This study provides a data base for developing intervention strategies aimed at helping staff cope with concerns regarding restraints. Most respondents believe patients should be restrained for safety even if it means loss of dignity, and that a caring manner should be conveyed to restrained patients. A large percentage felt that family members did not have the right to refuse the use of restraints, but that they should have that right if they were patients, suggesting negative attitudes toward restraints, of which they are unaware. Personal and professional characteristics, such as knowledge about restraints, years in geriatrics, and experience with elderly family members, showed no significant relationship to attitudes.

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The older individual may have to make more adaptations to altered body image, especially in light of the American culture's emphasis on youth, beauty, and wholeness.

Many clinical nurse specialists (CNSs) are involved in providing group teaching programs for individuals with chronic obstructive pulmonary disease (COPD). Although knowledge levels often are enhanced by these programs, what is less well known is whether such programs also can affect the coping methods used by those with this disease. The exploratory study described here was part of a larger research project aimed at determining patients' knowledge, specific psychological parameters (anxiety, hostility, depression), and coping strategies. Thirty people agreed to participate in the study. The Jalowiec Coping Scale (JCS) (Jalowiec & Powers, 1981) was used so that participants could rate each coping method according to the degree of use and to determine whether the methods employed were affective or problem-solving approaches. There was very little change in the pre- and posttest scores on the JCS, indicating that there was little change in coping strategies used. There also were no significant correlations between the JCS scores and the demographic characteristics of age, educational level, and the length of time since diagnosis of COPD. The results of this study seem to indicate that pulmonary rehabilitation programs should place more emphasis on appropriate coping strategies that the COPD patient can incorporate into his or her lifestyle.

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