ABSTRACT Purpose: The aim of this study was to illuminate the connotation of “dilemma” regarding the use of physical restraint on elderly patients as represented by female nurses working in general wards at community hospitals who also live with elderly adults at home. Method: The study used the questionnaire method with an independently prepared questionnaire. Participants: The objective of the study was explained to the persons in charge of nursing in the selected 17 hospitals, and 1929. Finally, this study of participants were 524 female nurses working in general 54 wards (excluding the emergency wards of psychiatry, pediatrics, obstetrics, outpatients, operating rooms, and intensive care units) at community hospitals who also live with elderly adults at home. Results and conclusions: Cronbach’s overall coefficient for the 20 items of dilemma was high (0.78) and the factor analysis extracted four dilemma factors as having a characteristic value of 1 (Kaiser-Meyer-Olkin measure value = 0.81) with a cumulative contribution ratio of 64.5%. The high Cronbach’s for these items (0.86, 0.88, 0.87 and 0.81) confirmed the internal consistencies. With respect to the dilemma where nurses working in general wards at community hospitals who also live with elderly adults at home are faced with the physical restraint of elderly persons, four factors in the clarification of the dilemma were extracted: accomplishment of medical-treatment and accident prevention, characteristic features in nursing for elderly patients with dementia, healthcare professional relationship in nursing for elderly patients with dementia, and priorities on the accident prevention for elderly patients with dementia. Therefore, the construction of four systems to cope with these dilemmas is suggested. These systems would enable practising nurses to: (i) institution of policies to encourage discussion between nurses and other medical staff to reach consensus on treatment; (ii) allocating elderly care specialists to wards to promote alternatives to restraints; (iii) establishment of safety standards to define nurses’ responsibilities; and (iv) institution of continuous ethical education for nurses.
Cite this paper
M. Yamamoto, S. Mizuno and M. Aota, "Ethical Dilemma Factor in Regarding Physical Restraints to Elderly of Female Nurses with the Living Together Experience," International Journal of Clinical Medicine, Vol. 3 No. 5, 2012, pp. 328-334. doi: 10.4236/ijcm.2012.35064.
 Ujiie S., A.Y., Shintaiteki Yokusei[ Physical restraints]. 6 ed. 2005; Tokyo: Igaku syoin.
 Abe T., C.Y., Kan go no ba ni okeru no jyou shiki. 2001.
 Evans, L.K. and N.E. Strumpf, Myths about elder restraint. Image J Nurs Sch, 1990; 22(2): p. 124-8.
 Scherer, Y.K., et al., The nursing dilemma of restraints. J Gerontol Nurs, 1991; 17(2): p. 14-7.
 Yamamoto M, I.K., Usui K., Dilemmas facing Japanese nurses regarding the physical restraint of elderly patients. Japan Journal of Nursing Science, 2006; 3(1): p. 43-50.
 DiFabio, S., Nurses' reactions to restraining patients. Am J Nurs, 1981; 81(5): p. 973-5.
 McHutchion, E. and J.M. Morse, Releasing restraints--a nursing dilemma. J Gerontol Nurs, 1989; 15(2): p. 16-21.
 Stilwell, E., Editorial: Nursing or nursing home administration--a nurse's dilemma. J Gerontol Nurs, 1975; 1(3): p. 3-4.
 Strumpf, N.E. and L.K. Evans, Physical restraint of the hospitalized elderly: perceptions of patients and nurses. Nurs Res, 1988;37(3): p. 132-7.
 Miwa Yamamoto, Yuko Aso, THE EFFECTS OF ETHICAL DILEMMAS REGARDING THE USE OF PHYSICAL RESTRAINTS IN ELDERCARE ON FEMALE NURSES WHO CARE FOR THEIR RELATIVES, in 8thInternational family nursing conference.2007;Thai land. p. p165.
 Crisham, P., Measuring moral judgment in nursing dilemmas. Nurs Res, 1981; 30(2): p. 104-10.
 Crisham, P., Moral: how can I do what's right? Nurs Manage, 1985; 16(3): p. 42A-42N.
 Kojima, M., in Kango jirenma taiou mapu kanjya tyushin no kango no tameni [Mapping for management of dilemmas of nurses - Communication with doctors for nursing focused on patients]. . 1997; Igaku syoin: Tokyo.
 Ham, K., Principled thinking: a comparison of nursing students and experienced nurses. J Contin Educ Nurs, 2004; 35(2): p. 66-73.
 Takagi, H., Nasu no tameno toukei-gaku deta no torikata ikashikata [Statistics for Nurses – A Method for Data Collection and Effective Use of Statistical Data for Nurses]. . 1984; Tokyo: Igaku-Shoin (in Japa-nese). .
 Kan, T., Subetega-wakaru-anketodeta-no-bunseki [Analysis of Questionnaire]. 1998; Kyoto: Gendai-sugaku (in Japanese). .
 A. D. S. Ishimura, “Dictionary of Statistics,” Vol. 8, Tkyou Tosyo, Tokyo, 2001.
 Fry, S.T., Defining nurses' ethical practices in the 21st century. Int Nurs Rev, 2002; 49(1): p. 1-3.