DOI QR코드

DOI QR Code

Families' Perception and Attitude toward Applied Physical Restraints in General Neurological Wards

신경계 병동에서 억제대를 적용 중인 환자가족의 억제대 적용에 대한 인식과 태도

  • Received : 2015.04.05
  • Accepted : 2015.05.07
  • Published : 2015.05.31

Abstract

This study was conducted to identify families' perception and attitude toward application of physical restraint(PR) in general neurological wards. The study is based on subjects from 70 family members who have cared patients applying PR. Data was collected using self-report questionnaires and reviewing of patients' medical records. 68.6% of subjects were female and the mean age was 47.9 years old. Family members were either sons, daughters or spouses. The questionnaires analyzed families' perceptions based on a score of 5, the results showed a mean score of 4.2, and items related to maintaining therapeutic tools scored the highest. The application of PR with two hands was perceived by families as more important than PR applied with one hand. In families' attitude toward PR, there was general agreement that families had the right to decide to apply and remove PR. Continuous education and information regarding PR is required to support families.

본 연구는 신경계병동에서 억제대를 적용 중인 환자의 가족을 대상으로 억제대 적용에 대한 인식과 태도를 파악할 목적으로 시행된 서술적 조사연구이다. 2014년 6월 1일부터 2014년 9월 30일까지 부산시 소재 일개상급종합병원의 신경계병동에서 억제대를 적용 중인 환자의 가족 70명을 대상으로 설문조사했고 환자자료는 의무기록으로 조사했으며 수집된 자료는 서술통계, t-test, ANOVA, $Scheff\acute{e}$ tests로 분석했다. 환자가족은 여자가 68.6%, 평균 47.9세, 환자의 배우자나 자녀가 70% 이상이었고 일일 평균 15.4시간 동안 환자를 돌보고 있었다. 억제대 적용에 대한 인식의 평균점수는 4.2/5점이었고, 치료장치 유지와 관련된 인식점수가 높았고(평균 4.6-4.9/5점) 억제대 적용부위에 따라 양손이 한손보다 더 중요하다고 인식했다. 억제대 적용태도에 있어서는 환자와 가족에게 적용과 제거에 대한 결정권이 있다와 관련된 문항에 동의하는 가족이 많았다. 본 연구의 결과를 토대로 환자가족에게 억제대 관련 정보제공과 지속적인 교육을 통한 지원이 요구된다.

Keywords

References

  1. N. E. Strumpf, L. K. Evans, "Physical restraint of the hospitalized elderly: perceptions of patients and nurses", Nursing Research, Vol.37, No.3, pp.132-137, 1988. DOI: http://dx.doi.org/10.1097/00006199-198805000-00002
  2. A. F. Minnick, L. C. Mion, M. E. Johnson, C. Catrambone, R. Leipzig, "Prevalence and variation of physical restraint use in acute care settings in the US", Journal of Nursing Scholarship, Vol.39, No.1, pp.30-37, 2007. DOI: http://dx.doi.org/10.1111/j.1547-5069.2007.00140.x
  3. Y. Cho, J. Kim, N. Kim, H. Choi, J. Cho, H. Lee, R. Kim, Y. Sung, "A study on the use of physical restraints in ICUs", Journal of Korean Academic Society of Adult Nursing, Vol.18, No.4, pp.27-38, 2006.
  4. J. Kang, E. Lee, E. Y. Park, Y. Lee, M. M. Lee, "Emotional response of ICU patients' family toward physical restraints", Journal of Korean Academic Society of Adult Nursing, Vol.25, No.1, pp.148-156, 2013. DOI: http://dx.doi.org/10.7475/kjan.2013.25.2.148
  5. H. Ko, J. Kang, "Development and application of the sleeve-type restraints for intensive care unit patients", Journal of Korean Academic Society of Adult Nursing, Vol.25, No.6, pp.665-679, 2013. DOI: http://dx.doi.org/10.7475/kjan.2012.24.6.665
  6. Y. Lee, E. Cho, S. Kim, J. Kim, H. Kim, H. Kim, H. Song, "The study on physical restraint use in intensive care unit(ICU)", Journal of Korean Clinical Nursing Research, Vol.8, No.2, pp.117-130, 2003.
  7. D. Evans, J. Wood, L. Lambert, "A review of physical restraint minimization in the acute and residential care settings", Journal of Advanced Nursing, Vol.40, No.6, pp.616-625, 2002. DOI: http://dx.doi.org/10.1046/j.1365-2648.2002.02422.x
  8. M. Park, J. Tang, "Changing the practice of physical restraint use in acute care", Journal of Gerontological Nursing, Vol.33, No.2, pp.9-16, 2007.
  9. Joint Commission on Accreditation of Healthcare, Retrieved from December, 31, 2014, from http://www.nursingworld.org/
  10. Korea Institute for Healthcare Accreditation, "Standards_Hospital", Retrieved December, 31, 2014, from https://www.koiha.or.kr/home/data/data/doView.act? boardno=166,
  11. K. S. Kim, J. H. Kim, S. H. Lee, H. K. Cha, S. J. Shin, S. A. Chi. "The physical restraint use in hospital nursing situation", Journal of Korean Academy of Nursing, Vol.30, No.1, pp.60-71, 2000. https://doi.org/10.4040/jkan.2000.30.1.60
  12. E. Lee, S. Ha, J. Kang, "Development and testing of an instrument to measure family's emotional response toward physically restrained patients", Journal of Korean Academy of Nursing, Vol.38, No.4, pp.629-638, 2008. DOI: http://dx.doi.org/10.4040/jkan.2008.38.4.629
  13. J. H. Song, "Awareness and attitudes of nursing staff and patients' family toward the application of restraints in intensive care unit", Unpublished master's thesis, Chung-Ang University, Seoul, 2014.
  14. S. Kurata, T. Ojima, "Knowledge, perceptions, and experiences of family caregivers and home care providers of physical restraint use with home-dwelling elders: a cross-sectional study in Japan, Geriatrics, Vol.14, No.39, pp.1-11, 2014. DOI: http://dx.doi.org/10.1186/1471-2318-14-39
  15. D. Lee, S. S. Yoon, "Delirium and acute confusion state", Journal of Neurocritical care, Vol.4, pp.25-34, 2011.
  16. J. M. Yeo, M. H. Park, "Effects on education program for nurses on the use of restraints", Journal of Korean Academy of Nursing, Vol.36, No.3, pp.532-541, 2006. https://doi.org/10.4040/jkan.2006.36.3.532
  17. K. Kwak, S. Kim, E. Bae, E. S. Lee, E. H. Lee, Y. Choi, Y, Lee, "Decreasing the application rate of unnecessary physical restraint through the establishment of a guideline for restraint application", Journal of Korean Society of Quality Assurance in Health Care, Vol.15, No.2, pp.93-103, 2009.
  18. E. Yeun, J. H. An, J. A. Kim, M. S. Jeon, "Perceptions of family care-givers toward use of physical restraints: An application of Q-methodology", Journal of Korean Academic Society of Adult Nursing, Vol.25, No.3, 2013. DOI: http://dx.doi.org/10.7475/kjan.2013.25.3.344
  19. J. Kim, H. Oh, "Perceptions and attitude on use of physical restraints among caregivers in long term care facilities", Journal of the Korean Gerontological Society, Vol.26, No.2, pp.347-360, 2006.
  20. L. Janelli, G. Kanski, Y. Scherer, M. Neary, "Physical restraints: practice, attitudes and knowledge among nursing staff", The Journal of Long Term Care Administration, Vol.20, No.2, pp. 22-25, 1991.
  21. S. M. Azab, L. A. Negm, "Use of physical restraint in intensive care units (ICUs) at Ain Shams University hospitals, Cairo", Journal of American Science, Vol.9, No.4, 2013.
  22. M. Kim, J. Park, "A study on the application of physical restraints in intensive care units", Korean Journal of Fundamentals of Nursing, Vol.17, No.2, pp.177-186, 2010.
  23. K. S. Kim, S. A. Chi, "A study on perceptions about physical restraints: Use of nurses' and doctors' in hospital setting", Chung-Ang Journal of Nursing, Vol.5, No.1, pp.65-78, 2001.
  24. A. Haut, N. Kolbe, S. Strupeit, H. Mayer, G. Meyer, "Attitudes of relatives of nursing home residents toward physical restraints", Journal of Nursing Scholarship, Vol.42, No.4, pp.448-456, 2010. DOI: http://dx.doi.org/10.1111/j.1547-5069.2010.01341.x
  25. M. Vassallo, C. Wilkinson, R. Stockdale, N. Malik, R. Baker, S. Allen, "Attitudes to restraint for the prevention of falls in hospital", Gerontology, Vol.51, pp.66-70, 2005. DOI: http://dx.doi.org/10.1159/000081438
  26. I. Chang, S. Lee, "Fall risk factors and characteristics of an acute hospital setting across clinical departments", Journal of Korean Academy of Fundamentals of Nursing, Vol.21, No.3, pp.264-274, 2014. DOI: http://dx.doi.org/10.7739/jkafn.2014.21.3.264