急診護理人員照護精神疾病病人經驗之探究

急診是精神病人急性發作時尋求幫助的第一個重要單位，而急診護理的專業知識普遍著重於急重症護理，面臨精神病人身心靈照護的需求是一大挑戰，精神疾病相關之急診照護成為急診工作的壓力因素，更影響護理人員照護的自信心，目前研究缺乏急診護理人員照護精神疾病病人經驗之相關探討。因此，本研究旨在探究急診護理人員照護精神疾病病人之經驗。本研究採質性研究法，以立意取樣收集中部某醫學中心共17位急診護理人員，利用半結構式訪談深入探討其照護精神病人之經驗，收案期間自2019年4月13日至2019年12月27日，訪談資料經過參與者同意錄音並轉為逐字稿，以主題式內容分析法進行資料分析。研究結果顯示，急診護理人員照護精神病人之經驗可歸納出四個主題與六個次主題：一、思維定式；二、精神照護的困境：暴力與孤立無援、缺乏治療性溝通技巧；三、開放式空間的困境：安全性不足、隱密性不足；四、精神科護理的教育需求：提升疾病認知與精神照護能力、轉換正向思維。本研究結果有助於了解急診護理人員在照護精神疾病病人的經驗，期將研究結果提供急診精神護理實務發展之參考，以提升急診精神病人之照護品質。

關鍵字

急診護理人員；精神護理；心理疾病；照護經驗

並列摘要

Emergency department is the first important unit that patients with mental illness can seek help from in case of an acute attack. Emergency nursing generally focus on acute and critical care. Addressing the physical, mental and spiritual needs of patients with mental illness is a big challenge. Emergency care related to mental illness has become a work-related stress that affects the self-confidence of the emergency nursing staff. Existing studies rarely focus on the experience of emergency nurse in caring for patients with mental illness. Therefore, this study aimed to explore the experiences of emergency nursecaring for patients with mental illness in the Emergency Department. Qualitative research was adopted in this study. The participants were collected using purposive sampling in a medical centre in Taiwan. The data were collected by semi-structured interview during 13 April 2019 to 27 December 2019. The interviews were recorded and transcribed to manuscript with the consent of the participants and analysed by thematic content analysis. The results showed four themes and six sub-themes as follows: 1. Mind-set; 2. The dilemma of mental care: violence, alone and helpless, and lack of therapeutic communication skills; 3. The dilemma of open space: insufficient security and privacy; and 4. Educational needs of psychiatric nursing: improving cognition in psychiatric patients and changing negative thinking into positive thinking. Theresults revealed the experience of emergency nursing staff in caring for patients with mental illness. Results will provide deep viewpoints for improving the quality of emergency nursing for patients with mental illness.