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題名：身體約束教育方案對護理人員的知識、態度與行為成效之探討
書刊名：護理暨健康照護研究
作者：謝佳容 引用關係／盧美秀／林秋芬 引用關係
作者(外文)：Hsieh, Chia-jung／Lu, Meei-shiow／Lin, Chiou-fen
出版日期：2014
卷期：10:4
頁次：頁265-275
主題關鍵詞：身體約束；教育方案；知識；態度；行為；Physical restraint；Education program；Knowledge；Attitude；Behavior
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(1) 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:1
  • 共同引用共同引用:23
  • 點閱點閱:245
背景：身體約束是醫院常見的措施之一，但卻會造成許多負面衝擊，同時護理人員也會感到罪惡感，或是過份高估好處。過去研究指出透過教育方式，可獲得維護病人安全的訊息，目前國內尚無以醫院為基礎的身體約束方案之介入研究。目的：執行教育介入課程後，探討護理人員於身體約束認知、態度與行為的改善成效。方法：採類實驗研究法，單組前、後測設計，為立意取樣方法。對象為某二家教學醫院之護理人員（380名）。使用身體約束介入照護手冊進行團體教育課程計8次，每次2小時。工具為「身體約束之認知、態度與行為量表」，測量時間為介入前（T1），課程結束（T2）及介入後第三個月（T3），以SPSS 20.0統計軟體，採重複測量分析方法。結果：研究對象在第一次前與後測（T2）身體約束認知得分率改變量（M=-7.13, p＜.01）、約束態度（M=-0.08, p＜.001）及約束行為改變量（M=-0.11, p＜.01）皆有顯著改善，同時後測（T3）測量值也具顯著成效，表示方案具有持續作用。研究對象無論工作年資、工作單位或年齡不同，方案介入皆可有效提升其身體約束的認知、態度和行為。結論／實務應用：本方案可提升護理人員身體約束認知，以及態度與約束行為的改變，故建議未來在職課程可持續導入此主題，以促進護理人員的知能，並提升態度與行為的正確性。
Background: Although the use of physical restraints (PR) is a very common strategy used in hospitals, this strategy poses significant psychological and emotional drawbacks. Moreover, nurses may feel guilt or overestimate the benefits of using PR. Previous studies have indicated that an education program may ameliorate patient safety and thus minimize the negative aspects of PR use. No hospital‐based intervention study on this topic has previously been conducted in Taiwan. Purpose: This study evaluates the effects of education programs on nursing staff in terms of improving PR‐use knowledge, attitudes, and behaviors. Methods: This quasi‐experimental study used a pre‐post testing research design and used purpose sampling to recruit nurses working at two teaching hospitals in northern Taiwan (N=380). We used PR guideline handbooks for eight sessions and conducted an education program and a group lesson for 2 hours during one session. We adopted the scale of knowledge, attitude, and behavior of PR to collect data at baseline (T1), at four‐week immediate post‐program (T2), and at three months follow‐up (T3). SPSS/PC 20.0 analyzed data using repeated measures ANCOVA. Results: The intervention significantly improved knowledge (M=‐7.13, p＜.01) and altered both the attitudes toward PR use (M=‐0.08, p＜.001) and the behaviors toward PR use (M=‐0.11, p＜.01) of the participants in the first pre‐post measurement. Additionally, the second pre‐post measurement realized similar and significant improvements. The results indicate that, despite differences in length of work, unit of work, and participant ages, the PR intervention program significantly improved scores in knowledge, attitudes, and behaviors toward PR use. Conclusions / Implications for Practice: A thorough education program may improve staff knowledge, attitudes and behaviors related to using PR. These findings may guide future hospital training by promoting knowledge on the use of PR in clinical settings.
期刊論文
1.邵明芬、彭淑慧、張筠喬、吳坤鴻、歐麗玲(20070900)。精神科病患身體約束品質提升專案。精神衛生護理雜誌，2(2)，55-63。  延伸查詢new window
2.施淑萍、黃碧華、張碧容、胡慧芬(20080500)。某地區醫院加護病房病患身體約束執行作業之改善方案。高雄護理雜誌，25(1)，22-33。  延伸查詢new window
3.黃麗萍、顧乃平(20061100)。病人安全--使用約束的倫理議題。源遠護理，1(1)，63-68。  延伸查詢new window
4.錢美容、陳幼珍、郭容美、李雅文(20040900)。在職教育對成人加護病房護理人員執行約束的知識、態度與行為之影響。長庚護理，15(3)=47，248-257。new window  延伸查詢new window
5.Abrahamsen, C.(2001)。Guide to new technology-patient restraints: JCAHO and HCFA issue new restraint guidelines。Nursing Management，32(12)，69-70。  new window
6.Brenner, Z. R.、Duffy-Dumin, K.(1998)。Toward restraint-free care。American Journal of Nursing，98(12)，16F+16H-16I。  new window
7.Choi, K.、Kim, J.(2009)。Effects of an educational program for the reduction of physical restraint use by caregivers in geriatric hospitals。Journal of Korean Academy of Nursing，39(6)，769-780。  new window
8.Heinze, C.、Dassen, T.、Grittner, U.(2012)。Use of physical restraints in nursing homes and hospitals and related factors:A cross-sectional study。Journal of Clinical Nursing，27(7)，1033-1040。  new window
9.Huizing, A. R.、Hamers, J. P. H.、Gulpers, M. J. M.、Berger, M. P. F.(2009)。A cluster-randomized trial of an educational intervention to reduce the use of physical restraints with psychogeriatric nursing home residents。Journal of the American Geriatric Society，57(7)，1139-1148。  new window
10.Hurlock-Chorostecki, C.、Kielb, C.(2006)。Knot-So-Fast: A learning plan to minimize patient restraint in critical care。Dynamics，77(3)，12-18。  new window
11.Janelli, L. M.、Stamps, D.、Delles, L.(2006)。Physical restraint use:A nursing perspective. Medsurg Nursing。Official Journal of the Academy of Medical-Surgical Nurses，75(3)，163-167。  new window
12.Koemer, J. G.(2003)。The virtues of the virtual world: Enhancing the technology/knowledge professional interface for lifelong learning。Nursing Administration Quarterly，27(1)，9-17。  new window
13.Kriiger, C.、Mayer, H.、Haastert, B.、Meyer, G.(2013)。Use of physical restraints in acute hospitals in Germany: A multi -centre cross-sectional study。International Journal of Nursing Studies，50(12)，1599-1606。  new window
14.Lane, C.、Harrington, A.(2011)。The factors that influence nurses’ use of physical restraints: A thematic literature review。International Journal of Nursing Practice，77(2)，195-204。  new window
15.Martin, B.(2002)。Restraint use in acute and critical care settings:Changing practice。AACN Advanced Critical Care，13(2)，294-306。  new window
16.Meyer, G.、Kopke, S.、Haastert, B.、Muhlhauser, I.(2009)。Restraint use among nursing home residents: Cross-sectional study and prospective cohort study。Journal of Clinical Nursing，18(1)，981-990。  new window
17.Minnick, A. F.、Mion, L. C.、Johnson, M. E.、Catrambone, C.、Leipzig, R.(2007)。Prevalence and variation of physical restraint use in acute care settings in the US。Journal of Nursing Scholarship，39(1)，30-37。  new window
18.Mohler, R.、Richter, T.、Kopke, S.、Meyer, G.(2012)。Interventions for preventing and reducing the use of physical restraints in long-term geriatric care--A Cochrane review。Journal of Clinical Nursing，27(21)，3070-3081。  new window
19.Sokol, D. K.(2010)。When is restraint appropriate?。British Medical Journal，341，c4147。  new window
20.Watson, R.(2001)。Restraint: Its use and misuse in the care of older people。Nursing Older People，13(3)，21-26。  new window
21.Werner, P.、Cohen-Mansfield, J.、Koroknay, V.、Braun, J.(1994)。Reducing restraints: Impact on staff attitudes。Journal of Gerontology Nursing，20(12)，19-24。  new window
22.Zwijsen, S. A.、Depla, M. F. I. A.、Niemeijer, A. R.、Francke, A. L.、Hertogh, C. M. P. M.(2011)。The concept of restraint in nursing home practice:A mixed-method study in nursing homes for people with dementia。International Psychogeriatrics，23(5)，826-834。  new window
23.江明珠、許玲女、陳翠娥、郭美玲(19990300)。護理人員對身體約束知識與態度之探討。長庚護理，10(1)=25，42-50。new window  延伸查詢new window
24.Choi, E.、Song, M.(2003)。Physical restraint use in a Korean ICU。Journal of Clinical Nursing，12(5)，651-659。  new window
25.Cruz, V.、Abdul-Hamid, M.、Heater, B.(1997)。Research-based practice: Reducing restraints in an acute care setting-phase 1。Journal of Gerontological Nursing，23(2)，31-40。  new window
26.明勇、孟祥越、范保羅(20020600)。「身體約束的使用」臨床之評估與應用。慈濟護理雜誌，1(2)，24-30。  延伸查詢new window
27.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
28.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
29.柯莉珊、周幸生、熊道芬、林麗華、陳玉枝(20100600)。重症護理人員執行病人身體約束之影響因素。榮總護理，27(2)，161-170。new window  延伸查詢new window
30.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
31.MacPherson, D. S.、Lofgren, R. P.、Granieri, R.、Myllenbeck, S.(1990)。Deciding to restrain medical patients。Journal of the American Geriatrics Society，38(5)，516-520。  new window
學位論文
1.李慧真(2005)。加護病房護理人員對身體約束之知識、態度及其行為之相關性探討(碩士論文)。輔英科技大學。  延伸查詢new window
圖書
1.財團法人醫院評鑑暨醫療品質策進會(2003)。台灣醫療品質指標計畫--急性照護指標2002年統計年報。台北市：財團法人醫院評鑑暨醫療品質策進會。  延伸查詢new window
2.邱皓政(2012)。量化研究方法(三)測驗原理與量表發展技術。臺北市：雙葉書廊。  延伸查詢new window
3.Ayers, S.、Baum, A.、McManus, C.、Newman, S.、Wallston, K.、Weinman, J.、West, R.(2007)。Cambridge handbook of psychology, health and medicine。Cambridge, UK：Cambridge University Press。  new window
4.Food and Drug Administration(1992)。FDA safety alert: Potential hazards with restraint devices。Rockville, MD：United States Department of Health and Human Services。  new window
其他
1.American Nurses Association(2012)。Position statements:Reduction of patient restraint and seclusion in health care settings，http://www.nursingworld.org/restraintposition。  new window
 
 
 
 
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