護理人員對精神病患者的暴力風險評估與其常見護理問題的處理自信

Nurses' Risk Assessment of Assault and Caring Competence in Usual Nursing Problems with Psychotic Patients

陳杏佳(S. C. Chen)

《護理研究》 1卷4期 (1993/12) Pp. 359-368

https://doi.org/10.7081/NR.199312.0359

摘要

本描述性研究之目的在初步探索護理人員對精神病患者的暴力風險評估與其常見護理問題的處理自信，以及比較精神科臨床工作經驗與醫院內外情境不同之影響。研究者以自擬之結構型問卷，對大台北地區設有精神科病房的六所合格教學醫院之護理人員隨機抽樣調查。完整問卷中含有與無精神科臨床工作經驗的兩組護理人員各有191與204位。
資料以次數分配、平均值差異檢定、因素分析、度量線性相關等統計方法處理。結果發現護理人員一般對精神病患者有偏高的暴力風險評估且對其常見護理問題有中等的處理自信，此二變項並無統計相關性。其中有精神科臨床工作經驗者雖然深得在醫院工作單位中接觸病情發作的的精神病患者時，自己有更高可能性受到患者身體攻擊，但是他們無論對患者的個人衛生、情緒波動、自殺企圖、妄想幻覺、暴力攻擊、及拒絕醫療等常見護理問題（依序由易至難）皆覺更有把握處理好；然而在醫院外情境時，上述二變項則無顯著差異，顯示此二變項可能受治療環境的影響甚大，但在具治療性的環境中則與精神科臨床工作經驗相關。
此重要發現可供大家對於照顧精神病者的護理人員的工作壓力之瞭解，醫療環境配合條件之提醒，及護理能力提昇方向之參攷。

關鍵字

護理人員 ； 精神科臨床工作經驗 ； 精神病患者 ； 暴力 ； 風險評估 ； 處理自信

並列摘要

This descriptive survey is designed to explore nurses’ risk assessment of assault and caring competence in usual nursing problems with psychotic patients under different psychiatric working experience and milieu. A stuctured questionnaire was designed to collect data. The subjects were composed of 191 nurses who had psychiatric working experience atid 204 nurses who had none. They came from six teaching hospitals which had psychiatric wards in Taipei city and suburbs by a stratified random sampling.
The data was analyzed using frequency, test, factor analysis, and linear correlation.
Results show that nurses generally hold high risk assessment of assault and have moderate caring competence in usual nursing problems with psychotic patients. There was no significant correlation between nurses’ risk assessment of assault and caring competence with psychotic patients. Therapeutic milieu was an important attribution factor of this two variables, but nurses’ psychiatric working experience will have an effect under therapeutic milieu.

並列關鍵字

nurse ； psychiatric working experience ； psychotic patient ； assault ； risk assessment ； caring competence