住院精神病患者意外事件相关因素分析与对策

Analysis of correlated factors with accidents in inpatients with mental disorder and nursing care strategy

目的了解住院精神病患者意外事件发生情况和相关因素,探讨护理对策。方法回顾1986年1月—2005年12月期间住院,符合CCMD-3诊断标准的住院精神病患者的临床资料,采用自行设计的调查表,进行回顾性的调查研究和分析。结果在1 398例住院精神病患者中意外事件的发生率为20.17%,由于意外事件而造成伤害者占意外事件总数的13.12%,占住院患者总数的2.65%。92.55%意外事件的发生在患者入院后1个月之内,其中73.05%发生在入院后1～5d之内,65.96%发生在患者首次住院期间,23.40%发生在傍晚16时至20时之间。年龄越小发生意外事件的可能性越多。躁狂症、抑郁症发生意外事件的比例高于其他诊断。小学、初中发生意外事件的比例高于其他文化程度的患者。结论意外事件的发生与患者的年龄、文化程度、住院时间、入院次数、疾病诊断和病情状况等均有一定的关系,应根据患者的不同情况,采取有针对性的预防措施。

Objective To survey the accident situation and correlated factors in inpatients with mental disorder,and to explore the nursing care strategy.Methods A retrospective study was made in inpatients who met diagnosis criteria of CCMD-3 in our hospital from January,1986 to December,2005.Results In 1 398 cases,the accident rate was 20.17%.Up to 13.12% of total accidents led to injury（accounting for 2.65% of total inpatients）.73.05% and 92.55% of total accidents occurred within 5 d and within a month after admission.23.40% of total accidents occurred in the evening between 4：00 p.m.to 8：00 p.m..65.96% of total accidents occurred in the first admission.The younger inpatients had more accident possibility.The patients with diagnosis of mania and depression had more accidents.Furthermore,the patients with educational background of primary and junior middle school have more accidents.Conclusion The occurrence of accidents relates to age,educational background,hospital stay,admission times,disease and patient＇s condition.The targeted preventive measures should be taken according to individual condition.