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[精神科住院患者与护士及护理员之间的治疗联盟:一项前瞻性、观察性横断面研究]

[Therapeutic alliance between sectorial psychiatry inpatients and nurses and aides: A prospective, observational and cross-sectional study].

作者信息

Morvillers Jean-Manuel, Roy Carine, Laouénan Cédric, Goutté Nathalie

机构信息

26952GHU Paris psychiatrie et neurosciences, Paris, France.

Département d'Epidémiologie, Biostatistiques et Recherche Clinique, Hôpital Bichat Claude Bernard, Paris.

出版信息

Can J Psychiatry. 2022 Nov;67(11):854-863. doi: 10.1177/07067437221111377. Epub 2022 Jul 3.

Abstract

BACKGROUND

Therapeutic alliance represents a rarely studied object when it relates to nurses and care provided by a nursing team in acute care hospitalization.

OBJECTIVE

The objective was to study how factors might influence the therapeutic alliance built between nurses and aides and adult inpatients in an acute care unit of sectorial general psychiatry.

METHOD

This is a prospective, observational and cross-sectional study using a therapeutic alliance measurement scale. Therapeutic alliance (TA) score was measured with a STAR-P scale in a sample of 240 patients.

RESULTS

The median score found is 33.4 (±7.8) out of a maximum theoretical score of 48. The global score of TA in patients aged 60 years old or more is significantly higher than the score of patients between 18 and 29 years old (=0.021). The lack of external follow-up in the three months after hospital release is not associated with TA global score (=0.73). If inpatients, no matter what their diseases or types of care are, under legal obligation or not, consider their TA is rather good after their hospital stay. Only sociodemographic factors like age, housing conditions (insecure or sustainable), having a job or not, living alone or with a partner affect TA and follow-up.

CONCLUSION

Results evoke concepts of anomie and attachment, that seem to play an important role in the lack of follow-up after hospital stay, and indicate the mandatory global approach to care and an involvement of health professionals as well as social beings, where empathy must find its place.

摘要

背景

当治疗联盟与护士以及急性护理住院期间护理团队提供的护理相关时,它是一个鲜有研究的对象。

目的

研究在专科医院普通精神病科的急性护理单元中,各种因素如何影响护士、助理与成年住院患者之间建立的治疗联盟。

方法

这是一项采用治疗联盟测量量表的前瞻性、观察性横断面研究。使用STAR - P量表对240名患者样本进行治疗联盟(TA)评分测量。

结果

在理论最高分48分中,所发现的中位数分数为33.4(±7.8)。60岁及以上患者的TA总体评分显著高于18至29岁患者的评分(=0.021)。出院后三个月内缺乏外部随访与TA总体评分无关(=0.73)。无论住院患者的疾病或护理类型如何,无论是否有法定义务,他们都认为住院后自己的治疗联盟相当良好。只有年龄、住房条件(不安全或稳定)、有无工作、独居或与伴侣同住等社会人口统计学因素会影响治疗联盟及随访情况。

结论

研究结果引出了失范和依恋的概念,这些概念似乎在住院后缺乏随访方面起着重要作用,并表明必须采取全面的护理方法,且卫生专业人员以及社会人员都要参与其中,其中同理心必须占有一席之地。

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