社區精神病患之主要照顧者被病患攻擊的經驗及反應

本研究之目的為探討社區精神病患之主要照顧者被病患攻擊的經驗及其反應，以立意取樣、採結構式問卷訪談，於民國92年1 至3月在高雄市某精神專科醫院門診，選取診斷為精神分裂症和情感性疾患的社區精神病患、有遭受攻擊的主要照顧者為研究對象，共236人。研究結果發現：236位研究對象，其中有10.2%在最近一個月遭受身體攻擊，21.2%在最近一年遭受到身體攻擊，44.1%的研究對象在病患生病以來有遭受到身體攻擊。常被攻擊的部位以單一部位最多(56.7%)，其中以手腳佔多數(26.0%)。遭受身體攻擊的原因以病患的要求未被滿足(96.1%)最多。遭受到身體攻擊的主要照顧者，身體曾有受到傷害者佔43.3﹪。影響主要照顧者遭受病患身體攻擊的經驗之顯著因素為病患「有無住院」，而與其他的病患屬性因素，以及主要照顧者屬性因素無關。主要照顧者遭病患身體攻擊後在情緒、生物生理學、認知與社交等反應的平均得分，以「情緒反應」最明顯，其次依序為「社交反應」與「生物生理學反應」，標準化得分除「情緒反應」為52.0分，其他反應均在38.0分以下。同時發現與病患關係為親子、性別是女性的主要照顧者，其遭身體攻擊後之情緒反應得分顯著較高。本研究結果可作為精神科護理人員提供精神病患家屬護理指導與居家服務工作之參考。

關鍵字

精神病患；主要照顧者；攻擊；反應

並列摘要

The purpose of this study was to explore the experiences and reactions of primary caregivers who were assaulted by psychotic patients in the community. The purposive sampling was used for data collection. There were 236 primary caregivers who had been assaulted by psychotic patients were recruited into this study. The results were revealed that 44.1% of the primary caregivers had been assaulted since onset of the patients, 21.2% of the sample had been assaulted during the proceeding year, and 10.2% of them had been assaulted during the recent one month. The most frequent of the assaulted body site were legs and arms. 96.1% of physical assaults were triggered by the unsatisfying demands of the patients. 43.3% of the assaulted caregiver had physical injuries. The significant factor related to experiences was that the patients were ever admitted. Emotional response of caregivers was the most negative reaction toward assaulted by patients. The relationships of parent-child between caregivers and patients, and female caregivers were more likely to have negative emotional response. The results of this study could be used as a reference of psychiatric home care in the community.