Slevin Eamonn
School of Nursing, University of Ulster, Newtownabbey, County Antrim, Northern Ireland, UK.
J Clin Nurs. 2004 Jul;13(5):571-9. doi: 10.1111/j.1365-2702.2004.00911.x.
There is scant knowledge on the contacts community nurses for people with learning disabilities have with clients who display challenging behaviours, or the numbers of such people on these nurses' caseloads. This study was undertaken in a UK region with a population of 1.68 million people. In this region it is estimated that there are 8500 people with learning disabilities who are in contact with services, this includes around 500 people remaining in hospitals awaiting resettlement.
The research aims were to identify the overall caseload sizes of the nurses, the prevalence of people with learning disabilities who have challenging behaviours on the nurses' caseloads and what contact demands these people required. An additional aim was to discover courses or training that helped the nurses to fulfill their roles.
A postal survey was undertaken of the total population of community nurses for people with learning disabilities in the region. The method of data collection was a self-completion questionnaire.
The study found that people with challenging behaviours accounted for over a quarter of the combined caseloads, and these clients required the most frequent visits from the nurses. There was a wide range in the number of clients on the caseloads of each nurse but overall these were higher than in other parts of the UK.
It is concluded that community nurses for people with learning disabilities have large caseloads and people with learning disabilities who have challenging behaviours, who account for over one-quarter of the clients they visit, require much more frequent contact visits than other clients. The combination of high numbers of clients (or low numbers of these nurses) may impact on how such nurses are able to perform their role and functions.
An increase in the numbers of community nurses for people with learning disabilities and skill development in caring for people with challenging behaviours is recommended. If this is not performed the clinical effectiveness of this group of nurses with respect to their work with people who challenge services may be unduly hampered.
关于社区护士与有学习障碍且表现出挑战性行为的患者的接触情况,以及这些护士所负责的此类患者数量,目前所知甚少。本研究在英国一个拥有168万人口的地区开展。据估计,该地区有8500名有学习障碍的人与服务机构有接触,其中包括约500人仍在医院等待重新安置。
该研究旨在确定护士的总体工作量规模、有学习障碍且表现出挑战性行为的患者在护士工作量中的比例,以及这些患者需要何种接触服务。另一个目的是发现有助于护士履行职责的课程或培训。
对该地区为有学习障碍者提供服务的社区护士全体进行了邮寄调查。数据收集方法为自填问卷。
研究发现,表现出挑战性行为的患者占总工作量的四分之一以上,这些患者需要护士最频繁的探访。每位护士所负责的患者数量差异很大,但总体上高于英国其他地区。
得出的结论是,为有学习障碍者服务的社区护士工作量大,且有学习障碍且表现出挑战性行为的患者占他们所探访患者的四分之一以上,比其他患者需要更频繁的接触探访。患者数量众多(或护士数量不足)的情况可能会影响这些护士履行其职责和功能的能力。
建议增加为有学习障碍者服务的社区护士数量,并开展针对照顾有挑战性行为患者的技能培训。否则,这组护士在与对服务构成挑战的患者工作方面的临床效果可能会受到不当阻碍。