不同年资护士应对精神科暴力行为能力的调查

目的:了解河北省不同年资护士应对精神科暴力行为的能力与需求,为有针对性地做好精神科护士防暴技巧培训提供依据。方法:采用自制调查问卷,以河北省5所精神疾病专科医院的291名临床护理人员为调查对象,对不同年资精神科护士应对精神科暴力行为的能力与需求进行调查。结果:不同年资护士在应对精神科暴力行为能力和对防暴专业知识、技巧的需求方面存在显著性差异(P<0.05)。结论:应根据不同年资精神科护士的能力与需求,有针对性地做好精神科护士防暴知识和技巧的培训,减少精神科暴力行为的伤害。     

精神科护士遭受工作场所身体暴力事件的现况调查

目的 探讨精神科护士遭受工作场所暴力的形式及心理情况的现状,为临床护士及管理者提供研究依据.方法 采取整群抽样的调查方法,对该院一年内遭受工作场所身体暴力的精神科护士的遭受暴力形式和心理状态调查,采用χ2以及单因素方差分析进行统计分析.结果 仅有9.9%的精神科护士掌握暴力防范技巧.精神科女护士较精神科男护士更易遭受暴力行为在身体性袭击(χ2=9.611)、遭遇患者或家属打砸(χ2=4.085)、和被威胁(χ2=5.172)等三方面,差异均有统计学意义(均P<0.05).71.8%的人认同医院暴力事件越来越多;83.0%的人认为不信任家属,对家属感到恐惧;74.6%的人认为经常失眠、伴有焦虑,但男女比较,差异无统计学意义(P>0.05).结论 精神科护士缺乏掌握工作场所暴力攻击的知识,大部分护士遭受过工作场所暴力,并且出现不良的心理状态(尤其是女护士),为管理者提供一定依据,以制定相应对策,降低工作场所暴力.     

精神科护士应对暴力行为能力培训研究进展

有效的干预措施可以提升精神科护士应对暴力行为能力,降低精神科护士处理暴力行为受伤害风险,保护病人安全的同时保证护士职业的安全。本文通过查阅文献及结合临床现状,从精神科护士应对暴力行为能力和干预措施等方面进行精神科护士应对暴力行为能力培训研究进展综合分析,以期为进一步提升精神科护士应对暴力行为能力的培训研究提供参考。     

防暴力训练与精神科护士离职意愿的相关性研究

目的:了解防暴力训练能否转变精神科护士离职意愿。方法:采用自制精神科护士离职意愿调查表,调查结束后对护理人员进行防暴力训练,后再次对护理人员进行调查。结果:防暴力训练在一定程度上提高了护理人员应对暴力行为的能力和精神科护士的离职意愿。结论:防暴力训练与精神科护士离职意愿有相关性。     

17家广西公立精神病院医护人员应对职业暴力现状调查

目的 了解精神科医护人员应对精神科暴力的现状,为提高其应对暴力行为能力提供培训依据.方法 采用自制问卷,对17家广西公立精神病院共891名医护人员进行回顾性调查.结果 (1)在工作中,精神科医护人员遭受不同程度和频率的心理暴力和躯体暴力;在处理精神科暴力行为时,62.6%的医生和70.6%的护士受到过暴力伤害,护士受伤害的频率明显高于医生.(2)41.1%的医护人员不掌握或43.2%很少掌握处理精神科暴力行为专业知识和操作技能.(3)42.8%的医护人员没有参加或53.3%参加1次处理精神科暴力行为专业知识和操作技能的培训.(4)95.8%的医护人员对精神科暴力行为专业知识和96.0%对操作技能的培训是需求或非常需求.结论 广西精神科医护人员非常缺乏处理临床普遍存在的暴力行为专业知识和操作技能,应从精神科暴力评估、沟通、降温、脱身法、约束法和控制法等内容,对医护人员进行系统的理论和操作培训考核,才能提高精神科医护人员应对暴力行为能力,降低处理精神科暴力行为伤害发生率.     

情景模拟联合微格教学在精神科低年资护士暴力处理操作培训中的应用

[目的]探讨情景模拟联合微格教学在精神科低年资护士暴力处理操作培训中的应用效果。[方法]采用情景模拟联合微格教学的方法对精神科工作1～5年的护士进行暴力处理操作培训,于培训前后用焦虑自评量表(SAS)、抑郁自评量表(SDS)测评护士的焦虑和抑郁情绪,用自制问卷调查表调查护士对暴力处理能力的自我测评,用观察记录表记录护士处理病人暴力行为时护士、病人、周围人的受伤情况及病人对物品的破坏情况、保护性约束使用率和时数。[结果]培训前后护士的焦虑、抑郁情绪得分比较差异有统计学意义(P0.05),培训后护士的暴力处理能力明显提升,在处理病人暴力行为时护士、病人、周围人受伤害和病人对物品的破坏、保护性约束使用率和时数明显降低。[结论]情景模拟联合微格教学用于精神科低年资护士的暴力处理操作培训,可改善护士的焦虑与抑郁情绪,增强护士处理暴力行为能力,降低处理精神科暴力行为时护士、病人、周围人伤害发生率,减少病人对物品的破坏,降低病人保护性约束使用率和约束时数。     

精神科护士情绪智力与应对方式相关性研究

目的探讨精神科护士情绪智力水平及应对方式的特征。方法采用情绪智能量表和精神科护士应对方式问卷对重庆市5家综合医院的464名精神科护士进行调查,采用Logistic回归模型评价精神科护士背景因素和情绪智力对职业压力应对方式的影响。结果精神科护士情绪智力水平和压力应对方式受到人口学变量的影响,不同年龄护士在自我情绪的感知和表达能力、评价和感知他人情绪的能力、对自我情绪的管理和控制能力、情绪的引导和运用能力低分与高分的分布差异有显著性（P〈0．05或0．01）,不同职务者在自我情绪的感知和表达能力、评价和感知他人情绪的能力、情绪的引导和运用能力、低分与高分的分布差异有显著性（P〈0．01）;精神科护士较多使用问题解决和正面认识的应对方式,很少采用回避与自责的方式应对职业压力;精神科护士的情绪智力与职业压力应对方式存在相关性（R=-0．123～0．253,P〈0．01～0.05）。结论情绪智力的四个能力维度对精神科护士职业压力的6种应对方式有不同程度的预测作用。     

精神科护士心理健康状况及应对方式的性别差异

目的：了解精神科护士心理健康状况及应对方式的性别差异。方法：采用症状自评量表（SCL-90）和应对方式问卷对精神科护士男女各40例进行调查评定,对比分析精神科男护士和女护士SCL-90总分及各因子分和应对方式各因子分。结果：精神科女护士SCL-90总分及人际关系敏感、抑郁、焦虑因子分均低于男护士,差异有显著性（P〈0.05） 应对方式问卷中除合理化外各因子分男女护士存在显着性差异（P〈0.05或P〈0.01）,其中,解决问题、求助因子分女护士高于男护士,幻想、自责、退避因子分女护士低于男护士。结论：精神科女护士心理健康状况及应对方式优于男护士。     

我国精神科暴力行为分析及防范与处理

综述了精神科暴力行为的诱因、先兆表现、攻击对象、方式及防范与处理,认为采取规范的以暴力防范技能培训为主导的应对策略,可提高精神科暴力行为应对能力,保障精神科患者及医护人员的安全。     

应对精神科暴力行为培训对不同年资护士影响的调查研究

目的探讨应对暴力行为培训对精神科不同年资护士的影响,为有针对性的做好精神科护士应对暴力行为培训提供依据。方法 148名于我院工作的临床护士按工作年限分为四组,A组:工作5年以下,52名。B组:工作6~15年,31名。C组:工作16~25年,35名。D组:工作25年以上,30名。对入选护士进行应对暴力行为处理技巧培训。比较分析培训前后四组护士应急理论知识、应急技能操作和应对能力考核,并应用状态-特质焦虑量表对四组护士培训前后的情绪状态进行比较。结果培训后四组护士的应急理论知识、应急技能操作和应对能力考核成绩较培训前提高;正性情绪、负性情绪、焦虑情绪评分较培训前改善,护士的年资越低其变化幅度越大,培训前后差值四组比较有显著性差异(P0.05)。结论应对暴力行为培训对低年资护士,尤其是新上岗护士影响最大,可有效提高其应对暴力行为的能力,减轻暴力行为对其造成的伤害,缩短低年资护士的成长过程。     

精神科护士遭受工作场所暴力与共情能力的关系研究

目的调查精神科护士遭受工作场所暴力和共情能力的现状,探讨精神科护士遭受工作场所暴力与共情能力之间的关系。方法采用方便抽样法,于2019年3—4月选取南京脑科医院精神科的护士198名进行问卷调查。调查工具包括一般资料调查表、医院工作场所暴力调查问卷、杰弗逊共情量表。结果本研究共发放198份问卷,回收有效问卷190份。190名精神科护士共情能力得分为(77.8±10.2)分。精神科护士遭受语言攻击、工作场所暴力得分与共情能力中的情感护理维度呈负相关(r值分别为-0.182、-0.150;P<0.05)。结论精神科具有较高的工作场所暴力发生率,可通过改变共情能力的情感护理维度对精神科护士遭受工作场所暴力情况进行调节。     

团体心理辅导在精神专科护士培训教学中的应用研究

目的 探讨团体心理辅导在精神专科护士培训教学中对学员心理健康状况、压力调整及应对方式的影响.方法 对39名参加四川省精神专科护士培训班的学员进行为期10周,每周一次,共10次的规范化团体心理辅导,采用SCL-90、压力自测量表、简易应对方式问卷、自制的教学质量评价表作为研究工具,对所有学员培训前后进行评估.结果 (1)团体心理辅导前,学员的心理健康水平(SCL-90评分)仅在强迫症状(3.69±0.67)/(常模1.62±0.58)(t=6.21,P=0.000)和人际关系(3.33±0.60)/(常模1.65±0.61)(t=11.34,P=0.000)两项显著高于常模,差异有显著意义;经过辅导后,人际关系因子分(2.08±0.4)较辅导前(3.33±0.60)显著下降,差异有显著意义(t=3.43,P=0.001);(2)压力量表总分辅导后(9.15±3.77)较辅导前(11.08±3.59)低,差异有显著意义(t=3.43,P=0.001);消极应对因子分由辅导前的(10.26±3.40)下降为辅导后的(8.59±2.78),差异有显著意义(t=3.59,P=0.001);(3)人际关系、调控情绪、师生关系、职业发展、总体收获几个方面,学员自己感到满意的比例均超过了90％.结论 团体心理辅导在精神专科护士培训教学中,对改善学员的心理健康状况、调整压力及应对方式起着重要的作用,也受到学员的好评.     

Staff sickness and its relationships to violent incidents on a regional secure psychiatric unit

This study aimed to examine the relationship between absenteeism in nurses and disturbed and/or violent incidents in patients. It was conducted in the Interim Secure Psychiatric Unit at the Bethlem Royal Hospital, London (which later transferred to the Denis Hill Unit) during 1985. Data was gathered from sickness figures recorded on the ward and in the nursing administration office. Violence records were collected from incident reports made by all grades of nursing staff. The hypothesis to be tested was that as violence increased then staff sickness would decrease. Results indicate that such a correlation is not present. However, staff sickness was significantly concentrated around days off. Some considerations for future research are given.     

Family systems nursing: a guide to mental health care in Hong Kong

In Hong Kong, mental health care has traditionally focused on the individual and the concept of considering the family as the unit of care is relatively new. The purpose of this article is to describe the process of planning, implementing, and evaluating a family systems nursing project in a psychiatric setting in Hong Kong. Psychiatric nurses (N = 110) participated in seminars focusing on family systems nursing concepts and individuals and families suffering from mental illness. The Calgary Family Assessment Model and the Calgary Family Intervention Model formed the framework for practice. Significant changes were found both in the nurses' critical appraisal of their clinical practice related to family systems nursing and in their reflections on the reciprocity in their nurse/family relationships. In addition, hospital-wide systems outcomes were noted. This project appears to demonstrate that a family systems nursing approach is relevant for psychiatric nurses caring for Chinese individuals and their families suffering from mental illness.     

Burnout and job satisfaction: a comparative study of psychiatric nurses from forensic and a mainstream mental health service

Within the nursing profession stress and burnout are considered to be widely present and problematic. These factors tend to impact negatively on job satisfaction and ultimately affect the retention of nurses. Psychiatric/mental health nursing as a specialty is considered to be a highly stressful environment; however, there is a paucity of research in this area. The current study adopted a survey design to compare forensic psychiatric nurses ( n = 51) with psychiatric nurses from a mainstreamed mental health service ( n = 78) in relation to burnout and job satisfaction. Forensic nurses displayed lower burnout and higher job satisfaction than their counterparts from the mainstreamed services. These findings are surprising in light of the image of forensic psychiatric nursing as dangerous and unpredictable.     

军队医院精神科护士工作压力源分析及应对措施

目的 了解军队医院精神科护士的工作压力状况及影响因素,并制定有针对性的干预措施.方法 对某军队医院56名精神科护士采用护士工作压力源量表和自制一般情况调查表进行测评分析.结果 本组精神科护士在护士工作压力源量表的病人护理方面得分最高,其次是工作环境及资源方面问题,工作量及时间分配问题和护理专业及工作方面的问题得分相对较低.精神科护士的压力与护龄、职务、学历、健康状况、兴趣爱好、家庭经济状况和心理卫生知识知晓状况呈显著相关性（P＜0.05或0.01）.结论 精神科护士存在较大的工作压力,其影响因素较多,应从多方面予以有针对性的干预,以缓解或消除工作压力.     

Patient classification system in psychiatric nursing: clinical validation

The scarcity of publications about personnel dimensioning in psychiatric nursing motivated the development of an Instrument to Classify the Level of Dependence in Psychiatric Nursing, the initial stage for the establishment of the ideal number of professionals in the nursing crew of the specialty. The purpose of this study was to look for the clinical validation through reliability and construct validity tests, as well as to verify its applicability in the management practice of nurses. Two samples were used, of which n = 40 pairs of instruments filled in Stage 1 of data collection and n = 100 instruments filled in Stage 3 of the study, with different statistical criteria being applied, among them the Kappa coefficient and the Spearman correlation. The Instrument to Classify the Level of Dependence in Psychiatric Nursing was considered reliable, with good indicators of agreement, and the construct was validated, determining the degree of dependence of mental disorder patients.     

The human science basis of psychiatric nursing: theory and practice

Psychiatric nurses in the United Kingdom (UK) have begun to reattend to people with 'serious and enduring mental illness'. At the same time research in the USA and UK has refocused much of its attention on neuroscientific theories and models of serious mental illness. Psychiatric nurses are being encouraged to consider the value of biomedical explanations of serious illness, such as schizophrenia, and to accomodate these theories and models in the practice of nursing. This paper will examine the challenge of the biomedical approach for the continued development of psychiatric nursing theory and practice. It is proposed that psychiatric nursing needs to develop further its own 'proper focus', if it is to survive as a key player in the health care field of the 21st century.     

Perceived characteristics of psychiatric nurses: stigma by association

The focus of this study was the concept of stigma by association, or the negative characteristics attributed to individuals (usually family members) who are in close contact with people who are stigmatized. Psychiatric nurses may likewise be affected by this stigma. Responses from 122 nurses indicated that psychiatric nursing is the least preferred specialty of 10 areas. Psychiatric nurses were least likely to be described as skilled, logical, dynamic, and respected. The findings suggest that psychiatric nursing may be stigmatized by association. Implications, especially in terms of the role of health care professionals in perpetuating stigma, are explored.     

对精神疾病患者实施保护性约束的知识、态度与行为调查

目的了解护士对精神疾病患者实施保护性约束的现状。方法使用自行设计问卷对我院从事精神科临床护理工作的110名护士进行调查。结果护士对精神疾病患者实施保护性约束的知识、态度和行为呈正相关,即对约束知识了解越多,越能适当地实施约束行为;约束态度得分越高,则越可恰当地使用保护性约束。结论护士应不断加强业务知识和法律知识学习,转变服务观念,规范护理行为,才能更好地为精神疾病患者服务。