Whitehead Elizabeth, Mason Tom
School of Health and Social Care, University of Chester, Chester, UK.
Int J Ment Health Nurs. 2006 Dec;15(4):235-41. doi: 10.1111/j.1447-0349.2006.00429.x.
The use of special observations in psychiatric practice may be employed as an alternative to more restrictive methods such as the use of seclusion and restraint. From the literature, special observations are used for a complex array of signs and symptoms (and risk behaviours) which include suicidal intent, self-injurious behaviour, hallucinatory experiences, and absconding. This paper reports on research into the use of special observations in both forensic and non-forensic psychiatric settings. A comparative approach was adopted to establish if the perceived risk factors leading to the adoption of special observations were similar in both settings. Three groups of nursing staff were requested to assess 30 patients who were placed on special observations. Before this, nurses were requested to rate the risk factors in terms of their severity on a 7-point Likert scale. The rank-ordering analysis revealed a similarity of identified risk factors and anova (one-way, unrelated) and the Jonckheere Trend Test revealed that there were significant differences between the scores in the forensic and the non-forensic settings. The statistical differences existed for risk factors relating to harm to self and others but not for psychiatric symptomatology.
在精神科实践中，使用特殊观察可作为诸如隔离和约束等更具限制性方法的替代手段。从文献来看，特殊观察用于一系列复杂的体征和症状（以及风险行为），包括自杀意图、自伤行为、幻觉体验和逃跑。本文报告了在法医精神病学和非法医精神病学环境中使用特殊观察的研究情况。采用了一种比较方法来确定在这两种环境中导致采用特殊观察的感知风险因素是否相似。三组护理人员被要求对30名接受特殊观察的患者进行评估。在此之前，要求护士根据风险因素的严重程度在7点李克特量表上进行评分。排序分析揭示了已确定风险因素的相似性，方差分析（单因素、非相关）和琼克尔趋势检验表明，法医环境和非法医环境中的评分存在显著差异。与对自己和他人造成伤害相关的风险因素存在统计学差异，但精神症状方面不存在差异。
