| 摘要: | 本研究目的在探討護理人員對病人執行身體約束之決策影響因素。採橫斷式研究方式，經立意取樣，以台灣北部四所醫院內外科普通病房及加護病房護理人員為研究對象，運用結構式問卷收集基本屬性、約束使用情形、約束知識、約束看法、工作壓力與工作滿意度等資料，並將所得資料利用SPSS 17.0電腦套裝軟體，以百分比、平均值、標準差、皮爾森積差相關、t檢定、單因子變異數分析、與逐步迴歸等方法進行統計分析。研究結果發現超過90%護理人員在兩年內曾有約束病人的經驗; 肢體躁動、情緒不穩定、及身上有許多管路的患者是最常被約束的對象;護理人員約束病人的主要原因是為預防或減少病人受傷;手腕與手套式約束是最常被使用的方式，多數約束發生於夜班時間，且有近三成的約束狀況會持續3天以上，而護理人員約束病人時間與其約束看法有顯著相關。經逐步迴歸分析發現有、年齡、婚姻狀態與無繼續在職進修三者對護理人員決定約束類型的解釋力為13.9%;婚姻狀態、是否繼續在職進修及兩年內有無參加約束教育課程等對護理人員決定約束時間長短的解釋力則為17%。本研究結果期作為國內制定病人安全之職前或在職教育的參考，亦可提供相關領域學者設計約束防治介入處置之初探。
To investigate nurses’ reasons for using physical restraint in nursing practice, and in addition, to explore the influence factors of decisions regarding physical restraint use. A cross-sectional design is employed. Purposive sampling is used to obtain potential subjects.168 register nurses from the Medical-Surgical Wards and Intensive Care Units of four teaching hospitals in Metropolitan Taipei area participated in this study. Data collection was performed by well-trained research assistants and the research tools included the demographic data, survey of restraint use, knowledge of restraint use, Perceptions of Restraint Use Questionnaire (PRU), Job Burden Interview (JBI), and Minnesota Satisfaction Questionnaire (MSQ). Descriptive statistics, Pearson correlation, t-test, ANOVA, Stepwise regression were used to analyze all obtained data. Study revealed that over 90% nurses have been restraint patient within two years. To prevent or minimize any harm was the main reason for using physical restraint. The types of wrist and gloves restraint were the preferable choices of nurses. Mostly restraint using occur in night, and the length of restraint use was positively associated with the nurse’s perceptions of restraint. Stepwise regression analysis demonstrated that age, marital status, in-service education are predictors of the type of restraint which account for 12.3%, on the other hand, in-service education, marital status, on-the-restraint training, also are predictors of length of restraint use which account for 17% of the total variance of physical restraint use. The research finding not only can be view as a data to assist in shaping educational training program of patient safety, but also serve as references for nursing professional to provide “restraint-free” interventions to acute care settings in the future. |
