精神科急性病房病患的暴力行爲研究

Study of Patients' Violent Behavior in an Acute Psychiatric Ward

陳杏佳(Shing-Chia Chen)

《護理研究》 5卷2期 (1997/04) Pp. 195-205

https://doi.org/10.7081/NR.199704.0195

摘要

本研究之主要目的的實徽探討本士精神疾患的暴力行爲與處理之特色。採個案系列前瞻性研究法，對象爲某教學醫院精神笠急性病房住院病患，在民國83年2至6月，共五個月期間，發動肢體攻擊之暴力行爲者，共28人89産生件暴力事件，有38人遭受攻擊。使用自擬問卷與「簡便精神症狀檢查表」，以臨床參與觀察爲主，訪談與病曆記錄爲輔，雲解攻擊者的個人屬性與精神症狀、暴力行爲過程、及處理現況。結果發現暴力事件在正常上班日(66.3%)與白班(56.2%)發生略多，平均5天發生3次，病房幹擾或人物受損客觀情況不嚴重，而有攻擊史的精神疾患易再重複出現暴力行爲，其發生前多有外界刺激事件(69.6%)，大半有原因存在(87.7%)。文中除描述討論精神疾患的暴力行爲與處理，還找出相關的精神症狀、情境因素、與前後徽兆，並進一步分析預防之道。

關鍵字

急性病房 ； 精神疾患 ； 暴力

並列摘要

The purpose of this study is to investigate psychiatric patients’ violent behavior and ways of manageing it. The study was conducted on a locked, university-based, short-term inpatient psychiatric unit. The duration was from Feburary to June 1994. The procedure consisted of clinical observation, interview, and chart review. There were two questionaires used to collect data: one was designed by the author to understand the attackers’ and victims’ basic data, as well as the process of violence and medical management; the other was used to assess patients’ pathological symptoms, which had been well developed and translated in to Chinese by others. The result shows that 89 incidents of physical violence were yielded by 28 psychiatric inpatients, and 38 persons were attacked in the incidents. The incidents took place about 3 times per 5 days; 56.2% of them were during the early day shift and 66.3% on non-holidays. The disturbance injury and damage caused by the incidents were not severe. Most incidents were repeatedly started by patients who had a history of making attacks. About 69.6% of the incidents had antecedents and 87.7% had provocations which could be followed up. This study not only described and discussed the phenomenon of the violence, but found the significant pathological symptoms which were related to violence. This study also mentioned the situational factors and the impending clues. From the above, we can analyze the ways to intervene and prevent the psychiatric inpatients’ violent behavior.

並列關鍵字

acute ward ； psychiatric patient ； violence