Aggressive behaviour on acute psychiatric wards: prevalence, severity and management
Aggressive behaviour on acute psychiatric wards: prevalence, severity and management
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DOI：
10.1111/j.1365-2648.2007.04169.x
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发表时间：
2007-04-01
影响因子：
3.8
通讯作者：
Nijman, Henk
中科院分区：
文献类型：
--
作者：
Foster, Chloe;Bowers, Len;Nijman, Henk
瞄准本文报道了一项研究，旨在调查针对工作人员和其他患者的住院患者攻击行为的性质和流行率，以及在患者自我伤害的情况下，护理人员使用的管理方法。攻击行为对精神科护理人员的身心健康构成威胁。在潜在危险的环境中工作所产生的恐惧也可能对患者护理产生破坏性影响。在英国一家医院的五个急性住院病房的护理人员收集的攻击事件的数据，使用工作人员观察攻击量表-修订在10个月期间，从2001年6月至2002年4月。记录在案的侵略事件有254起。工作人员是最常见的目标，参与了57.1%的事件。最常见的挑衅行为是病人被拒绝离开病房（29.5%的事件）。患者最常用的手段是言语攻击（60%的事件），受害者最常见的结果是感觉受到威胁（59%的事件），言语干预最常用于管理攻击行为（43.7%）。尽管许多事件涉及言语攻击的工作人员和患者为目标的侵略，35.9%的事件涉及工作人员和25%的事件涉及其他患者导致隔离。据估计，在这项研究中，在医院的12个月期间，护士每年有十分之一的机会因患者攻击而受到任何类型的伤害。尽管口头攻击占主导地位，但在这样的环境中工作产生的恐惧和难以理解患者攻击的原因可能会激励工作人员经常使用隔离和约束等物理方法来管理攻击性事件。
Aim. This paper reports a study to investigate the nature and prevalence of inpatient aggressive behaviour directed at staff and other patients and, in the case of patient self-harm, the methods used by nursing staff to manage this.Background. Aggressive behaviour poses a threat to the physical and psychological health of psychiatric nursing staff. The fear that results from working in a climate of potential danger can also have a damaging impact on patient care.Methods. Nursing staff on five acute inpatient wards in one hospital in the United Kingdom collected data on aggressive incidents using the Staff Observation Aggression Scale - Revised during a 10 month period from June 2001 to April 2002.Results. There were 254 incidents of aggression recorded. Staff were most commonly targeted and were involved in 57.1% of incidents. The most frequent provocation of the aggression was the patient being denied something such as leave from the ward (29.5% of incidents). The most frequent means used by patients was verbal aggression (60% of incidents), the most frequent outcome for the victim was feeling threatened (59% of incidents), and verbal interventions were used most frequently to manage the aggressive behaviour (43.7%). Despite many incidents involving verbal aggression in both staff- and patient-targeted aggression, 35.9% of incidents involving staff and 25% of incidents involving other patients resulted in seclusion.Conclusion. It is estimated that in a 12 month period at the hospital in this study a nurse would have a one in 10 chance per year of receiving any kind of injury as a result of patient aggression. Despite the predominance of verbal over physical aggression, the fear generated from working in such an environment and a difficulty in understanding the causes of patient aggression may motivate staff to manage aggressive incidents with physical methods such as seclusion and restraint on a frequent basis.