Biomedical subjects
Publications and source records attributed to G W Kanski.
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.
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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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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.
Although the use of physical or mechanical restraints is decreasing in long-term care facilities, there always will be some patients who require them. If a restraint is to be employed at all, it needs to be used correctly. A convenience sample of 118 nursing staff members who work in a county nursing home was asked to complete an 18-item knowledge questionnaire regarding restraint usage. Scores ranged from 6 to 17 (potential range 0-18), with a mean score of 13.2 (SD = 2.1). Overall, the staff's knowledge level can be considered good; however, there were some areas of concern. For example, a majority of the respondents (82.2%) believed that it was appropriate to keep a patient restrained lying flat in bed. Implications for administrators and rehabilitation nurse clinicians are identified.
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.
Roy's Adaptation Model is used in a case study approach to begin examining the potential of music intervention in hospitalized, restrained patients. Restraints were removed during the time in which the patient listened to a musical tape through a headset. Mr. D, presented in this case study, was one of the 30 medical-surgical patients who participated. His observable positive behaviors increased from 10 during the preintervention period to 12 during the musical intervention. Mr. D displayed no negative behaviors during the entire study period.
PURPOSE OF THE STUDY: To determine whether children's attitudes toward alcohol consumption changed as they grew older and to what extent peers might influence the decision to drink alcoholic beverages. METHOD: A cross-sectional descriptive study of 500 children ages 8-15 years was performed using a questionnaire. Data analysis included descriptive statistics and contingency analysis. RESULTS: Age was the only variable significantly related to decision making. Attitudes toward alcohol were more favorable in older children. Peer influence did not appear to affect drinking behavior. CONCLUSION: Older children (ages 14-15) are more favorably disposed to drinking than younger children. Children may be more influenced by parents than is realized. Parental guidance just prior to age 14 may be an effective intervention.