Research On The Status Quo Of Physical Restraints And Stakeholders’ Cognitive Experience Of Restraints In Aged Care Facilities In Hunan Province

Objective:1.Investigate the use of physical restraint by the elderly in aged care facilities in Hunan Province,and analyze the influencing factors of the use of physical restraint by the elderly in pension institutions.2.To understand the cognitive experience of managers of aged care facilities and family members of the restrained elderly on the implementation of physical restraint.Methods:1.The aged care facilities of hunan province elderly people use current situation and influencing factors of study: Stratified cluster random sampling method was adopted to sample,that is,according to the regional and economic development level,Hunan province was divided into three regions: eastern Hunan,northern Hunan and southwest Hunan,and then the randomization method was adopted to select the elderly care facilities meeting the inclusion and exclusion criteria in the three regions as the research site..From March 2021 to July 2021,the researchers used the questionnaire on the Use of Physical Restraint by the Elderly in aged care facilities consulted by experts to investigate and observe all the elderly meeting the inclusion and exclusion criteria in aged care facilities,and collected 988 valid questionnaires.Descriptive statistical analysis was used to describe and analyze the use of physical restraint in aged care facilities,and binary Logistic regression analysis was used to explore the influencing factors of physical restraint in aged care facilities.2.Qualitative research on constrained cognitive experience by stakeholders of physical restraint: Using the method of purposeful sampling and the principle of information satiety,the researchers conducted phenomenological interviews with 11 managers and 29 restrained elderly family members in 8 facilities..The interview data and recordings were transcribed and coded word for word by the researcher himself,and the Colaizzi seven-step method in phenomenological research was used to guide the data analysis.Results:1.Use of physical restraint in aged care facilities in Hunan Province:the use rate of physical restraint in aged care facilities in Hunan Province is 23.2%.Among them,the most frequent use of physical restraint was from 19:30 to 21:30 in the evening.The common position of physical restraint was double upper limbs.The most common position of physical restraint was supine,and the most common tool of physical restraint was restraint belt.In addition,160 of the 229 elderly subjects with restraint used physical restraint 3 times,accounting for 69.87%;There was no record of physical restraint in all the nursing institutions investigated.All aged care facilities obtained the consent of the elderly or their family members by signing informed consent or oral promise before exercising physical restraint,and 222 elderly people exercised physical restraint after undergoing physical evaluation;The most common interval between the physical restraint inspection of the elderly by nursing staff in aged care facilities is 0.5~< 1 hour;Among 229 subjects,39 had skin redness at the restricted site,and 8 had skin ulceration at the restricted site.2.Influencing factors of physical restraint of the elderly in aged care facilities in Hunan Province: Binary classification Logistic Regression analysis shows that pension agency nature of facilities,nursing staff and check in the ratio of the elderly,the elderly age,cultural degree,marital status,number between homes,daily activity ability,cognitive function,whether suffering from alzheimer’s,if there is a stomach tube,is there a catheter,whether there is a vein indwelling needle,type of diet were independent factors affecting the elderly physical restraint use(P< 0.05).3.The cognition and attitude of aged care facilities managers on the use of physical restraint include: Angles to the body used to think,sita know physical constraints theory and implementation present situation,the specification and reduce physical constraint measures,most managers have a certain understanding and practice of constraint to the body using a neutral attitude,some managers expressed support for physical constraints to use,only a few managers against physical constraint is routine before use,the use of physical restraint,need to assess their will The implementation of physical restraint should conform to the norms,and actively seek alternative methods of restraint,the elderly care is difficult and the lack of nursing staff in the facilities,elderly family members do not understand and do not cooperate in the use of restraint,aged care facilities generally pay low attention to physical restraint.4.The physical restraint experience of family members of the elderly subject to restriction in aged care facilities includes: Heart afflictive,inner body without too much feelings,accept and use is,no choice but to support the body constraints of fair use,against physical constraints,abuse and non-standard use,apply to the parties agree to use constraint,the elderly should receive more attention,subject to constraints should be constrained the elderly to provide more fine and high-quality care.Conclusion:1.There are still many irregularities in the implementation of physical restraint in aged care facilities in Hunan Province.The standardized implementation of physical restraint and the formulation of reduction plans still need the joint promotion of all parties.In addition,physical restraint in aged care facilities is affected by a variety of factors,so the managers of aged care facilities need to address the relevant factors affecting the use of physical restraint by the elderly,so as to reduce the application of physical restraint in aged care facilities.2.Managers of aged care facilities should clarify the improvement direction of the use of physical restraint,overcome obstacles in the process of standardizing and reducing physical restraint,and actively promote the implementation process of standardization and minimization of physical restraint.At the same time,in the process of carrying out physical restraint,aged care facilities should understand the psychological experience of the restrained elderly family members and meet the reasonable requirements of the family members,so as to reflect the humanistic care of nursing.