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日本精神科访视护士遭受的暴力暴露及由此产生的心理影响。

Violence exposure and resulting psychological effects suffered by psychiatric visiting nurses in Japan.

作者信息

Fujimoto H, Hirota M, Kodama T, Greiner C, Hashimoto T

机构信息

Kobe University Graduate School of Health Sciences, Kobe, Japan.

Mie University, Mie, Japan.

出版信息

J Psychiatr Ment Health Nurs. 2017 Oct;24(8):638-647. doi: 10.1111/jpm.12412. Epub 2017 Aug 24.

Abstract

UNLABELLED

WHAT IS KNOWN ON THE SUBJECT?: There is a developing body of research on violence in healthcare workplaces. Although psychiatric visiting nurses (PVNs) are an important group of professionals who provide medical services for people with mental disorders live in the community, little is known about the experiences and characteristics of violence exposure among PVNs, or the characteristics and work situations of PVNs related to violence exposure. WHAT THIS STUDY ADDS TO EXISTING KNOWLEDGE?: Approximately 40% of participants were exposed to violence during the previous 12 months; approximately 50% had been exposed during their PVN careers in PVN settings. The most frequent violence was verbal abuse. Longer career length as a PVN and greater number of visits per month were both positively associated with verbal abuse during the previous 12 months. Twenty-eight of the 34 participants (83%) who completed the IES-R-J survey had some residual psychological distress, and two (6%) had a potentially high risk of posttraumatic stress disorder. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: In devising policies and strategies against violence, PVN organizations and administrators should consider the characteristics of the violence, especially verbal abuse, as well as the characteristics and work situations of PVNs that are related to verbal abuse. Furthermore, they might provide relevant information on violence in PVN settings within their violence-prevention manuals or education. It would be important to provide support and to construct a safe workplace environment for PVNs who are experiencing residual psychological distress.

ABSTRACT

Introduction Psychiatric visiting nurses (PVNs) play a crucial role by providing medical services for community-living individuals with mental disorders in Japan. However, little is known about violence towards PVNs. Aim This cross-sectional study investigated violence during visits and the resulting psychological effects for PVNs. Methods PVNs were assessed using a violence exposure questionnaire and the Impact of Event Scale-Revised (IES-R-J); a measure of posttraumatic distress. Result Thirty-eight (41%) of 94 participants had experienced violence during the previous 12 months and 49 (53%) over their entire career. The most frequent violence was verbal abuse. Career length as a PVN and number of visits per month were significantly positively associated with verbal abuse during the previous 12 months. The IES-R-J scores indicated 28 of the 34 participants who completed the questionnaire exhibited psychological distress for the most traumatic violence during their career and two had a potentially high risk of posttraumatic stress disorder. Discussion and Implications Policies and strategies aimed at reducing violence in PVN settings should be developed according to characteristics of the violence, as well as the characteristics and work situation of PVNs. Furthermore, the provision of support and a safe workplace environment would be important for PVNs with residual psychological distress.

摘要

未标注

关于该主题已知的信息有哪些?:针对医疗保健工作场所暴力的研究正在不断发展。尽管精神科访视护士(PVN)是为社区中患有精神障碍的人提供医疗服务的重要专业人员群体,但对于PVN遭受暴力的经历和特征,或者与暴力暴露相关的PVN的特征和工作情况,我们了解甚少。本研究对现有知识的补充是什么?:在过去12个月中,约40%的参与者遭受过暴力;在其PVN职业生涯中,约50%的人在PVN工作环境中遭受过暴力。最常见的暴力形式是言语辱骂。作为PVN的职业生涯更长以及每月访视次数更多,都与过去12个月内的言语辱骂呈正相关。在完成IES - R - J调查的34名参与者中,有28名(83%)存在一些残留的心理困扰,两名(6%)有创伤后应激障碍的潜在高风险。对实践有何启示?:在制定针对暴力的政策和策略时,PVN组织和管理人员应考虑暴力的特征,尤其是言语辱骂,以及与言语辱骂相关的PVN的特征和工作情况。此外,他们可以在其预防暴力手册或教育中提供有关PVN工作环境中暴力情况的相关信息。为经历残留心理困扰的PVN提供支持并营造安全的工作场所环境非常重要。

摘要

引言 在日本,精神科访视护士(PVN)通过为社区中患有精神障碍的个人提供医疗服务发挥着关键作用。然而,对于针对PVN的暴力行为知之甚少。目的 本横断面研究调查了PVN访视期间的暴力情况及其产生的心理影响。方法 使用暴力暴露问卷和事件影响量表修订版(IES - R - J)对PVN进行评估;IES - R - J是一种创伤后困扰的测量工具。结果 94名参与者中有38名(41%)在过去12个月中经历过暴力,49名(53%)在其整个职业生涯中经历过暴力。最常见的暴力形式是言语辱骂。作为PVN的职业生涯长度和每月访视次数与过去12个月内的言语辱骂显著正相关。IES - R - J得分表明,在完成问卷的34名参与者中,有28名在其职业生涯中因最具创伤性的暴力行为而表现出心理困扰,两名有创伤后应激障碍的潜在高风险。讨论与启示 应根据暴力的特征以及PVN的特征和工作情况,制定旨在减少PVN工作环境中暴力行为的政策和策略。此外,为有残留心理困扰的PVN提供支持和安全的工作场所环境很重要。

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