第五章 討論
第三節 建議
本研究除提供某地區地區養護機構身體約束盛行率及實地狀況，對於養護機構使用
身體約束之危險因子，根據本研究結果以及研究過程中獲得的經驗，提出幾項建議，分
述如下：
一、實務工作方面
（一）過去研究指出，自我照顧能力為住民被約束主要因素。本研究發現，機構中空間
環境條件像走道及房間地板反光、房間沒有防滑地板為住民被約束之因素，建議
機構中環境能夠改善，如此也可減低住民被約束。
（二）研究者於研究過程中發現，大多未簽署約束同意書，以列等機構簽署約束同意書
居多，期望各家機構之後均能在專業人員正確評估下，與家屬解釋、討論、簽署
同意書後才約束住民。
（三）觀察過程中發現照護人員極少評估住民狀況及家屬感受，所以照護人員需要注意
及加強對於約束住民後續身、心、靈之照護，以提升受約束住民的照護品質。
二、研究方面
（一）在研究過程中發現，國內探討關於養護機構身體約束的文章並不多，多集中於急
性醫療領域，顯示國內對於養護機構身體約束議題欠缺關注。且國內養成教育中
也沒有獨立探討身體約束之章節。因此建議可以發展，身體約束之整體評估、正
確身體約束判斷流程、身體約束替代方案及種類、身體約束之倫理考量等，以提
供照護人員在職學習須具備對於身體約束充分之知識與技能。
（二）此地區較少有正職之護理人員，建議未來可採隨機取樣並且擴大樣本數，以增加
研究結果推論及全面性之了解。
（三）發現使用約束帶（棒球手套）與褥瘡之間，呈顯著差異，建議可做為未來研究探
究之議題。
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