El-Sayad Sonia M
Psychiatric and Mental Health Nursing, Faculty of Nursing, Port-Said University, Egypt.
Arch Psychiatr Nurs. 2018 Jun;32(3):403-412. doi: 10.1016/j.apnu.2017.12.005. Epub 2017 Dec 19.
Limit setting facilitates the development of a therapeutic, caring and supportive relationships, it can also decrease patients' feelings of anxiety and uncertainty. It is a two-way process that should be delivered professionally by the nurse and perceived therapeutically by the patient, so patient considered a vital participant of the technique.
The present study aimed at exploring psychiatric patients' and nurses' opinions as well as their information about limit setting.
All nurses working at the hospital and working along the day (the three day shifts) were included in the study (N=88), as well as all convenient patients that were willing to participate in the study (N=104).In order to collect data for the present study, three open-ended structured questionnaires were developed by the researcher.
Psychiatric nurses working at Port-Said psychiatric hospital have insufficient information concerning limit setting in which use of threats and authoritarian communication is nurses' style of application. Regrettably, nurses of the present study disagreed with essential and indispensible principles that should be followed when setting limits. Concerning psychiatric patients, the study revealed that patients had negative experiences with limit settings that contributed to enforcement of misconceptions and negative opinions about limit setting. Also, psychiatric patients viewed limit setting technique as nurses' way of punishment as well as humiliation.
Providing nurses with sufficient information about different psychiatric nursing skills such as communication skills and use of restraint; through holding educational workshops and seminars. Secondly, nurses need specific and professional training course accompanied with clinical application or simulation. As regard psychiatric patients, providing courses by professional and competent nursing staff regarding limit setting emphasizing its therapeutic uses and outcomes is a must; in order to correct misconceptions they acquired.
设定界限有助于建立治疗性、关怀性和支持性的关系,还能减轻患者的焦虑和不确定感。这是一个双向过程,应由护士专业地实施,并被患者从治疗角度来理解,因此患者被视为该技术的重要参与者。
本研究旨在探究精神病患者和护士对设定界限的看法以及他们所掌握的相关信息。
纳入在该医院工作且值白班(三个白班班次)的所有护士(N = 88),以及所有愿意参与研究的方便选取的患者(N = 104)。为收集本研究的数据,研究者编制了三份开放式结构化问卷。
在塞得港精神病医院工作的精神科护士对设定界限的信息掌握不足,他们采用威胁和专制的沟通方式来应用这一方法。遗憾的是,本研究中的护士不同意设定界限时应遵循的基本且不可或缺的原则。关于精神病患者,研究表明患者在设定界限方面有负面经历,这加剧了他们对设定界限的误解和负面看法。此外,精神病患者将设定界限技术视为护士惩罚和羞辱他们的方式。
通过举办教育工作坊和研讨会,为护士提供关于不同精神科护理技能(如沟通技能和约束使用)的充分信息。其次,护士需要有特定的专业培训课程并伴有临床应用或模拟。对于精神病患者,必须由专业且称职的护理人员提供关于设定界限的课程,强调其治疗用途和效果,以纠正他们所形成的误解。