影響加護病房護理人員執行病患身體約束行為之因素

Factors Associated with Behavior of Physical Restraint among Nurses in the Intensive Care Unit

本研究旨在探討影響加護病房護理人員執行病患身體約束行為之相關因素。研究對象為南部某醫學中心所有加護病房護理人員，共294位，完成受測率為65.31％(192/294)。研究工具為江、許、陳及郭(1999)所發展之身體約束知識及態度結構式問卷，身體約束行為資料則由病歷查閱病患被約束的人次數。資料以SPSS for windows 10.0軟體進行多變項逐步回歸分析。結果顯示：護理人員身體約束知識平均答對率為70.43％；身體約束態度平均3.83±0.40分，趨向於同意執行身體約束；每位護理人員執行約束的次數平均8.18±6.28人次。回歸分析顯示外科單位、N1進階層級、護理師職稱者所執行之約束行為次數較多，可解釋約束行為總變異量的15.1％；知識或態度得分與約束行為無顯著線性相關。所以建議護理主管應針對外科加護單位、N1進階層級的臨床護理人員進一步追蹤約束行為，同時創造與醫療團隊討論約束的機會及制訂合理的政策。未來研究則應再分析影響身體約束行為決策的非護理人員因素。

The purpose of this study was to explore factors associated with behavior of physical restraint among nurses in the intensive care unit (ICU). The ICU nurses who worked at a medical center in southern Taiwan participated in the study. One hundred and ninety-two (65.31%) eligible nurses completed the questionnaire regarding their sociodemographic variables, knowledge, and attitude toward physical restraint. The frequency of physical restraint was collected from reviewing patients’ chart. A multivariate analysis was performed using multiple linear regressions by SPSS for windows 10.0 software. The regression model showed that nurses at surgical ICU, nurse with N1 clinical ladder, and non-leader or head nurses had higher frequency of using physical restraint. These variables explained 15.1% of the total variation. The nursing mangers could improve the use of physical restraint by monitoring the behavior among nurses with N1 clinical ladder or in surgical ICU. Researches about decision making of physical restraint should be further studied in the future.