DOI QR코드

DOI QR Code

요양병원에서 신체억제대를 적용한 일부 치매노인 환자의 특성과 부작용 관련성

Characteristics and Side effects Relevance of Physically Restrained Elderly Patients with Dementia in the Nursing Hospitals

  • 김수연 (강동대학교 의무부사관과) ;
  • 채경숙 (신성대학교 간호학과)
  • Kim, Su-Youn (Department of Medical Non-Commissioned Officer, Gangdong University) ;
  • Chae, Kyung-Suk (Department of Nursing, Shinsung University)
  • 투고 : 2018.02.09
  • 심사 : 2018.04.20
  • 발행 : 2018.04.28

초록

본 연구의 목적은 신체억제대를 적용한 치매노인 환자의 구체적인 특성과 부작용 발생 관련성을 파악하기 위함이었다. 2016년 5개 요양병원에서 치매노인에게 신체억제대를 적용한 간호사, 간호조무사, 요양보호사를 대상으로 구조화된 설문지를 이용하여 자료를 수집하였다. 190개의 자료를 SPSS 21.0의 신뢰도 분석, 기술통계, 카이제곱검정으로 분석하였다. 연구결과 '75- 84세' 연령의 환자가 58.3%, 1일 총 적용시간 중 '17-24시간'인 환자가 22.6%, 밤에 적용한 환자가 57.4%, 낙상과거력이 없는 환자가 54.2%를 차지하였다. 연령은 국소부종, 관절구축과 관련성이 있으며 특히 85세 이상의 환자에서 관절구축의 발생빈도가 25%로 나타났다(p<.05). 보행능력은 욕창과 관련이 있었으나 걸을 수 없는 환자보다 걸을 수 있는 환자의 욕창 발생빈도가 오히려 더 많았다. 총 적용시간은 피부발적, 국소부종, 관절구축의 3가지 부작용과 관련성이 있음을 알 수 있었다(p<.05). 본 연구를 기초로 신체억제대를 적용한 환자 돌봄 시 연령과 총 적용시간을 고려한 접근이 필요함을 제언하는 바이다.

참고문헌

  1. Health Insurance Review & Assessment Service. (August. 1. 2017). Healthcare bigdata hub, dementa., Healthcare bigdata hub(online). http://opendata.hira.or.kr
  2. Korea Health Industry Development Institute Korean Health Industry Statistics System. (August. 2, 2017). National health insurance service Annual Medical Insurance Statistics for 2015 and 2010. KHISS(online). https://www.khiss.go.kr
  3. Bundang Seoul National University Hospital /Ministry of Health and Welfare. (2011). Dementia elderly survey final report, Bundang publishing.
  4. Ministry of Health and Welfare. (March. 31, 2018). National Health and Medical Care Survey final, Ministry of Health and Welfare(online), http://www.mohw.go.kr
  5. A. P. Retsas. (1998). Survey findings describing the use of physical restraints in nursing homes in Victoria. Australia. International Journal of Nursing Study, 35(3), 184-191. DOI :http://dx.doi.org/10.1016/S0020-7489(98)00027-3 https://doi.org/10.1016/S0020-7489(98)00027-3
  6. Ministry of Health and Welfare. (December. 23. 2013). Guideline for safe use of physical restraint in geriatric hospitals, Ministry of health and Welfare(online). http://www.mohw.go.kr
  7. D. H. Kim, C. M. Kim, E. M. Kim & M. S. Park. (2011). Application of Physical Restraints by Health personnel in Nursing Homes. Journal of Korean Gerontological Nursing, 13(2), 131-141.
  8. S. Marangos-Frost & D. Wells. (2000). Psychiatric nurses'Thoughts and Feelings about Restraint Use: a Decision Dilemma. Journal of Advanced Nursing, 31(2), 362-369. DOI : http://dx.doi.org/10.1046/j.1365-2648.200X.01290. https://doi.org/10.1046/j.1365-2648.2000.01290.x
  9. A. R. Yoo & H. S. Kim. (2016). Physical restraints use and associated factors among older adults in nursing homes. Korean Health Economic Review, 22(1), 39-58.
  10. R. Nay & S. Koch. (2006). Overcoming restraint use: Examining barriers in Australian aged care facilities. Journal of Gerontological Nursing, 32(1), 33-38. DOI: http://dx.doi.org/10.3928/0098-9134-20060101-13 https://doi.org/10.3928/0098-9134-20060101-13
  11. E. Bellenger, JE. Ibrahim, L. Bugeja & B. Kennedy. (2017). Physical restraint deaths in a 13-year national cohort of nursing home residents. Age Ageing, Jan 3. [Epub ahead of print] DOI: http://dx.doi.org/10.1093/ageing/afw246. https://doi.org/10.1093/ageing/afw246
  12. H. J. Lee & K. H. Kim. (2016). Perceptions and Intention of Nurses in Using Physical Restraints for Dementia Patients in Geriatric Hospitals. Journal of Korean Gerontological Nursing, 18(3), 159-171. https://doi.org/10.17079/jkgn.2016.18.3.159
  13. C. H. Kim. (2006). Characteristics of geriatric diseases. Korean Journal of Internal Medicine, Symposium. 71(2), S844-S847.
  14. O. Kirkevold, L. Sandvik & K. Engedal. (2004). Use of contraints and their correlates in Norwegian nursing homes, International Jouranl of Geriatric Psychiatry, 19(10), 980-988. DOI: http://dx.doi.org/10.1002/gps.1197 https://doi.org/10.1002/gps.1197
  15. N. G. Castle, B. Fogel & V. Mor. (1997). Risk factors for physical restraint use in nursing homes: pre-and post implementation of the nursing home reform Act. Gerontologist, 37, 737-747. DOI: http://dx.doi.org/10.1093/geront/37.6.737 https://doi.org/10.1093/geront/37.6.737
  16. M. H. Lim & I. S. Ko. (2012). Risk Factors leading to Accidents associated with the use of Physical Restraints in Nursing Homes. Journal of Korean Gerontological Nursing, 14(1), 1-11.
  17. J. Y. Kang, E. N. Lee, E. Y. Park, Y. Lee & M. M. Lee. (2013). Emotional Response of ICU Patients'Family toward Physical restraints. Korean Journal of Adult Nursing 25(1), 148-156. DOI: http://dx.doi.org/10.7475/kjan.2013.25.2.148 https://doi.org/10.7475/kjan.2013.25.2.148
  18. S. M. Kim, Y. J. Lee, D. H. Kim, S. Y. Kim, H. Y. Ahn & S. J. Yoo. (2009). Perception, Attitude, and Knowledge about Physical Restraints among Nursing Personnel in Long Term Care Facilities, Journal of Korean Academic Society Nursing Education, 15(1), 62-71. https://doi.org/10.5977/JKASNE.2009.15.1.062
  19. M. H. Lim & I. S. Ko. (2013). Protocol for Physical Restraints of Patients in Nursing Homes. Journal of Korean Academic Fundamental Nursing, 20(4), 345-358. DOI: http://dx.doi.org/10.7739/jkafn.2013.20.4.345 https://doi.org/10.7739/jkafn.2013.20.4.345
  20. M. Yamada, et al. (2008). Incidence of Dementia, Alzheimer Disease, and Vascular Dementia in a Japanese Population: Radiation Effects Research Foundation Adult Health Study. Neuroepidemiology, 30(3), 152-160. DOI: http://dx.doi.org/10.1159/000122332. https://doi.org/10.1159/000122332
  21. H. Hofmann, E. Schorro, B. Haastert & G. Meyer. (2015). Use of physical restraints in nursing homes: a multicentre cross-section al study. BioMedCentral Geriatrics, 15(129), Published online DOI:http://dx.doi.org/10.1186/s12877-015-0125-x. https://doi.org/10.1186/s12877-015-0125-x
  22. K. Lam, et al. (2017). Factors Associated With the Trend of Physical and Chemical Restraint Use Among Long-Term Care Facility Residents in Hong Kong: Data From an 11-Year Observational Study. Journal of the American Medical Directors Association, Aug 23. [Epub ahead of print]. DOI:http://dx.doi.org/10.1016/j.jamda.2017.06.018 https://doi.org/10.1016/j.jamda.2017.06.018
  23. S. H. Lim. (2016. October.31.). Domestic deme ntia patient increase by 20% annual average, The most(online). http://www.monews.co.kr
  24. K. J. Lee, G. S. Park & Y. S. Park. (2016). Family Member's Perceptions of Side Rail Use in Geriatric Hospital. Journal of Digital Convergence, 14(12), 503-513. DOI:http://dx.doi.org/10.14400/JDC.2016.14.12.503 https://doi.org/10.14400/JDC.2016.14.12.503
  25. H. S. Song. (2016). A study on the Relationship among Depression, Walking and Quality of Life for the Elderly-Focusing on the Moderation Effects of Walking. Journal of Digital Convergence, 14(8), 515-525. DOI:http://dx.doi.org/10.14400/JDC.2016.14.8.515 https://doi.org/10.14400/JDC.2016.14.8.515
  26. H. Hofmann & S. Hahn. (2014). Caracteristics of nursing home residents and physical restraint: a systematic literature review. Journal of Clinical Nursing, 23(21-22), 3012-3024. DOI:http://dx.doi.org/10.1111/jocn.12384 https://doi.org/10.1111/jocn.12384
  27. R. Mohler & G. Meyer. (2014). Attitudes of nurses towards the use of physical restraints in geriatric care: a systematic review of qualitative and quantitative studies. International Journal of Nursing Studies, 51(2), 274-288. DOI:http://dx.doi.org/10.1016/j.ijnurstu.2013.10.004 https://doi.org/10.1016/j.ijnurstu.2013.10.004
  28. S. K. Chung & E. Y. Jeong. (2016). Accidental self-removal of medical devices according to use of physical restraints: systematic review. Asia-pacific Journal of Multimedia Services Convergent with Art, Humanities, and Sociology, 6(11), 253-267. DOI:http://dx.doi.org/10.14257/AJMAHS.2016.11.06 https://doi.org/10.14257/AJMAHS.2016.11.06