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患者对工作人员的攻击行为:美国一家急性住院精神病教学医院心理健康工作人员的观点

Patient-on-Staff Assaults: Perspectives of Mental Health Staff at an Acute Inpatient Psychiatric Teaching Hospital in the United States.

作者信息

Ezeobele Ifeoma E, Mock Ardell, McBride Rachel, Mackey-Godine Arslee, Harris Dorothy, Russell Christine D, Lane Scott D

机构信息

UTHealth Harris County Psychiatric Center, Houston, TX, USA.

Department of Psychiatry and Behavioral Sciences, UTHealth McGovern Medical School, Houston, TX, USA.

出版信息

Can J Nurs Res. 2021 Sep;53(3):242-253. doi: 10.1177/0844562120904624. Epub 2020 Feb 13.

Abstract

INTRODUCTION

Physical assaults perpetrated by patients in psychiatric hospitals against mental health staff (MHS) is a serious concern facing psychiatric hospitals. Assaulted staff reports physical and psychological trauma that affects their personal and professional lives. There is a dearth of literature exploring this phenomenon.

PURPOSE

To explore MHS perspectives of assault by psychiatric patients.

METHODS

A transcendental phenomenological qualitative design was used to explore and analyze the perspectives of a purposeful sample of 120 MHS perspectives at an acute inpatient psychiatric hospital. Participants' age ranged from 22 to 63 years (mean age = 32.4). Moustakas' theoretical underpinnings guided the study.

RESULTS

Two patterns, 8 themes, and 19 subthemes were identified: (a) Psychological impacts revealed four themes-increase of anxiety/fear level, helplessness and hopelessness, flashbacks/burnout, and doubting own competency. (b) Physiosocial impacts revealed four themes-unsupportive superiors, stigmatization of staff victim, failure to report the incident, and environmental safety.

DISCUSSION

Participants verbalized that assaults by patients have instilled fear and trauma in them. Most of the assaults occurred when staff were performing their routine job functions and setting limits to patient's behavior.

CONCLUSION

The study allowed MHS opportunities to narrate their lived experiences of being assaulted by patients and provided validation of their perspectives. Findings illuminated the phenomenon and may help to support policy changes in psychiatric hospitals.

摘要

引言

精神病院患者对精神卫生工作人员(MHS)实施的身体攻击是精神病院面临的一个严重问题。遭受攻击的工作人员报告了身体和心理创伤,这些创伤影响了他们的个人生活和职业生活。目前缺乏探索这一现象的文献。

目的

探讨精神卫生工作人员对精神病患者攻击行为的看法。

方法

采用先验现象学定性设计,对一家急性住院精神病院的120名精神卫生工作人员的有目的样本的看法进行探索和分析。参与者的年龄在22岁至63岁之间(平均年龄=32.4岁)。研究以穆斯塔卡斯的理论基础为指导。

结果

确定了两种模式、8个主题和19个子主题:(a)心理影响揭示了四个主题——焦虑/恐惧水平增加、无助和绝望、闪回/倦怠以及对自身能力的怀疑。(b)生理社会影响揭示了四个主题——上级不支持、工作人员受害者被污名化、事件未报告以及环境安全。

讨论

参与者表示,患者的攻击行为给他们带来了恐惧和创伤。大多数攻击行为发生在工作人员履行日常工作职责并对患者行为设定限制时。

结论

该研究为精神卫生工作人员提供了讲述他们被患者攻击的生活经历的机会,并验证了他们的观点。研究结果阐明了这一现象,可能有助于支持精神病院的政策变革。

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