Meehan T, McIntosh W, Bergen H
University of Queensland, Service Evaluation & Research Unit, The Park, Centre for Mental Health, Wacol, Qld, Australia.
J Psychiatr Ment Health Nurs. 2006 Feb;13(1):19-25. doi: 10.1111/j.1365-2850.2006.00906.x.
Twenty-seven patients undergoing treatment in a high-secure forensic facility participated in focus group interviews to elicit their perceptions of (1) the factors leading to aggressive behaviour; and (2) strategies to reduce the risk of such behaviour. The focus group interviews were audiotaped, transcribed and analysed using content analysis. The participants identified that a combination of patient, staff and environmental factors contributed to violence in the study wards. The cause of aggressive behaviour centred around five major themes: the environment; empty days; staff interactions; medication issues; and patient-centred factors. Potential strategies identified by patients to reduce aggressive behaviour included: early intervention; the provision of meaningful activities to reduce boredom; separation of acutely disturbed patients; improved staff attitudes; implementation of effective justice procedures; and a patient advocate to mediate during times of conflict. Findings suggested that social and organizational factors need to be addressed to change the punitive subculture inherent in forensic psychiatric facilities, and to ensure a balance between security and effective therapy.
27名在高度戒备的法医机构接受治疗的患者参加了焦点小组访谈，以了解他们对以下方面的看法：(1)导致攻击行为的因素；(2)降低此类行为风险的策略。焦点小组访谈进行了录音、转录，并采用内容分析法进行分析。参与者指出，患者、工作人员和环境因素共同导致了研究病房中的暴力行为。攻击行为的原因集中在五个主要主题上：环境；空虚的日子；工作人员互动；药物问题；以及以患者为中心的因素。患者提出的降低攻击行为的潜在策略包括：早期干预；提供有意义的活动以减少无聊感；隔离急性精神错乱患者；改善工作人员态度；实施有效的司法程序；以及在冲突期间有患者代言人进行调解。研究结果表明，需要解决社会和组织因素，以改变法医精神病设施固有的惩罚性亚文化，并确保安全与有效治疗之间的平衡。
