England Margaret
Faculty of Nursing University of Windsor, Windsor, Ontario, Canada.
J Adv Nurs. 2007 Apr;58(2):130-9. doi: 10.1111/j.1365-2648.2006.04162.x.
This article reports a study of nurses' assessments of a voice hearer's voices and psychiatric symptoms, and associations of these perceptions with nurses' education, career experience and primary care role.
Traditional views in nursing suggest that to engage voice hearers in a discussion of their voices is to support the psychopathology of the voice hearers. Research into how voice hearers conceptualize voice hearing has generated a range of perspectives, raising concerns about whether nurses capture sufficient, accurate and specific assessment data about the experiences of voice hearers.
One hundred and fifteen psychiatric nurses rated items on an Inventory of Voice Experiences and the Brief Psychiatric Rating Scale while viewing a videotaped assessment of a voice hearer with serious and persistent mental illness. The voice hearer in the videotape used the same instruments to rate his own voices and symptoms. This self-assessment was undertaken 30 days before and immediately before production of the video-recorded assessment. The data were collected between 2000 and 2002.
The voice hearer's ratings of his voice hearing experiences and psychiatric symptoms were consistent over a 30-day period. Most nurse ratings of the voice hearer's voices and psychiatric symptoms did not match those of the voice hearer. However, the voice hearer and nurses demonstrated a moderately positive association between the voice hearer's voices and symptoms. Ratings of graduate-educated case managers and clinical nurse specialists (n=30) in clinical practice settings were more consistent with one another and corresponded more closely with the ratings of the voice hearer, particularly for the association between the voice hearer's voices and symptoms.
Accurate and specific assessment of voice hearing may facilitate engagement with voice hearers and improve the selection of strategies to help them manage the voices that upset them.
本文报告了一项关于护士对幻听患者的幻听及精神症状评估的研究，以及这些认知与护士的教育背景、职业经历和初级护理角色之间的关联。
护理领域的传统观点认为，与幻听患者讨论他们的幻听是在支持幻听患者的精神病理学表现。对幻听患者如何理解幻听的研究产生了一系列观点，引发了人们对护士是否能获取关于幻听患者经历的充分、准确和具体评估数据的担忧。
115名精神科护士在观看一名患有严重持续性精神疾病的幻听患者的录像评估时，对幻听体验量表和简明精神症状评定量表上的项目进行评分。录像中的幻听患者使用相同的工具对自己的幻听和症状进行评分。这种自我评估在录像评估制作前30天和即将制作前进行。数据收集于2000年至2002年期间。
幻听患者对其幻听经历和精神症状的评分在30天内保持一致。大多数护士对幻听患者的幻听和精神症状的评分与幻听患者的评分不匹配。然而，幻听患者和护士在幻听患者的幻听与症状之间表现出中度正相关。在临床实践环境中，接受过研究生教育的个案管理员和临床护理专家（n = 30）的评分彼此之间更一致，并且与幻听患者的评分更接近，特别是在幻听患者的幻听与症状之间的关联方面。
对幻听进行准确和具体的评估可能有助于与幻听患者建立联系，并改善帮助他们应对困扰他们的幻听的策略选择。
