本研究旨在探討社區精神病患之主要照顧者所採用之自殺防範措施,採立意取樣以南部某市立精神專科醫院社區精神病患之主要照顧者為對象,以結構式問卷親自訪談進行研究資料收集,有效樣本276人(反應率95.5%),採描述性及推論性統計進行資料分析。結果發現(1)「整體自殺防範措施」標準化得分為69.5分,所包含之三個分量表標準化得分為:「自殺風險評估」64分、「實際使用防範措施」89.3分、「積極尋求資源程度」59.5分。同時顯示照顧者在實際採用自殺防範措施以醫藥遵從行為主,且社會資源求助行為明顯不足。(2)僅有31.9%之照顧者由醫院獲得自殺防範知識,顯示自殺防範之衛教工作未受重視。(3)主要照顧者之年齡越小、教育程度越高、醫院有提供自殺防範知識、病患之發病時間較短、病患有自殺史、病患診斷為情感性精神病者,其採用之整體自殺防範措施越充足。主要照顧者之年齡越小、教育程度越高、未婚者、有就業、家庭功能良好、與病患同住、醫院有提供自殺防範知識、病患有自殺史、診斷為情感性精神病者,其自殺風險評估能力越佳。主要照顧者之年齡越小、教育程度越高、與病患同住、醫院有提供自殺防範知識、病患有自殺史與其診斷為情感性精神病者,其照顧者積極尋求資源之能力越佳。病患之發病時間短者,其照顧者實際使用自殺防範措施能力越佳。本研究結果可提供自殺防範之護理指導方向、居家護理實務之規劃,以及未來自殺防治相關研究之參考。
The purpose of this study was to explore the preventive strategies of suicide that adopted by primary caregivers of the psychotic patients in the community. A structure questionnaire was employed to collection data by private interviewing in a municipal psychiatric hospital in southern Taiwan. By purposive sampling, a total number of 276 participants were invited to participate in this study (responding rate was 95.5%). Data were analyzed by descriptive statistics and inferential statistics. The results were as follows : (1) The standardized score of the overall preventive strategies was 69.5; including three subscales which standardized scores were:「the suicide preventive strategies taken actually」was 89.3,「the assessment of suicide risk」was 64, and 「society resource seeking behavior」 was 59.5. The preventive strategies of suicide taken by the primary caregivers were mainly concerned with the compliance of medication, society resource seeking behavior was obviously insufficient, (2) There were only 31.9% of the primary caregivers got knowledge about preventive strategies of suicide from hospital. It indicated that the provision of suicide prevention education was not enough. (3) The participants with younger age, had higher level of education, with the suicide preventive strategies offered by hospital, patients were short period of time with onset, patients with suicidal history, and with diagnosis of affective disorder, were more likely to have better overall preventive strategies The participants with younger age, had higher level of education, unmarried, obtain employment, well family function, living with patients, with the suicide preventive strategies offered by hospital, and patients with suicidal history and with diagnosis of affective disorder, were more likely to have better assessment of suicide risk. The participants with younger age, higher level of education, living with patient, with the suicide preventive strategies offered by hospital, patient with suicidal history and with diagnosis of affective disorder, were more likely to have active resource seeking behavior. It was more likely to have active preventive strategies by the caregiver of patients with shorten period of onset. The results of this study could be help providing nursing guidelines for suicide prevention, developing an effective psychiatric home care program, and may serve as a reference for clinical and research purposes.
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