本研究以質性研究法,對住院中曾經接受身體約束的老人進行深入訪談,目的在於探討住院老人對身體約束的經驗及感受。個案來自嘉義(一家)及台南(三家)地區級以上醫院之住院老人,使用半結構式問卷訪談15位意識清醒之個案,經其同意並以錄音方式記錄訪談內容,再以內容分析法進行資料歸納及分析。收案時間自2002年7月至2004年2月止。結果顯示老人有四個主要感受及經驗:(1)身體的囹圄與禁錮:活動受限、日常活動不便;(2)情緒的衝擊與映照:包括無力感、焦慮、憤怒、自責、憂鬱等情緒反應;(3)嘗試因應以求自在:嘗試掙脫束縛、逆來順受之隱忍、只好被迫的說服;(4)自我詮釋的宿命觀:合理化觀點、消極被懲罰、宿命因果觀。身體約束的主要決策者經常為護理人員,因此護理人員應正視老人的經驗感受,提供更貼近人性及個別化的照護方式。
The purpose of this study was to explore and understand hospitalized elderly patients' perceptions and experiences of physical restraints. In-depth interviews and observations were used to collect data in four hospitals in southern Taiwan. Purposive sampling was applied, and 15 elderly patients who had experienced physical restraints during their hospitalization were interviewed using semi-structured questionnaires. The data collection period was from July 2002 to February 2004. Content analysis was used to analyze and categorize the data, which were classified into four thematic categories, as follows: (1) physical limitation and inconvenience: limited use of limbs and inconvenience associated with daily activities, (2) emotional impact: powerlessness, anxiety, anger, self-blame, and depression, (3) coping strategies: trying to free oneself from the restraint, patiently putting up with it, being convinced without choice, and (4) fatalistic self-interpretation: a rationalized perspective, being punished passively, a fatalistic concept of cause and effect. The findings of this research may help nurses, the main decision-makers as regards the use of restraints, to understand the perceptions and experiences of hospitalized elderly patients who are restrained. This may assist them in providing individual and human care.