Prevalência da contenção mecânica em idosos na atenção domiciliar

Abstract

Introduction: The concepto f physical restraint is used in health care in patients who are at risk of falling, agitated or disoriented in ways that restrict freedom, movement or normal access to one's own body. However, the hospital-home translation, without reflection, of this practice, the motivation and the type of material employed may be controversial factors in its applicability to home care Objectives: To estimate the prevalence of physical restraint in the elderly in home care; Characterize the profile of physical restraint and the contained elderly; To analyze factors associated with the practice of physical containment of the elderly in home care; Propose a Realistic Simulation Roadmap for Nurses. Method: Cross-sectional, observational study with a quantitative approach to measure the prevalence of physical restraint practice in home care. The research scenario was the residences visited by the nurse of a home care service of a federal hospital. Participants were aged over 60 years with an estimated sample of 162 participants (contained and not contained), randomly visited according to the schedule adopted by the service. It was assessed the prevalence of containment some of its associated factors Results: It is estimated that the prevalence of restraint in the elderly in home care is 13.0%, with a prediction error of 5.2% at the 95% confidence level. The contentions analyzed were physical restraint, typically made by bandages (38.1%), the most common contention is aggressiveness (28.6%), and they are contained 24 hours a day (42.9%). The results show that the contained elderly differ significantly from those not contained in relation to the alternate-day caregiver routine (p-value = 0.000 of the chi-square test), as well as ambulation (p-value = 0.002 of the chi-square test) (p-value = 0.006 of the chi-square test), the dependent variable for daily life activities (p-value = 0.000 of the Mann Whitney test); (p-value = .007 from the Mann-Whitney test and p-value = 0.017 from the chi-square test). The different incidences of friction lesions and pressure lesions were also observed in the group of elderly subjects (p-value = 0.001 and p-value = 0.000 of Fisher's exact test). It proposes as a product of the study the elaboration of training in the Realistic Simulation models for Nurses with the purpose of discussing risks, adverse events and alternatives to the use of physical restraint. Conclusion: The study demonstrated the prevalence and factors associated with physical containment at home. This study proposes to enable reflection on the practice of physical restraint containment in home care and the improvement of nurses' skills through Realistic Simulation