住院精神病患者暴力行为原因分析及护理对策

Analysis of causes of violence in hospitalized patients with psychosis and nursing countermeasures

目的研究住院精神病患者暴力行为发生的原因,采取相应的护理对策,尽量降低暴力行为发生率。方法对65例发生暴力行为的住院精神病患者临床资料进行回顾分析,找到暴力行为发生的主要原因,并提出相应的护理对策;然后再统计对策实施后的精神病患者暴力行为发生情况,以检验实施效果。结果发生暴力行为疾病多见于精神分裂症和双相情感障碍。在采取针对性防范措施后,暴力攻击行为发生率由2.6%下降到1.0%,差异有统计学意义(P<0.05)。两组暴力攻击率、精神分裂、双向情感等,拳击、脚踢等比较差异有统计学意义(P<0.05),抓伤无统计学意义(P>0.05)。结论多数暴力攻击行为由精神症状所致,尽早对精神病患者的症状进行控制,并采取对新入院患者予暴力风险评估、加强医护沟通、加强对患者的宣教、提升护士的防暴能力培训和建立良好的护患关系等措施,可有效降低暴力行为发生率。

Objective To study the causes of violence in inpatients with psychosis and to minimize the incidence of vi- olence by taking corresponding nursing measures. Methods The clinical data of 65 hospitalized patients with psychosis were retrospectively analyzed to find out the main causes of violence and the corresponding nursing measures were pro- posed. Then, the number of violence in psychiatric patients after the implementation of countermeasures was counted to test the implementation effect. Results The violent diseases were more common in schizophrenia and bipolar disorder. After taking targeted precautionary measures, the incidence of violent attacks decreased from 2.6% to 1.0% with a sig- nificant difference（P〈0.05）. There were statistically significant differences in violence attack rate, schizophrenia, bipo- lar disorder, boxing and kick between the two groups. There was no significant difference in scratch between the two groups（P〉0.05）. Conclusion Most violent attacks are caused by psychiatric symptoms. The symptoms of patients with psychosis should be controlled as soon as possible. Measures such as assessing the risk of violence in newly admitted patients, strengthening medical communication, strengthening patient education, enhancing training of nurses in riot prevention and establishing a good nurse-patient relationship can effectively reduce the incidence of violence.