精神專科醫院住院病人藥物與重複攻擊行為之病例對照研究

A Contrast Study on Drugs and Repeated Aggressive Behaviors of Psychiatric In-patients

黃燕茹(Yen-Ju Huang) ； 邵文娟(Wen-Chuan Shao) ； 李世凱(Shi-Kai Lee) ； 李名蟬(Ming-Chan Lee)

《精神衛生護理雜誌》 8卷1期 (2013/10) Pp. 1-11

https://doi.org/10.6847/TJPMHN.201310_8(1).0002

摘要

攻擊行為在精神照護中是一個非常重要的臨床問題，重複攻擊行為更是照顧者的困擾。本研究以某精神專科教學醫院為例，探討2009－2011年住院病人攻擊行為的相關因素及服用藥物與重複攻擊行為之關係。資料來源為病人安全委員會的通報資料庫，研究對象以這三年間曾發生身體攻擊行為之住院病人，將其分成病例組及對照組，並以邏輯斯迴歸分析影響服用藥物與重複攻擊行為之相關因素。研究結果病人之罹病年數、住院到攻擊期間、過去曾經因暴力行為而入院者及使用抗帕金森劑與發生重複攻擊有顯著相關。罹病年數在11－20年者有重複攻擊的風險是罹病年數在5年內的2.85倍；住院到攻擊天數在2.6年（933天）以上者有重複攻擊的風險最高，是住院到攻擊天數在一個月內的3.60倍；過去曾經因暴力行為而入院者，有重複攻擊的風險是沒有因暴力住院者的2.75倍；藥物方面，有使用抗帕金森劑的病人比沒有使用抗帕金森劑的病人，有重複攻擊的風險是沒有重複攻擊的1.79倍。本研究呈現2009－2011年某精神專科教學醫院住院病人服用藥物與影響重複攻擊行為的相關因素，可以讓醫療人員更清楚哪些病人為重複攻擊行為的高危險群，建議日後可以在使用藥物、硬體設備或人力規劃上做適當的安排，以降低病患重複攻擊行為的發生。

關鍵字

精神專科醫院 ； 住院病人 ； 藥物 ； 重複攻擊行為

並列摘要

Aggressive behavior is an important clinical issue over psychiatric nursing care. Besides, the repeated aggressive behaviors increased caregivers' burden of care. As an example of case studies, we have explored the psychiatric in-patient's aggressive behaviors and its related factors that involved in drugs taken and repeated aggressive behaviors from the year of 2009 to 2011 in a psychiatric teaching hospital. The information in the study was collected from the safety committee database from 2009-2011, and then we divided the psychiatric in-patients into control and contrast groups. We used multivariate logistic regression analysis to examine the related factors of drugs taken and its effects upon repeated aggressive behaviors. The factors in relation to repeated aggressive behaviors found were: the morbidity year, the hospitalized period of aggressive behaviors, the positive violent history, taking Parkinson agents that have resulted in a significant correlation. The results showed that the morbidity exceeding 10~20 years is 2.85 times of within 5 years (odd rate=2.85), and the aggressive behavior in hospitalization over 2.6 years is 3.6 times of 30 days (odd ratio=3.60), and the positive violent history is 2.75 times of no violent history (odd ratio=2.75), and as well as the use of anti-Parkinson agents is 1.79 times of non use of anti-Parkinson agents (odd ratio=1.79). At the end of the study during 2009~2011, it can be concluded that the related factors of drugs taken can cause effects of repeated aggressive behaviors upon psychiatric in-patients. We also elucidate that the high risk patients have repeated aggressive behaviors. Thus, we would like to suggest improving the hardware and manpower to reduce the repeated aggressive behaviors of those patients with high risk.

並列關鍵字

Psychiatric Hospital ； In-Patients ； Drugs ； Repeated Aggressive Behaviors