三级甲等医院精神科护士对患者攻击行为风险评估现状调查

Survey on the status of risk assessment on patients' aggressive behaviors among psychiatric nurses in 3A-grade general hospitals

目的调查精神科护士对攻击行为进行风险评估的现状,深入了解评估内容。方法采用量性研究和质性研究相结合的方法,对184名精神科护士进行问卷调查,并选择12名护士进行访谈。结果分别有96.20%和92.39%的护士认为评估时会考虑患者院外攻击行为史及患者目前精神状态。类属分析方法提炼出3个主题概念:攻击史因素、临床因素、一般资料。攻击行为史、家族史、精神症状及临时预警信号是精神科护士对患者进行攻击行为风险评估时考虑的主要方面。结论通过护士的动态观察和判断,及时进行评估是目前临床中常用的评估方法;动态观察患者的病情,及时发现异常信号并进行有效干预是预防攻击行为发生的重要途径。

Objective To investigate the status of risk assessment on patients＇aggressive behaviors among psychiatric nurses and further to explore the contents of assessment. Methods Qualitative research ＇and quantitative research were adopted in the study. A total of 184 psychiatric nurses were investigated with a questionnaire and 12 nurses were interviewed. Results History of aggression and patients＇present mental state were taken into consideration by 96.20% and 92.39 % of the nurses. Three themes, which were aggression history, clinical factors and general information, were extracted. History of aggression, family history of aggression, psychotic symptoms and temporary warning signal were the main aspects of risk assessment. Conclusion Timely evaluation based on the dynamic observation by nursing staff is the common method of clinical assessment recently. Dynamic observation of the patientg condition, early detection of the abnormal signals and effective intervention are important ways to prevent aggressive behaviors.