Assaultive Behavior by Psychiatric In-Patients and Its Related Factors

精神科住院病患攻擊行為及其相關因素之探討

周桂如(Kuel-Ru Chou) ； 陸汝斌(Ru-Band Lu) ； 張敏(Mm Chang)

《The Journal of Nursing Research》 9卷5期 (2001/12) Pp. 139-151

摘要

此研究之主要目的在於探討住院之精神病患其攻擊行為與病患特質（年齡、性別、教育程度、精神科診斷、藥物濫用、住院時問等變項）、環境特質（病患/護理人員數比、空問密度、攻擊發生時之時段、作息等變項以及護理人員特質（年齡、性別、教育程度、精神科工作年資、在職教育等變項）之相關性探討，運用標準量化問卷在一所醫院中之現有的四個精神科急性病房做追蹤性調查，在每一個病房運用日誌記錄系統進行記載病患攻擊行為之發生情形，研究人員並進一步做病歷之查證及與相關護理人員會談，在七個月的收案期間共有595件238位病患有攻擊行為的產生，四十一位護理人員參與此研究，進一步以羅吉斯迴歸區分具攻擊行為之病患與未具攻擊行為之病患、被攻擊者與未被攻擊護理人員之特質異，結果顯示與病患特質（精神科診斷、攻擊史、住院期間及吸菸史）、病房環境特性（病患/護理人員數比與空問密度）與護理人員特質（年齡、精神科之工作年資、接受預防病患攻擊訓練課程）等變項有關。此研究分析了許多可能影響病患攻擊行為之因素，其結果可提供臨床護理人員在防範病患攻擊行為上之參考。

關鍵字

攻擊行為 ； 攻擊 ； 精神科住院病患

並列摘要

The purpose of this article is to explore assaultive behavior of psychiatric in-patients in a hospital and to examine the interplay of patient, environmental, and staff factors related to assault. The present study was carried out prospectively using standardized instruments applied in four acute wards in one hospital. A log system was used to record the occurrence of assaults. The results showed 595 episodes of assault from 238 patients in 7 months. Forty one nurses participated in the study. To further examine the differences between assaultive and non-assaultive patients, and assaulted and non-assaulted nurses, a logistic regression analysis was used. The results indicated that patient factors (diagnosis, history of assault, time since admission, and history of smoking), environmental factors (patient/nurse ratio and spatial density), and staff factors (age, length of work experience, training program received in prevention and management of assaults) are contributing variables to assaultive behavior. The present study examined a wider range of variables than have been included in many previous studies. This reinforces the necessary complexity of models likely to prove useful in predicting assaults among psychiatric inpatients.

並列關鍵字

assaultive behavior ； assault ； psychiatric in-patient

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