| Objectives:To investigate the level of knowledge,attitude,and behavior of elderly caregivers'use of physical restraints and analysis influencing factors,and to provide a reference for long-term care to carry out physical restraint knowledge and skills training;Explored elderly caregivers psychological feelings and cope methods of physical restraint on the elderly to gain an explanatory understanding of their restraining behaviors.Methods:(1)Quantitative research:convenient cluster sampling,from October 2019 to December 2019,a questionnaire survey was conducted on the elderly caregivers in the dementia and disability area of the social long-term care of Changsha(public),Lushan senior apartment(public),Qingsong senior apartment(private)and other 6 long-term cares.District nurses conducted a questionnaire survey.The survey tools include a general survey of elderly caregivers and a scale about physical restraint knowledge,attitude,and behavior which was adjusted and tested for reliability and validity by an expert group meeting.A total of 373 valid questionnaires were collected.Used Excel to double check the input data and SPSS22.0 software for statistical analysis,reliability test used Cronbach's?coefficient,content validity teat used expert consultation method to calculate content validity index;Descriptive analysis of the demographic characteristics of elderly caregivers,whether they have participated in physical restraint knowledge training,physical restraint knowledge,attitudes,behavior scores,and other descriptive statistics through percentage,mean,and standard deviation;T-test and one-way analysis of variance were used to compare the two-sample or multi-sample means of the general information of the elderly caregivers to determine whether there were statistical differences in knowledge,attitude and behavior scores.Multiple linear stepwise regression was used to analyze multiple factors that affect the level of knowledge,attitudes and behaviors of elderly caregivers in implementing physical constraints on the elderly;Pearson correlation analysis was used to analyze the relationship between body restraint knowledge,attitude and behavior.(2)Qualitative research:In October 2019,a semi-structured in-depth interview was conducted with 20 elderly caregivers from Changsha First Social Welfare Institute(public),Rongcheng Elderly Rehabilitation Center(public),and Qingsong Elderly Apartment(private)used the purpose sampling method and the information saturation principle.The researchers themselves transcribed and coded the interview recordings verbatim and verbatim,and used the Colaizzi seven-step analysis method in phenomenological research to analyze the information.The analysis result was discussed by the researcher and the tutor to reach an agreement and draw a conclusion.Results:(1)The physical restraint knowledge,attitude,and behavior scale has good reliability and validity:the total scale Cronbach's?coefficient was 0.800,the physical restraint knowledge dimension Cronbach's?coefficient was 0.635,the physical restraint attitude dimension was 0.601,and the physical restraint behavior dimension was0.837;The S-CVI was 0.891,the physical restraint knowledge dimension I-CVI was 0.974,and the physical restraint attitude dimension I-CVI was0.989.The I-CVI of the physical restraint behavior dimension was 0.989.(2)The physical restraint knowledge,attitude,behavior status and influencing factors of the elderly caregivers:the physical restraint knowledge score was(6.28±1.89),and the correct rate was 57.1%;The t-test and one-way analysis of variance showed statistically significant differences in knowledge scores among different ages,academic qualifications,and unit properties(P<0.05);Multivariate stepwise regression analysis showed that age,education,and unit properties were the main influencing factors affecting the physical restraint knowledge of the elderly caregiver(R~2=0.005,P=0.000);The physical restraint attitude score was(31.45±3.20).The t-test and one-way analysis of variance showed statistically significant differences in attitude scores among different ages,education,and unit properties(P<0.05);Multivariate stepwise regression analysis showed that age,education,unit nature,and total scores of physical restraint knowledge were the main influencing factors on the physical restraint attitude of the elderly caregivers(R~2=0.216,P=0.000);The score of physical restraint behavior was(36.68±3.79).The t-test and one-way analysis of variance showed that different ages,educational backgrounds,length of care work,the number of elderly carers per day,monthly salary,unit properties,and whether they participated in physical restraint knowledge training.There were statistically significant differences in behavior scores(P<0.05);Multivariate stepwise regression analysis showed that physical restraint knowledge scores,participation in physical constraint knowledge training,physical restraint attitude scores,daily number of elderly care,and age were the main influential factors affecting the physical restraint behavior of the elderly caregivers(R~2=0.236,P=0.000).(3)Pearson correlation analysis showed that there was a moderate positive correlation between the physical restraint knowledge and attitude(r=0.423),knowledge and behavior(r=0.373),and attitude and behavior score(r=0.310)of the elderly caregivers(P<0.001).(4)The results of qualitative research show that elderly caregivers considered physical restrain to be a necessary measure to protect the safety of the elderly,the use of physical restraints can avoid the legal liability caused by the elderly's accidents,elderly caregivers relied on experience to make physical restraint decisions based on the specific circumstances of the elderly;The workload of elderly caregivers,the opinions of elderly relatives,the history of falls and injuries of elderly people,and the lack of alternatives to physical restraint were the main factors leading to the implementation of physical care of elderly caregivers;The psychological experience of the elderly caregiver in implementing physical restraints includes negative emotions,conflicts,compassion,and no feelings;The measures taken by elderly caregivers to deal with negative emotions include:compensatory behavior,inner rationalization,mutual description among colleagues,obtaining leadership support,and self-release.Conclusions:(1)The level of knowledge of physical restraint for elderly caregivers was low,the level of physical restraint attitude was medium,the level of physical restraint behavior was high,and the overall level needed to be improved.(2)The level of physical restraint knowledge of elderly caregivers was affected by 3 factors:age,education,and the nature of the unit;the level of physical restraint attitude was affected by 4 factors:age,education,the nature of the unit,and the total score of physical restraint knowledge.The level of physical restraint behavior was influenced by 5 factors:knowledge score of body restraint,participation in knowledge training of body restraint,score of attitude of body restraint,daily care of the elderly,and age.(3)There was a medium positive correlation between the knowledge,attitude,and behavior of physical restraint.(4)Cognitive experience of elderly caregivers includes:physical restraint was a necessary measure to protect the safety of the elderly,the use of physical restraint could avoid legal liabilities caused by accidents of the elderly,and the elderly care workers relied on experience based on the specifics of the elderly Situation to make physical restraint decisions.(5)The workload of elderly caregivers,the opinions of family members of the elderly,the history of falls and injuries of the elderly,and the lack of physical restraint were the main factors that affect the physical restraint behavior of elderly caregivers.(6)Negative experience was the main emotional experience for elderly caregivers to use physical restraint on the elderly;the elderly caregivers mainly adopted three internal strategies and two external strategies:compensatory behavior,rationalization,self-release,colleagues narrate and leadership supports to deal with negative emotions. |
PDF Full Text Request