The purpose of the present study is to obtain an understanding of the primary school child's life world while resident at a Boys' Town. The study presents an extensive review of the literature on developmental phases of the primary school child, relationships with himself, his family and peer group while resident in an institution. The study employed the use of quantitative and qualitative measures to elicit information from the child. To enhance the findings of the study, information from a comparative group of primary school children with intact families from the wider community was utilized. The target subjects in the study included all primary school children resident at a Boy's Town in Tongaat. The results yielded useful insights in the life world of the primary school child. These insights into the life world of the primary school child formed the basis for recommendation and served the direction for future research. These insights into the life world of the primary school child formed the basis for recommendation and served the direction for future research. / Psychology of Education / M. Ed. (Psychology of Education)

Background: International research has clearly indicated that the world’s population is ageing: almost all countries in the world are experiencing a significant growth in the proportion of older persons in their population. This is also true for developing countries such as South Africa that are beginning to show signs and symptoms of an ageing population. Among Southern African Development Communities (SADC), South Africa has the highest number of ‘senior citizens’. Population reports indicate that the population of old people rose from paltry 2.8 million in 1996 to more than 4 million in 2011 and this is expected to skyrocket to seven million by 2030. In spite of the increasing number of senior citizens in socio-structural landscapes in South Africa, there is still lack of adequate, workable and effective policy frameworks for the wellbeing of the elderly. There is also paucity of psychological data of the elderly, especially along racial divides to determine whether the after-effects of apartheid still hold sway or not in post-apartheid South Africa. This study was conceived to investigate the psychological well-being of the elderly in Buffalo City, Eastern Cape, South Africa between two racial-ethnic elderly groups. The specific objectives of the study were to explore the relationship between the socio-demographic characteristics and psychological well-being of the black (Xhosa) and white (English) elderly in Buffalo City, South Africa and second, to validate the relationship between psychological well-being and physical activity, loneliness, spirituality/religiosity as well as ageism among the sampled population. The set-point theory, selective optimisation compensation theory (SOCT) as well as the continuity theory were employed to guide the conduct of the study. Method: Psychological measuring instruments were deployed to collect data for the study from a total of 301 elderly respondents in retirement and private individual homes (191 isiXhosa and 110 English speaking elderly). Both simple random sampling (SRS) and purposive sampling procedures were used to select the respondents. The measuring instruments included the Ryff Scales of Psychological Well-being (RSPWB), Physical Activity Scale for the Elderly (PASE), Assessment of Spiritual and Religious Sentiments Scale (ASPIRES), University of California at Los Angeles (UCLA) Loneliness Scale, the Palmore Ageism Survey scale and a biographical questionnaire. Data was analysed using MANOVA, One-way variance analysis and regression coefficient. The racial differences logically influenced the selection of the respondents for the study. Results: The study revealed a significant statistical relationship between physical activity (PA) and psychological well-being of the elderly, regardless of the sociodemographic variables. PA showed a significant relationship with psychological wellbeing of the elderly. The study also discovered that loneliness correlates significantly with all four of the psychological well-being scales. It shows that the higher the levels of loneliness experienced by the elderly, socio-demographic variables controlled, the lower the levels of psychological well-being in terms of autonomy, environmental mastery, purpose in life, and self-acceptance. However, with the exception of the relationship between loneliness and purpose in life, ethnic affiliation moderates autonomy, environmental mastery and self-acceptance. English elderly constantly experienced higher levels of autonomy than the isiXhosa elderly do with an increase in loneliness. The study also found a positive relationship between ageism and psychological well- being. However, with low levels of ageism, the English elderly, in comparison with the isiXhosa elderly, is likely to show higher levels of autonomy. In addition, a significant statistical relationship between ageism and environmental mastery and purpose in life was found among the isiXhosa elderly. Although, with an increase in ageism, there is a slight increase in autonomy in both groups, the English elderly throughout showed higher levels of autonomy than the isiXhosa elderly showed. The study found a positive relationship between religiosity/spirituality and psychological well-being of the elderly. However, race could moderate the relationship between prayer fulfillment and psychological well-being at all four levels (autonomy, environmental mastery, purpose in life, and self-acceptance). With an increase in prayer fulfillment, the autonomy of the English elderly increases fairly quickly, while the autonomy of the isiXhosa elderly decreases slightly. Comparatively, the study found that isiXhosa elderly reported lower levels of psychological well-being than the English elderly. Conclusion/Recommendation: The study concludes that there is the need to develop a solid national data bases on needs and use of services, and process of ageing in order to access research data to assist planning, dissemination, delivery and evaluation of effective service delivery for the elderly population in South Africa, especially along racial divides.

Long-term care for the elderly people is a widely discussed topic in recent years not only among health professionals but also by the general public. And it will not change in the future. According to the Czech Statistical Office (2012) in 2050, the population aged over 65 will double and the population older than 85 years even quintuple. This work deals with long-term care for the elderly from the perspective of nursing, for the current demographic trends affect it significantly. Long-term hospitalization of the elderly in medical facilities is linked to many complications, not only physiological, but also psychological, social and spiritual. The aim of the thesis entitled "Long-term care for the elderly in nursing perspective" was to find out what the nurses in long-term care for seniors consider as the greatest problems, if they would welcome a change in competences in long-term care for the elderly, and to obtain an opinion about the long-term institutional care and long-term home care. Individual opinions of nurses from different departments were compared; what kind of solution to the current problems of long-term care for the elderly the nurses propose themselves. Objective 1: Find out what the sisters find as the most crucial problem in long-term care for seniors. Objective 2: Determine whether nurses feel the necessity for change in nursing competences in the management of long-term ill elderly. Goal 3: Find out what is the opinion of nurses about long-term institutional care for the elderly compared to long-term community care at home. The main research question based on the research problem and the research objectives was defined as follows: What is the prospect of long-term care for the elderly in terms of nursing? I decided for an exploratory approach. I was looking for another connection to general research question and examined them in depth. I decomposed this relatively broad topic covered by the research questions into several specific questions: 1. Will it be necessary to make additional changes in financing long-term care, due to a growing demographic age of the population increases? 2. Could nurses in long-term care for the elderly take over certain powers previously belonging to doctors? 3. Will the importance of providing nursing care long-term ill seniors at home increase? 4 Should be a long-term care for the elderly moved out of hospitals to specialized facilities? 5. Will it be necessary to increase the number of health care facilities with the focus on long-term care because of the growing number of senior citizens? 6. In connection with the increasing number of hospitalized elderly, will medical facilities have enough of gadgets? For the research was chosen a qualitative interview method. Nurses from various departments were interviewed and the outcomes were processed using the content analysis. Sisters? perspective on a long-term nursing care for elderly is: closer connection of health and social services, to increase quality of care, to strengthen the autonomy of elderly, dignified care for the elderly, increased use of home care and informing the general public about it, streamlining communication with seniors and their families, safer environment and to increase the motivation of nurses to provide the highest quality of nursing care.

Many studies have shown that adopted children show higher levels of psychological adjustment than children living in institutions. However, there is little research comparing the behaviour and cognitive abilities of adopted and institution-reared children in Latin America, despite the large number of children living in institutional care. The aim of this thesis was to examine differences in the socio-emotional and cognitive functioning of adopted and institution-reared children in Chile, and to identify factors associated with the psychological adjustment and cognitive ability of adopted children. Data were obtained from 52 adopted children and their parents, and a comparison group of 50 children living in institutions. All adoptions were national and the children were aged between 4-9 years. Children’s psychological problems and attachment difficulties were assessed using the Strengths and Difficulties Questionnaire and the Relationship Problems Questionnaire, respectively, completed by adoptive parents or caregivers and teachers. Cognitive functioning was assessed using the Wechsler Intelligence Scale for Children-Third Edition (WISC-III). The Structured Child Assessment of Relationships in Families was used to assess children’s perceptions of family relationships. Adoptive mothers and fathers were individually administered a standardised interview designed to assess parenting quality and questionnaire assessments of anxiety, depression, marital quality and parenting stress. Observational assessments of mother-child interaction were also carried out. Adopted children showed significantly higher levels of socio-emotional and cognitive functioning than institution-reared children, with the majority of adopted children scoring within the normal range and the majority of institutionalised children showed clinical levels of emotional and behavioural problems. The mean IQ score of adopted children was 23 points higher than that of the institutionalised group. Factors associated with more positive outcomes among the adopted children were a younger age at adoption and lower levels of maternal and paternal stress. Although a selection effect cannot be ruled out, with higher functioning children more likely to be adopted, the results point to a beneficial effect of adoption on the psychological development and wellbeing of institutionalised children in Chile.

Made available in DSpace on 2014-08-13T14:50:57Z (GMT). No. of bitstreams: 0 Previous issue date: 2014-02-26Bitstream added on 2014-08-13T17:59:54Z : No. of bitstreams: 1 000769602.pdf: 885305 bytes, checksum: 57c057d257078b94be3ceeef4048a3fc (MD5) / O envelhecimento da população tem se tornando um dos maiores desafios das últimas décadas, principalmente no que diz respeito à saúde pública, em países em desenvolvimento, como o Brasil. Objetivou se avaliar a qualidade de vida, saúde mental, autonomia funcional, risco de quedas de idosos que frequentam as Unidades Saúde da Família na cidade de Nova Campina. Trata-se de um estudo transversal descritivo, no qual foram aplicados instrumentos de avaliação geriátrica, validados para a população idosa, em 250 indivíduos cadastrados nos serviços de saúde do município. A análise revelou que as mulheres foram a maioria e com maior fragilidade. Mesmo os idosos referindo uma ou mais doenças consideram seu estado de saúde bom. O impedimento físico não alterou suas atividades básicas da vida diária, mas houve interferência significativa nas atividades instrumentais. A saúde mental apresentou-se preservada, o escore diminuído deveu-se ao fato da baixa escolaridade, não caracterizando distúrbio. Sentem-se felizes com a vida que vivem. Sinalizo que foi fator protetor para saúde mental, morar com algum familiar e viver em sua própria casa. Em relação marcha e equilíbrio observou-se que os idosos conseguem se movimentar livremente, chamando atenção para as mulheres que apresentaram maior lentidão na execução dos testes, em especial Time Up and Go, não apresentando riscos acentuados para quedas. A maioria referiu ter sofrido queda no ultimo ano e 14,94% sofreu fratura, em especial as mulheres. Os dados analisados possibilitaram identificar a condição real de saúde desses indivíduos inseridos na comunidade. Chama atenção para a importância de se implantar políticas municipais que garanta o acesso aos serviços de saúde, bem como ações de cuidados integrais, de acordo com as demandas de cada indivíduo, nas suas necessidades comprometidas. Atenção especial deve se dar ... / The aging of the population is becoming one of the biggest challenges in decades, particularly with regard to public health in developing countries like Brazil. Aimed to evaluate the quality of life, mental health, functional autonomy , risk of falls in patients attending Family Health Units in the City of New Campina. This is a descriptive cross-sectional study in which geriatric assessment instruments validated for the elderly population , in 250 enrolled in health services in the municipality individuals were applied. The analysis revealed that women were the majority and more fragile. Even the elderly referring to one or more diseases consider their health good. The physical impairment did not alter their basic activities of daily life, but there was significant interference in instrumental activities. Mental health was preserved, the score decreased was due to the fact of low education level, featuring disorder. Are happy with the life you live. I signal that was a protective factor for mental health, living with a family and live in your own home. In relation gait and balance it was observed that the elderly can move freely, calling attention to the women who had greater slowdown in the execution of tests, in particular Time Up and Go, showing no pronounced risks for falls. The majority reported having been dropped in the past year and 14.94 % suffered fractures, particularly women. The data analyzed possible to identify the actual health status of these individuals within the community. Calls attention to the importance of implementing municipal policies that ensure access to health services as well as comprehensive care actions, according to the demands of each individual in their needs compromised. Special attention should be given to professional training, on the topic aging and quality of life of persons assisted, especially the elderly. Also draws attention to the trainers of health bodies to this issue of elder ...

Bakgrund: Droger har förekommit i olika syften så långt tillbaka i tiden människan kan minnas. Först under 1800-talet myntades begreppet missbruk. Statistik visar att en relativt stor del av Sveriges befolkning har ett substansberoende vilket resulterar i fler patienter med denna typ av problematik även inom slutenvård. Sjuksköterskors kompetens och kunskap måste utvecklas i takt med samhället och omvårdnadsbehoven som är i konstant skiftning. De etiska aspekterna i yrket och relationerna som uppstår kräver kontinuerlig handledning. Syfte: Syftet med studien var att belysa eventuella brister i bemötande och kunskap gällande patienter med ett aktivt substansberoende inom somatisk heldygnsvård. Metod: Allmän litteraturöversikt med systematiskt genomförande bestående av elva artiklar varav majoriteten var kvalitativa. Resultat: Fyra teman identifierades: Förhållnings- och synsätt, Fördomar, Upptäcka substansberoende hos patienter och Ökad kunskap. Slutsats: Mötet mellan en patient i ett aktivt substansberoende och den yrkesutövande sjuksköterska var problematisk i varierande grad. Kunskapsgapet var stort liksom behovet av fortlöpande handledning och utbildning. Klinisk betydelse: Förhoppning att sjuksköterskor i klinisk praktik reflekterar över mötet med denna patientgrupp och söker kunskap för att nå en förbättring i omvårdnadsarbetet i stort. / Background: Illicit drugs have occurred in different forms for as long as mankind can remember. It was not until the 1800s that the concept of drug abuse was identified. Statistics have illustrated that substance abuse problems are relatively common in the Swedish population which leads to more patients with this type of problem who is in need of institutional care. Nurses’ competence and knowledge must be developed in line with the rest of society to be able to satisfy the need for care which is constantly changing. The ethical aspects within the profession as well as in the relationships between nurse and patient require continuous guidance. Aim: The aim of the study was to illustrate eventual inadequacies in the meeting and knowledge regarding patients with a substance abuse problem within the institutional somatic care. Method: A literature review with a systematic approach resulted in eleven articles, of which the majority were of a qualitative design. Results: Four themes were identified: Approach and attitude, Prejudice, Discovering patients with substance abuse problems and More knowledge. Conclusion: The meeting between a patient with a substance abuse problem and a licensed nurse posed varying forms of difficulty. The lack of knowledge was great and continuous guidance is necessary. Clinical implications: The hope is that nurses in clinical practice will reflect on the meeting with a patient with a substance abuse problem and that they will seek the knowledge that is necessary in caring for patients with a substance abuse problem.

The environment, where we live, that means the dwelling environment, influences the quality of our lives very important. This space is more important for the seniors, because their abilities, which help them to move easy in our world, go down. The injuries represent a grave and special element in morbidity of the seniors. They happen more frequently, more weak is the health and functional disposition of the seniors. Compared to a younger age, their treatment is more complicated, longer and brings worse attainments and higher costs. Grave injuries are yoke together with higher mortality, than similar hurts in younger age. In this diploma work the author has tried to assess the prevention of the injuries of the seniors in the rest homes and to chart the factors, which most influence this adaptation. In the first part of the work, she alludes to attitude to the old people during the history and she mentions the actual situation in view at the old age. Other chapters treat of dividing of the periods of human life, bio-psycho-social changes in old age, most frequent health problems and their prevention, rehabilitation. In the second part of the work, the author is engaged in the survey in the rest homes. She locates in chosen institutions, if the living and life of the seniors is primary assured so, that the injury risk is minimal. For obtaining of the necessary data, the author has used a method of questioning and observation. Three of the rest homes were randomly chosen in the south-bohemian region. The author has used a quantitative research to get this data. The hypothesis, if the rest homes have equipment, which minimizes the injuries risk, was confirmed.

The title of my diploma thesis is The Rights of Children in Institutional Care. It is composed of a theoretical and a practical part. The theoretical part deals with concepts such as the right, the child, a part deals with the characteristics of The Convention on the Rights of the Child or the Committee for the Rights of the Child. The research was carried out by means of the directed interview method (partly standardized method) applying a questionnaire created by professor Gary Melton and his team in Columbia, South Carolina. The questionnaire comprises identification questions (age, sex, class), four general questions dealing with conceptual understanding of law and twelve situations when the child adjudicates rights. The questionnaire was enhanced by 15 supplemental questions for children (created by prof. Dunovský and prof. Kovařík) delimiting the conceptual understanding of a ``good citizen{\crq}q. Further the questioning method was applied for the research by means of a questionnaire. The research file was made up by 80 children and 20 employees in total. Two goals were set in the paper. Goal 1: the paper aims at finding out whether children have their own rights. Goal 2: The paper checks whether rights of the child are respected in child care institutions. One hypothesis was set. H1: Legal awareness of children placed in children's homes is lower than legal awareness of children from a common primary school. I believe the goals have been fulfilled, however the hypothesis was not confirmed.

As práticas de assistência às crianças e aos adolescentes alijados do convívio familiar de origem, resultantes de diferentes processos históricos e sociais, culminaram nos atuais programas sociais de proteção integral, dentre eles, os serviços de acolhimento institucional (abrigos). Partindo de perspectiva que entende o desenvolvimento humano como se dando nas inerentes relações estabelecidas com o outro e ambiente, aquelas sendo mediadas pela linguagem e engendradas num determinado contexto histórico-cultural, questionamos: como o bebê se relaciona com e nesse ambiente? Há especificidades no acolhimento e na construção de relações dessa faixa etária? Assim, a presente pesquisa propôs-se investigar como se dão as relações entre bebês, adultos e outras crianças. A meta é apreender a existência (ou não) do (re)conhecimento de pessoas e parceiros preferenciais; e, se ocorrem interações que envolvam trocas afetivas, com indícios de vínculos afetivos. O estudo foi realizado em cidade de médio porte do interior de São Paulo. Foram realizadas videogravações, por três meses, tendo como foco dois bebês, cujos nomes (fictícios) são Lucas (3 meses) e Luis/Guilherme (10 meses). Para apreensão das relações, foram utilizados dois métodos: uma observação sistemática, de caráter quantitativo, buscando avaliar, por meio do uso de recursos comunicativos e emocionais específicos, a ocorrência de \"orientação da atenção\", \"busca/manutenção de proximidade\" e \"trocas sociais\" com os diferentes interlocutores deste contexto; e, utilizando método de cunho qualitativo, também foram realizadas seleções e descrições de oito episódios interativos envolvendo trocas afetivas. A Rede de Significações, enquanto perspectiva teóricometodólogico, amparou o olhar para a complexidade e apreensão dos entrelaçados e múltiplos sentidos que se apresentam nas situações. A análise das relações bebê-adulto e bebê-bebê evidenciaram trocas afetivas, com carícias, brincadeiras, vocalizações e um padrão diferencial de interação. Os indícios de preferência (seletividade) e de compartilhamento sugeriram a manifestação de vínculos afetivos nesse contexto. Por outro lado, os dados também mostraram que são diversos os modos de relações estabelecidos no contexto de acolhimento institucional, dependendo tanto do perfil dos funcionários quanto das características de cada criança. Ainda que os bebês tenham demonstrado preferências e busca de proximidade, predominantemente, com funcionários, na maioria das vezes, esses não eram muito responsivos. Além dos funcionários, os próprios bebês/crianças foram outros importantes parceiros de interação e de trocas sociais, sendo, inclusive, mais responsivos aos comportamentos direcionados a eles. No entanto, no geral, devido à organização do ambiente e às conceções/normas, tais relações eram dificultadas, fragmentadas ou com ausência de objetos que mediassem suas atividades. Concluindo, os dados revelaram a ocorrência das relações envolvendo trocas afetivas, com indícios de vínculo, apesar dessas interações não serem freqüentes. Novos estudos devem aprofundar a questão, de modo a se considerar intervenções junto a essas instituições, que potencializem a qualidade das interações e a construção de vínculos, mesmo que a criança ali permaneça de forma temporária. / The assistance practices aimed to children and adolescents jettisoned from their biological family, resulted from different historical and social processes and culminated in the current diverse social programs of custody, one of which is the institutional care service. Based on a perspective that understands human development as unfolding from the inherent relationships established both with the other and the environment, the process being mediated by language and engendered in a particular historical and cultural context, we argued: how does the baby relates him/herself to and in that environment? Are there specificities of greeting, care and relationships construction regarding this age group? Considering this questions, this research aimed to investigate the forms of relationship construction between babies, adults and other children, seeking to apprehend the presence (or the absence) of the babies\' recognition of people around as well as presence (or the absence) of preferred partners, in the institutional care context. Specifically, the goal is to investigate if affective bonds are established in that context; and, in an affirmative case, investigate how they are established. The study has been carried out in a city of São Paulo. Video records were made during three months, focusing on two babies with the following ages and fictional names: Lucas (3 months); Luis/Guilherme (10 months). To grasp the relationships, we used two methods: a systematic observation (quantitative) seeking to evaluate, through the infant\'s use of specific emotional and communicative means, the occurrence of \"orientation of attention\", \"search/maintenance of proximity\" and \"social exchanges\" with different interlocutors in this context; and, by using a qualitative method, it was also performed selections and descriptions of eight interactive episodes involving emotional exchanges. The Network of meanings was the theoreticalmethodological support, which helped at analyzing the interwoven multiple meanings and at their complexity on the situation. Analysis of the infant-adult and infant-infant/children relations revealed the presence of emotional exchanges, constituted by caresses, games, vocalizations and a differential pattern of interaction. Evidence of preference (selectivity) and of sharing activities made unmistakable the manifestations of affective ties in this context. Moreover, data also showed that there are several modes of relationships established within the institutional care context, depending on the profile of both employees and the characteristics of each child. Although babies have shown preferences and proximity search, predominantly with employees, in most cases, adults were not highly responsive. In addition to employees, the other babies / toddlers were other important partners of interaction and social exchange, even being the most responsive to behaviors directed at them. However, in general, due to the organization\'s environment and conceptions, such relationships were hindered, fragmented or unfolding with the absence of objects that could mediate their activities. Finally, the data revealed the occurrence of relations involving emotional exchanges with evidence of linkage, although these interactions did not happen frequently. Further studies should examine the issue in order to consider interventions with these institutions to leverage the quality of interactions and bond constructions, even if the child stays there temporarily.

Abstract The purpose of this study was to describe and explain the use of physical restraints in institutional elderly care from the viewpoint of the elderly, their family members, nursing staff and nursing superiors. The empirical part of the study was conducted in two stages. The approach in the first stage was quantitative: data were collected with a questionnaire from the nursing staff (n = 1,148). The data were collected using stratified sampling in two stages: by type of institution and by province. The data were analysed using descriptive statistics as well as explorative factor analysis. The second stage of the study was conducted with a qualitative approach, collecting the data from the elderly (n = 7), their family members (n =  7), nursing staff (n = 16) and nursing superiors (n = 5) using participant observation, individual and group interviews. The data were analysed using inductive content analysis. The use of physical restraints on the elderly was common in institutional care, especially in health centre wards. Both direct and indirect forms of restraint were used to limit the mobility of the elderly. The most commonly used form of direct restraint was elevating the sides of the bed (84%). Indirect forms of restraint included removing the patient’s mobility aid, clothes or alarm bell, as well as a mode of operation that promotes passivity. The nursing staff considered the use of physical restraints on the elderly as an ethical conflict situation. A family member of the elderly could be an active agent, either by using physical restraints or demanding that the nursing staff use them. The nursing staff stated that lack of legislation has an effect on the widespread use of physical restraints. Thirty-three per cent of the nursing staff reported having written instructions on the use of physical restraints in their work unit. The use of physical restraints made the elderly susceptible to hazardous situations, maltreatment and institutionalisation. Attempts were being made to reduce the use of physical restraints by using alternative methods. The participation of a doctor and a physical therapist in elderly care would promote the use of alternative methods, as would support provided by the work unit superiors. The information obtained from the study can be used to widen the gerontological knowledge basis of nursing science as well as to develop gerontological nursing practices in elderly care. The new information can be utilised in basic, further and updating education in the field of social and health care, as well as in producing and developing institutional care services for the elderly. / Tiivistelmä Tämän tutkimuksen tarkoituksena oli kuvata ja selittää fyysisten rajoitteiden käyttöä vanhusten laitoshoidossa vanhusten, omaisten, hoitohenkilökunnan ja hoitotyön esimiesten näkökulmasta. Tutkimuksen empiirinen osio tehtiin kahdessa vaiheessa. Ensimmäisen vaiheen lähestymistapa oli kvantitatiivinen ja aineisto kerättiin kyselylomakkeella vanhusten hoitotyöhön osallistuvalta henkilökunnalta (n = 1148). Aineisto kerättiin käyttäen ositettua otantaa kaksivaiheisesti: laitostyypeittäin ja lääneittäin. Aineisto analysoitiin käyttäen kuvailevan tilastotieteen menetelmiä sekä eksploratiivista faktorianalyysia. Tutkimuksen toisen vaiheen lähestymistapa oli kvalitatiivinen ja aineistot kerättiin vanhuksilta (n = 7), omaisilta (n = 7) sekä vanhusten hoitotyöhön osallistuvalta henkilökunnalta (n = 16) ja hoitotyön esimiehiltä (n = 5) osallistuvan havainnoinnin sekä yksilö- ja ryhmähaastatteluiden menetelmillä. Aineistot analysoitiin induktiivisella sisällön analyysimenetelmällä. Fyysisten rajoitteiden käyttö oli yleistä vanhusten laitoshoidossa, erityisesti terveyskeskusten vuodeosastoilla. Vanhuksen liikkumisen rajoittamiseen käytettiin sekä suoria että epäsuoria rajoittamismuotoja. Yleisimmin käytetty suora rajoittamismuoto oli ylösnostetut sängynlaidat (84 %). Epäsuoria rajoittamismuotoja olivat liikkumisen apuvälineen, vaatteiden, soittokellon poisottaminen sekä passivoiva toimintatapa. Hoitohenkilökunta piti fyysisten rajoitteiden käyttöä eettisenä ristiriitatilanteena, jossa hoitaja joutui valitsemaan vanhuksen turvallisuuden lisäämisen ja henkilökohtaisen vapauden riistämisen välillä. Omainen saattoi olla aktiivinen toimija käyttäessään itse tai vaatiessaan hoitohenkilökuntaa käyttämään fyysisiä rajoitteita. Hoitohenkilökunta totesi lainsäädännön puuttumisen vaikuttavan fyysisten rajoitteiden runsaaseen käyttöön. Hoitohenkilökunnasta 33 % ilmoitti työyksikössään olevan kirjalliset ohjeet fyysisten rajoitteiden käytöstä. Fyysisten rajoitteiden käyttö altisti vanhuksen vaaratilanteille, kaltoinkohtelulle sekä laitostumiselle. Vanhusten laitoshoidossa pyrittiin vähentämään fyysisten rajoitteiden käyttöä vaihtoehtoisia toimintatapoja käyttämällä. Lääkärin ja fysioterapeutin osallistuminen vanhusten hoitoon edistäisi vaihtoehtoisten toimintatapojen käyttöä, samoin työyksikön esimiesten tuki. Tutkimuksessa tuotetulla tiedolla voidaan laajentaa hoitotieteen gerontologista tietoperustaa ja kehittää gerontologisen hoitotyön toimintoja vanhusten hoitotyössä. Uutta tietoa voidaan hyödyntää sosiaali- ja terveydenhuoltoalan perus-, jatko- ja täydennyskoulutuksessa sekä tuotettaessa ja kehitettäessä vanhusten laitoshoitopalveluja.