重性精神疾病患者主要照顾者遭受暴力攻击的现状调查

目的：了解重性精神疾病患者的主要照顾者在院外遭受患者暴力攻击的现状。方法采用自制的调查问卷对北京某精神病医院208名精神疾病患者的主要照顾者进行调查。结果208名主要照顾者院外遭受暴力行为发生率为74．03％，其中遭受语言攻击者占61．54％，遭受威胁者占54．33％，遭受躯体攻击者占45．19％；患者常采取的躯体暴力攻击方式为徒手攻击；照顾者遭受暴力行为的后果以软组织损伤和疼痛居多；发生暴力行为的原因以患者受精神症状支配为主，占81．81％；照顾者遭受暴力行为后的应对方式以忍让回避为主，占69．48％。多因素分析结果显示患者年龄越大发生暴力行为的危险性越低，而患者文化程度低、单身、非自愿住院、多次住院是暴力行为发生的危险因素。结论精神疾病患者的主要照顾者遭受暴力攻击发生率高，对暴力行为处理能力差，应在医院和社区制定合理护理干预及为照顾者提供健康教育，从而达到有效预防、减少家庭照顾中照顾者受暴力攻击的发生，提高照顾者信心与生活质量。

Survey on violent attacks to primary caregivers of patients with severe mental disorder

Objective To investigate the current situation of primary caregivers who suffer from violent attacks from patients with severe mental disorder outside of the hospital .Methods A self-made questionnaire was used to investigate 208 caregivers of patients with severe mental disorders from one psychiatry hospital in Beijing.Results The incidence rate of violent behaviors to primary caregivers outside of the hospital was 74.03%;during which verbal assault accounted for 61.54%, threats accounted for 54.33% and physical attacks accounted for 45.19%.Patients often attacked caregivers with their bare hands .Caregivers normally suffered with soft tissue injury and great pain after receiving attack .The main cause of violent attacks was the domination of psychiatric symptoms （81.81%）.The main way to deal with these attacks for caregivers was tolerance （69.48%）.Multiple-factor analysis showed patients with elder age had low risk , and patients with low education level, single, involuntary hospitalization and many times hospitalization had high risk . Conclusions Primary caregivers suffer a high incidence rate of violent attacks and cannot deal with this properly.Effective nursing interventions should be made in hospitals and communities .Health education should be provided for caregivers to achieve effective intervention and reduce violent attacks and boost the confidence and life quality of caregivers .