中部地區公共衛生護士強制精神病患送醫意願之相關因素研究

Factors Related to the Willingness of Public Health Nurses to Send Psychiatric Patient for Coerced Treatment in Central Taiwan

邵文娟

公共衛生護士、精神病患、強制送醫 ； public health nurse ； psychiatric patients ； coerced treatment

亞洲大學長期照護研究所學位論文

2007年

碩士

劉俊昌

繁體中文

近年來，國內屢見強制精神病患送醫過程中發生意外事件。現今社區精神病患的照護体系及法規，仍有缺乏完善之處，值得探討。研究目的在瞭解公共衛生護士強制精神病患送醫之意願相關因素。本研究採橫斷性調查法，問卷內容包括人口學、專業經驗、資源、困難及執行意願等變項。困難及意願題目採四點量表計分。研究對象為中部地區彰化縣、南投縣、台中縣、台中市、雲林縣等衛生所之公衛護士。調查期間自95 年8 月至9 月止，共發出641 份，回收有效問卷為635 份(98%)。以SPSS/PC12.0 套裝軟體進行分析。 結果發現，有91.8%護士表示與危險精神病患接觸有困難，70.8%擔心被告強制送醫之合法性。經分析發現，執行經驗、上級單位支持度以及感受到執行的困難度等三者為與執行意願最密切的主要因素。近二年曾處置過強制送醫者，意願較低；感受到衛生局主辦人員 支持度高者，其意願高；感到強制送醫困難度愈高者，其意願愈低。加強公共衛生護士接觸危險精神病患之專業能力，衛生局主管業務人員主動支持，以及整合強制送醫之流程，將可提高公衛護士執行意願。

Objective：Some adverse events happened during the coerced treatment process of psychiatric patients Taiwan in recent years. It is worthwhile to find out the shortcomings of the present caring system and regulations of the mental health community in Taiwan. This study aims to explore the influence factors to the willingness of Taiwan public health nurses to send psychiatric patients coerced treatment. Method：The study is a cross-sectional survey, and a self-administered questionnaire which was developed for this study. The questions consist of variables such as demography, professional experiences, resources, execution difficulties, and execution willingness. Among the questions, the ones concerning difficulties and willingness were all evaluated using a four-point scale. Data on all public health nurses working in middle Taiwan including these five areas: Changhua County, Nantou County, Taichung County, Taichung City, and Yunlin County. The questionnaire was collected from August to September 2006. 635 nurses (98%) out of 641 anonymous ones responded to the questionnaire. Data was analyzed by descriptive method and logistic regression (SPSS/PC120 bundled software). Results：Study results indicated that 91.8% claimed they had difficulties contacting the patients, and 70.8% worried about the legitimacy of coerced treatment process. Additional analysis showed three major factors affecting nurses’ willingness of carrying out coercive treatment process: execution experiences, the level of support from superintendents, and the degree of difficulties confronted during the procedure. Those who ever dealt with coerced treatment patients in the last two years were less willing; those who had higher support from the officers of local health bureau were more willing; those who experienced higher degree of difficulties at the process were again less willing. Conclusions ： The study suggests strengthening professional ability training programs for the public health nurses to deal with dangerous psychiatric patients. The local bureau in charge should actively finds out the obstacles that executors are facing, and also positively support and integrate the coerced treatment procedure.

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