Mullen Richard, Admiraal Anita, Trevena Judy
Department of Psychological Medicine, Dunedin School of Medicine, University of Otago, PO Box 913, Dunedin 9054, New Zealand.
N Z Med J. 2008 Nov 28;121(1286):85-91.
This study aimed to assess the extent of defensive clinical practice by psychiatrists and psychiatric nurses in a New Zealand Mental Health Service.
An anonymous questionnaire survey, addressing perceptions of a variety of defensive practices, was sent to all psychiatrists and psychiatric nurses working in acute clinical settings in the publically funded mental health service in Dunedin, New Zealand.
Defensive practice is perceived as widespread in psychiatric settings. In particular, practices such as questioning patients about their safety, admissions to hospital, and delayed discharge from hospital were often perceived as occurring for defensive purposes. Psychiatric nurses were more likely than psychiatrists to perceive such practices as defensive.
Defensive practice is common in mental health. This is despite New Zealand's no-fault compensation scheme, and so presumably results from concerns other than the risk of financial liability. There may be particular pressures in mental health to practice defensively.
本研究旨在评估新西兰一家心理健康服务机构中精神科医生和精神科护士的防御性临床实践程度。
向新西兰达尼丁市由公共资金资助的心理健康服务机构中在急性临床环境工作的所有精神科医生和精神科护士发送了一份匿名问卷调查，询问他们对各种防御性医疗行为的看法。
防御性医疗行为在精神科环境中被认为普遍存在。特别是，诸如询问患者安全情况、住院情况以及延迟出院等行为，常常被认为是出于防御目的而发生的。精神科护士比精神科医生更倾向于将此类行为视为防御性的。
防御性医疗行为在心理健康领域很常见。尽管新西兰实行无过错赔偿计划，但这一现象可能是由除经济责任风险之外的其他担忧导致的。心理健康领域可能存在特殊压力促使人们采取防御性医疗行为。
