School of Nursing, Peking Union Medical College, 33 Badachu Road, Beijing 100144, China.
Department of Nursing, Anding Hospital, Capital Medical University, 5 Ankang Lane, Beijing 100088, China.
Arch Psychiatr Nurs. 2019 Dec;33(6):167-176. doi: 10.1016/j.apnu.2019.08.009. Epub 2019 Aug 26.
The purpose of this study is to investigate the current situation of violence on primary caregivers of people with severe mental illness outside the hospital and the cognition of primary caregivers about violence among mental patients.
A self-designed questionnaire was used to investigate the primary caregivers (N = 208) of people with severe mental illness in a psychiatric hospital in Beijing.
The incidence rate of violence suffered by primary caregivers was 74.03%, of which 61.54% had experienced verbal attacks, 54.33% had experienced threats, and 45.19% experienced physical attacks. Physical violence, mainly by unarmed attacks, has resulted in soft tissue injury and pain in the majority of caregivers. Multiple admission times, a lower educational level, single in marital status and involuntary hospitalizations were risk factors; growing older was protective factor. The causes of violence were dominated by mental symptoms in 120 cases (57.69%). Tolerance and avoidance were the coping styles of most caregivers adopted after violence, accounting for 51.44%. Furthermore, most of primary caregivers have limited knowledge of violence and adopted an attitude of pessimism towards patients' violence.
It was reported that violence was suffered by primary caregivers of persons with severe mental illness outside the hospital. The study indicated that formulating reasonable nursing intervention, providing health education as well as organizing training towards violence of patients are required to play an important role in effectively preventing and reducing the violence among the people with severe mental illness in China. More information and support needs to be obtained to help caregivers fulfill their duty of care outside the hospital.
本研究旨在调查医院外严重精神疾病患者主要照顾者遭受暴力的现状和主要照顾者对精神患者暴力的认知。
采用自行设计的问卷对北京市某精神专科医院的 208 名严重精神疾病患者的主要照顾者进行调查。
主要照顾者遭受暴力的发生率为 74.03%,其中言语攻击占 61.54%、威胁占 54.33%、身体攻击占 45.19%。身体暴力主要以徒手攻击为主,多数照顾者软组织损伤和疼痛。多次住院、文化程度低、婚姻状况单一、非自愿住院是暴力的危险因素;年龄较大是保护因素。暴力原因以精神症状为主,共 120 例(57.69%)。暴力后,大多数照顾者采用容忍和回避的应对方式,占 51.44%。此外,大多数主要照顾者对暴力的认识有限,对患者暴力持悲观态度。
本研究报告了医院外严重精神疾病患者主要照顾者遭受暴力的情况。研究表明,制定合理的护理干预措施,提供暴力相关健康教育,组织对患者暴力的培训,对有效预防和减少中国严重精神疾病患者的暴力行为具有重要作用。需要更多的信息和支持来帮助照顾者在医院外履行照顾责任。