计划行为理论视角下养老机构护理人员实施身体约束行为的质性研究

A qualitative study on practice of nursing staff toward physical restraint use in elder-care institutions based on the Theory of Planned Behavior

目的基于计划行为理论探究养老机构护理人员对老年人使用身体约束的行为信念、规范信念和控制信念,为规范身体约束使用提供参考。方法运用质性研究方法,以目的抽样选取重庆市2所养老机构20名护理人员进行开放性问卷调查、12名护理人员进行半结构式访谈,采用Colaizzi 7步分析法进行内容分析。结果提炼出护理人员对老年人使用身体约束的行为信念、规范信念、控制信念3部分,包括对使用身体约束的认知、态度、情感体验、团体压力、道德压力、责任压力、外在促进因素、外在阻碍因素8个主题。结论养老机构应开展规范的身体约束培训,改善护理人员对老年人身体约束的认知与态度;制定身体约束规范及干预措施并提供决策与实践支持,以减少老年人使用身体约束。

Objective To explore the behavioral,normative and control beliefs of nursing staff toward physical restraints use in institutional care based on the Theory of Planned Behavior,and to provide references for standardizing the use of physical restraints.Methods Applying qualitative research methods,20 nursing staff from 2 long-term care facilities in Chongqing were selected for an open-ended questionnaire survey and 12 nursing staff for semi-structured interview.Data were analyzed by Colaizzi′s phenomenological method.Results Nursing staff′s behavioral,normative and control beliefs of physical restraint use were identified,including eight themes as following:cognition,attitude,emotional experience,group pressure,moral pressure,responsibility pressure,external facilitators and barriers.Conclusion Long-term care facilities should carry out standardized education for nursing staff to enhance their knowledge and attitudes toward use of physical restraints,formulate norms and interventions,and provide support,thus to reduce the use of physical restraints on institutionalized elders.