This study provides a data base for developing intervention strategies aimed at helping staff cope with concerns regarding restraints. Most respondents believe patients should be restrained for safety even if it means loss of dignity, and that a caring manner should be conveyed to restrained patients. A large percentage felt that family members did not have the right to refuse the use of restraints, but that they should have that right if they were patients, suggesting negative attitudes toward restraints, of which they are unaware. Personal and professional characteristics, such as knowledge about restraints, years in geriatrics, and experience with elderly family members, showed no significant relationship to attitudes.
Lack of appropriate alternatives to the use of restraints in hospitals and rehabilitation settings is a major concern of nurses. The purpose of this pilot study was to determine the behavioral effects of music intervention with physically restrained patients. The results demonstrated that the number of positive behaviors increased significantly during the music-listening period, during which patients were not restrained, as compared to their typical restrained status. No differences were found that related to the number of negative behaviors displayed before, during, or after the music intervention. Listening to music of their own choosing may help produce positive behaviors in previously restrained patients; however, further studies are needed to confirm this.
1. Families do not realize that a patient has a right to refuse restraints and that the family members have a voice in the decision-making process. 2. Families in general are interested in restraint issues but do not have information at their disposal. 3. Nursing staff should be encouraged to educate family members regarding restraints through open communication and printed material.
1. A component of the Omnibus Budget Reconciliation Act of 1987 declared that nursing home residents have the right to be free from physical or chemical restraints that are not required to treat specific "medical symptoms." 2. The literature suggests that the use of restraints has a negative influence on the caregiving process by restricting creativity and individual treatment. 3. Decreased reliance on restraints can be accomplished in nursing homes without an increase in staffing. 4. Transition to limited restraint use requires an organized, planned effort to change attitudes, beliefs, practices, and policies of a facility.
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