Zheng Chaodun, Li Sijue, Chen Yingmei, Ye Junrong, Xiao Aixiang, Xia Zhichun, Liao Yao, Xu Yu, Zhang Yunlei, Yu Lin, Wang Chen, Lin Jiankui
Department of Early Intervention, Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, China.
Department of Nursing Administration, Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, China.
Int J Nurs Sci. 2019 Oct 12;7(1):116-120. doi: 10.1016/j.ijnss.2019.10.001. eCollection 2020 Jan 10.
Seclusion was widely used in mental health service, which had caused various negative effects on patients and nurses. In China, the clinical use of seclusion was gradually increasing, which had led to ethical dilemma and had gained public concern. This article aimed to synthesize the ethical issue according to the principle of autonomy, justice, beneficence, and non-maleficence. Given that nursing workforce was limited and work burden among psychiatric nurses was heavy, seclusion was one of coercive interventions managing aggressive behavior. In relation to cope with ethical dilemma, it was proposed to improve therapeutic environment, and to apply de-escalation technique. Additionally, reducing clinical use and adverse effects of seclusion was also important, this goal would be achieved by building appropriate patient-nurse relationship, increasing staff engagement, and promoting guideline of seclusion.
隔离在精神卫生服务中被广泛使用，这对患者和护士造成了各种负面影响。在中国，隔离的临床使用逐渐增加，这引发了伦理困境并受到公众关注。本文旨在根据自主、公正、行善和不伤害原则综合伦理问题。鉴于护理人力有限且精神科护士的工作负担沉重，隔离是管理攻击性行为的强制性干预措施之一。为应对伦理困境，建议改善治疗环境并应用降级技术。此外，减少隔离的临床使用和不良影响也很重要，这一目标将通过建立适当的护患关系、提高工作人员参与度以及推广隔离指南来实现。
