[[alternative]]Relative factors of using physical restraint in Long-Term Care Facilities - take some area as an example.

[[abstract]]本研究旨在瞭解某地區地區養護機構身體約束的盛行率，瞭解養護機構不同評鑑等級、住民基本屬性、照護人員的基本屬性及身體約束知識、身體約束態度、自我效能影響使用身體約束（physical restraint）之因素，本研究採橫斷面相關性研究設計，對某地區地區全部養護機構採立意取樣問卷調查法，共收16家養護機構，住民507人，護理人員18人，本籍照顧服務員41人，外籍照顧服務員57人。研究設計複製黃惠璣第一年國科會NSC 95-2516-S-227-002之研究，研究工具：採用國內黃惠璣（2006）發展之身體約束之量表，問卷內容包括住民約束評估表、巴氏量表（Barthel Index）、認知功能表（Mini-Mental State Examination, MMSE）、肌肉測驗（Muscle power）、照顧人員人口學資料、身體約束知識量表、身體約束態度量表、自我效能量表。以SPSS 14.0 for Window套裝統計軟體，進行描述性、推論性統計分析。結果發現某地區地區養護機構住民有、無身體約束在自我照顧能力、認知功能、走道地板有反光、房間無防滑地板、房間地板有反光，呈顯著差異。影響約束之相關因素：約束比率與評鑑等級呈顯著的正相關。以邏輯斯迴歸方式分析發現，住民之自我照顧能力、認知功能、機構評鑑等級為身體約束之危險因子。由於實際觀察發現此地區護理人員也較少教導照顧服務員之照護活動，故建議未來研究可採隨機取樣並且擴大樣本數，以增加研究結果推論及全面性之了解。根據臨床所見及研究結果，研究者建議機構負責人需建立照護人員正確觀念與知識，加強機構中環境安全並且在專業人員評估下，與家屬解釋、討論、簽署同意書後才約束住民，並同時執行每兩小時鬆綁的約束政策。照顧人員需要同時評估被約束住民及家屬，後續身、心、靈之照護，以提升良好照護品質。[[abstract]]The purpose of this study was to understand the prevalence of physical restraint in long-term care facilities. Understand the relative factors of physical restraint. It adopted a cross-sectional research design and purposive sampling in 16 long-term care facilities. The total number of resident was 507, nursing staff was 18, domestic caretaker was 41, foreign caretaker was 57. The research design duplicates Hui-chi Huang national science council NSC 95-2516-S-227-002 first year research. The research tools use Hui-Chi Huang develop in 2006 physical restraint‘s scales, included resident’s demographic data, Barthel Index, Mini-Mental State Examination, Muscle power, staff personal data, restraint’s knowledge, attitude and self-efficacy use questionnaire measures. Data was analyzed by SPSS 14.0 statistic software. This study explored the physical restraint in resident’s self-care, MMSE, the aisle floor has the reflection, the room non- skid prevention floor, the room floor has the reflection was different. The relative factors of physical restraint：the restraint ratio with difference ranking level reveals the correlation. The analysis discovery by logistic regression：resident’s self-care, MMSE, ranking level are restraint’s risk factors. Because actual observes discovered this area nursing staff less teach caretaker the activity. Therefore the suggestion the futurology might pick the random sampling and the expanded sample number, will increase the findings deduction and the comprehensive understanding. According to clinical sees and the findings, the researcher suggested the organization person in charge must establish according to protects the personnel correct idea and the knowledge. Strengthens in the organization the environment security and under the specialist appraisal, after the family member explained, discussion and signature agreement then restrains the resident, and simultaneously carries out the restraint policy which every two hours deregulates. Caretaker needs simultaneously to appraise is restrained the resident and the family member, following there body, heart, spirit care, promotes good according to protect the quality