Yang Chin-Po Paul, Hargreaves William A, Bostrom Alan
Psychiatr Serv. 2014 Feb 1;65(2):251-4. doi: 10.1176/appi.ps.201200531.
Disruptive behavior leading to seclusion or restraint increases with patients in a high-acuity stage of mental illness who have histories of aggressive behavior. The study examined whether greater nursing staff empathy skills and motivation reduced use of seclusion and restraint and whether empathy training can further this effect.
In 1,098 nursing shifts in 2 six-month periods one year apart, hierarchical analyses examined the effects of nursing shift and patient characteristics, the effect for each shift of nurses' skill and motivation to use empathy, and whether empathy training reduced use of seclusion and restraint.
With controls for shift, patient, and other staffing variables, analyses showed that the presence of more nursing staff with above-average empathy ratings was strongly associated with reduced use of seclusion and restraint but empathy training showed no further benefit.
Recruiting and retaining empathic nursing staff may be the best way to reduce the use of seclusion and restraint.
对于有攻击性行为史的处于精神疾病高急性期的患者，导致隔离或约束的破坏性行为会增加。本研究调查了更高的护理人员共情技能和动机是否能减少隔离和约束的使用，以及共情培训是否能进一步产生这种效果。
在相隔一年的两个六个月期间的1098个护理班次中，分层分析检验了护理班次和患者特征的影响、护士运用共情的技能和动机对每个班次的影响，以及共情培训是否减少了隔离和约束的使用。
在对班次、患者和其他人员配备变量进行控制后，分析表明，共情评分高于平均水平的护理人员数量较多与隔离和约束使用的减少密切相关，但共情培训并未显示出进一步的益处。
招募和留住有共情能力的护理人员可能是减少隔离和约束使用的最佳方法。
