某精神科急性病房住院病患自殺行為與處理狀況之探討

A Study of Inpatients' Suicidal Behavior and Clinical Management in an Acute Psychiatric Ward

陳妙絹(Miao-Chuan Chen) ； 陳杏佳(Shing-Chia Chen) ； 熊秉荃(Ping-Chun Hsiung)

《護理研究》 4卷2期 (1996/06) Pp. 127-136

https://doi.org/10.7081/NR.199606.0127

摘要

本研究目的在於瞭解精神科急性病房中自殺行爲發生情形，分析病患特質及醫護人員實際處理病患的狀况，幷探討照顧自殺病患的護理方向。研究方法乃要據臺北市某醫學中心精神科急性病房，於78.11-82.12.31.之病房報告本中及病歷上的記錄，針對曾於病房中發生自殺行爲者的人口學特色、行爲過程與臨床處理進行回溯性的描述性研究。收集到的研究對象計九位，共有22位人次之自殺事件。研究結果顯示：(1)精神科急性病房發生自殺行爲的病患主要爲分布在20至40歲未婚無業的年輕男性病患。(2)近八成的個案有自殺過去史，且使用的方法最多爲割傷及服藥。本研究的九位個案中有七位在病房裡重覆出現自殺行爲的次數約1-3次。(3)白班是自殺的高危險時段。(4)對於有自殺行爲的病患最常用的醫療處置爲限制外出與自殺防治；而護理措施多著重於立即性措施，其次是預防性措施，再則爲保護性措施，對病患及家屬支持性措施較少。

關鍵字

自殺 ； 精神病患 ； 臨床護理

並列摘要

The purposes of the descriptive study is to: (1) understand psychiatric inpatients' suicidal behavior, (2) analyze the characteristics of the suicidal patients, (3) explore the clinical management of the suicidal behavior, and (4) discuss the direction of nursing care for the suicidal patients. It was focused on the demographic data of suicidal patients, the process of suicidal behavior, and clinical management in the psychoiatric ward, by way of a retrospective study. Data was collected from word reports and chart records in an acute psychiatric ward of a medical center in Taipei City. The sample comprised 9 psychiatric inpatients. Total number of suicide attempts were 22 from January 1, 1989 to December 31, 1993. The result revealed : (1) the inpatients at high risk of suicide were young unmarried men, (2) nearly 80% of the patients had suicidal history; cuts and overdose were frequent methods of suicide; of the nine patients studied, seven attempted suicide repeatedly while in care, each about 1-3 times, (3) the day shift was a period of high suicide risk, (4) clinical medical management for sucidal patients was often to limit their outings and take action to prevent their suicidal behavior. Therefore immediate intervention appears to be the highest percentage in nursing intervention, preventive intervention was the second highest, third was protective intervention, but supportive intervention for patients and their families was the least.

並列關鍵字

suicide ； psychiatric patients ； clinical nursing