School of Nursing, Midwifery and Paramedicine, Curtin University, Perth, Western Australia, Australia.
Int J Ment Health Nurs. 2017 Oct;26(5):445-460. doi: 10.1111/inm.12378.
Consumer aggression is common in the acute mental health inpatient setting. Mental health nurses can utilize a range of interventions to prevent aggression or reduce its impact on the person and others who have witnessed the event. Incorporating recovery-focussed care into clinical practice is one intervention, as it fosters collaborative partnerships with consumers. It promotes their engagement in decisions about their care and encourages self-management of their presenting behaviours. It also allows the consumer to engage in their personal recovery as their mental health improve. Yet there is a paucity of literature on how nurses can utilize recovery-focussed care with consumers who are hospitalized and in the acute phase of their illness. In the present study, we report the findings of a scoping review of the literature to identify how recovery-focussed care can be utilized by nurses to reduce the risk of consumer aggression. Thirty-five papers met the inclusion criteria for review. Four components were identified as central to the use of recovery-focussed care with consumers at risk of becoming aggressive: (i) seeing the person and not just their presenting behaviour; (ii) interact, don't react; (iii) coproduction to achieve identified goals; and (iv) equipping the consumer as an active manager of their recovery. The components equip nurses with strategies to decrease the risk of aggression, while encouraging consumers to self-manage their challenging behaviours and embark on their personal recovery journey. Further research is required to evaluate the translation of these components clinically in the acute care setting.
消费者攻击在急性心理健康住院环境中很常见。精神科护士可以采用多种干预措施来预防攻击行为，或减轻其对患者和目睹事件发生的其他人的影响。将以康复为重点的护理纳入临床实践是一种干预措施，因为它可以与消费者建立合作关系。它促进了他们参与关于自身护理的决策，并鼓励他们自我管理自身的表现行为。它还允许消费者在心理健康改善的同时参与个人康复。然而，关于护士如何在住院和疾病急性阶段的消费者中利用以康复为重点的护理的文献却很少。在本研究中，我们报告了文献范围综述的结果，以确定护士如何利用以康复为重点的护理来降低消费者攻击的风险。有 35 篇论文符合审查标准。确定了与有攻击风险的消费者一起使用以康复为重点的护理的四个核心要素：(i) 看到人，而不仅仅是他们的表现行为；(ii) 互动，而不是反应；(iii) 共同制定以实现既定目标；以及 (iv) 使消费者成为其康复的积极管理者。这些要素使护士能够采取策略降低攻击风险，同时鼓励消费者自我管理其挑战性行为并开始个人康复之旅。需要进一步研究来评估这些要素在急性护理环境中的临床转化。
