精神科住院病人與護理人員對約束及隔離之態度與感受之比較

The Attitudes and Perceptions of Patients and Nurses Toward Restraint and Seclusion: A Comparative Study

楊美賞(M. S. Yang) ； 鍾信心(H. H. Chung)

《護理研究》 1卷3期 (1993/09) Pp. 193-204

https://doi.org/10.7081/NR.199309.0193

摘要

本研究之目的在於瞭解住院病人被約束或約束隔離臨護的感受及其反應，并比較病人及護理人員所提之病人被或隔離的理由及他們對取代性措施之看法，利用問卷及訪談方式完成資料之收集，研究對象包括74位被約束或隔離的病人、74位參與此措施之護理人員以及74位目擊此措施之同病房病友。研究結果顯示80%被約束或隔離措施持有負向反應，包括身體不適及情緒不適。病人被約束或隔離時之因應反應為企圖解開約束、掙扎、靜躺及睡覺。病人及護士都認為導致約束或隔離的主要理由為對他人之身體功擊、破壞器物、激動及失控行為。對取代性措施之看法，兩者有明顯的不同；70.3%被約束或隔離的病人認為有取代性措施可用，包括動解、溝通、吃藥、打針。但只有14.6%的護理人員認為有取代性措施可用。雖然病人認為約束或隔離是一種痛苦的經驗，但仍有51.4%被約束或隔離的病人及77%的目擊者病友認為病房內應有此種措施存在。

關鍵字

約束 ； 隔離 ； 住院精神病人

並列摘要

The purpose of this study was to investigate the feeling of nurses and psychiatric patients about restraints and seclusions, as well as the coping responses patients showed to this kind of treatment. A comparison was done between the nurses’ and patients’ responses to discover if there were suggestions for any alternative measures. Two qrestionnaires and individual interviews were given to psychiatric in-patients, their primary nurses, and non-secluded patients who witnessed these practices. The results showed that 80% of the patients’ responses to the restraint and seclusion experiences were negative; this included physical discomfort and psychological distress. The coping behavior exhibited during restraint or seclusion was attempted removal of restriants, hitting, making verbal reqrests to discontinue, taking a rest or tring to sleep. Both patients and nurses agreed that the major reasons for restraint or seclusion were physical attacks on other persons, destruction of property. agitation, and uncontrollable behavior. However, the two groups differed greatly in their opinions about restraints and seclusions. 70.3% of the restrained or the secluded patients felt there could have been some alternative measures, such as dissuasion, verbal communication, drug injection or oral medication. Only 14.6% of nurses felt other alternatives were possible. Although restraints and seclusions were a negative experience for the patients. 51.4% of restrained or secluded patients and 77% of the nonrestrained patients agree that some measures of restraint or seclusion should be used in the psychiatric ward to help control the behavior of agitated patients.

並列關鍵字

restraint ； seclusion ； psychiatric in-patient