臺灣護理人員精神疾病與自殺企圖之風險：回溯性研究

Exploring risks of suicide attempt and psychiatric disorders among nurses in Taiwan: a retrospective study

林郁雯(Yu-Wen Lin)

指導教授 ： 張秀如

臺北醫學大學/護理學院/護理學研究所/碩士(2012年)

https://doi.org/10.6831/TMU.2012.00159

摘要

護理人力短缺之議題近來日漸嚴重，不僅造成對護理品質、病人安全的影響，更對執業護理人員身心健康產生重大影響。
本研究為回溯性研究設計，利用國家衛生研究院所釋出1997至2010年之健康保險資料，加以分析整理，探討曾經有住院紀錄之臺灣護理人員罹患精神疾病之現況，與所有有住院紀錄的非護理之醫療人員、非醫護人員之差異，進一步分析罹患精神疾病之護理人員的自殺風險。
研究結果發現，全病因住院檔中護理人員有精神疾病碼的比例女性為0.95%，男性為0.58%，低收入、執業年資越長，罹患精神疾病的風險越高。相較於醫學中心，於地區醫院以下層級醫院工作有較高的罹病風險。
將住院資料依職業別分為三個族群，分別為：護理人員、其他醫療人員與非醫護人員。從三個族群住院資料中有精神疾病碼的罹病個案比較中發現，護理人員有相對最低的精神科住院率，最高的強制住院率、自殺企圖住院率；其中女性護理人員的精神疾病罹病個案自殺企圖風險是非醫護人員的1.371倍，以不曾住過精神科病房、有強制住院紀錄與罹患情感性精神病有較高的自殺企圖風險。以罹患精神疾病之護理人員為主，以年齡配對之後的比較發現，女性護理人員相較於女性醫療人員，有較高的自殺企圖住院紀錄、較低的精神科住院紀錄；女性護理人員相較於女性非醫護人員，有較高的強制住院紀錄、較低的精神科住院紀錄。
研究結果提供衛生主管機關了解護理人員、醫療人員與非醫護人員住院人口中精神疾病之比率，罹病特性之差異，與自殺企圖者之特性；提供職場改善護理人員心理健康，與擬定自殺防治策略和推動方案時參酌。

關鍵字

護理人員 ； 精神疾病 ； 健保資料庫 ； 自殺企圖

並列摘要

The shortage in nursing manpower becomes an increasingly serious issue, which not only affects the nursing quality and patient safety but also results in major impact on the physical and mental health of the practiced nursing personnel.
The study adopted a retrospective design that applies the health insurance data from 1997 to 2010 as released by the National Health Research Institute. The purposes of this were to explore the prevalence of psychiatric disorders among Taiwanese nursing personnel who suffer from psychiatric disorders with records of hospitalization. Also we compared the differencesin records of hospitalization, risk of psychiatric disorders and suicide among nursing personnel, non-nursing medical personnel and non-medical personnel.
The study results showed that female accounts for 0.95% and male accounts for 0.58% of the nursing personnel from the hospitalization archive with psychiatric disorders code; whereas low-income and longer seniority of practice tend to suffer higher risks of psychiatric disorders. In comparison with the medical center, the hospital works under regional hospitals suffer higher risks of psychiatric disorders.
The hospitalization data is divided into three groups according to occupations, namely: nursing personnel, other medical personnel and non-medical personnel. The three groups of patient cases having hospitalization data with psychiatric disorders code show that the nursing personnel have relatively lower psychiatric hospitalization rate, the highest mandatory hospitalization rate and attempted suicide hospitalization. In which, the risk of suffering psychiatric disorders with attempted suicide among female nursing personnel is 1.371 more than that of non-medical personnel, while the cases without having stayed in psychiatric ward, records of mandatory hospitalization and suffering emotional illness, tend to have higher risks of attempted suicide. The comparison of age matching for nursing personnel suffering from mental illness shows that the female nursing personnel has higher records of attempted suicide hospitalization and lower psychiatric hospitalization than female medical personnel. In comparison with female non-medical personnel, the female nursing personnel tend to have higher records of mandatory hospitalization and lower records of psychiatric hospitalization.
The study results provide the competent health authorities with understanding to the ratio of psychiatric illness in the hospitalization population, differences between illness characteristics and characteristics of attempted suicides in nursing personnel, medical personnel and non-medical personnel. Hence, the nursing personnel can be offered with reference on the psychological health, formulation of suicide prevention strategies and promotional solutions at workplace.

並列關鍵字

Nurses ； Psychiatric disorders ； suicide attempt ； National Health Insurance (NHI) database.

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