。
19.
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。
20.
Huang HC.(2004)。A checklist to assist assessment of risk offall in older people。J Nurs Res,12,131-142。
21.
Huang HC, Lee CH, Wu SL.(2006)。Hip protectors: a pilot study of the elderly in Taiwan。J Clin Nurs,15,436-443。
22.
黃惠璣(2004)。銀髮族之運動。中華民國長期照護雜誌,8,11-23。
延伸查詢
23.
Purser JL, Piepen CF, Poole C, Morey M.(2003)。Trajectories of leg strength and gait speed among sedentary older adults: longitudinal pattern of dose response.。J Gerontol A Biol Sci Med Sci,58,1125-1134。
24.
Janelli LM, Stamps D, Delles L.(2006)。Physical restraintuse: a nursing perspective。Medsurg Nurs,15,163-167。
圖書
1.
Hazzard WR, Blass JP, Halter JB, Ouslander JG, Tinetti ME(2003)。Principles of Geriatric Medicine & Gerontology.5th ed.,。Philadelphia。
2.
Wolf R, Daichmann L, Bennett G.(2002)。Abuse of the elderly。World Report on Violence and Health。Geneva, Switzerland。
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