Galbert Ilya, Azab Abed N, Kaplan Zeev, Nusbaum Lika
Department of Nursing, Recanati School of Community Health Professions, Ben-Gurion University of the Negev Faculty of Health Sciences, Beer-Sheva, Israel.
Department of Clinical Biochemistry and Pharmacology, Ben-Gurion University of the Negev Faculty of Health Sciences, Beer-Sheva, Israel.
Int J Ment Health Nurs. 2023 Feb;32(1):106-116. doi: 10.1111/inm.13064. Epub 2022 Sep 7.
The failure of efforts to significantly reduce the use of physical coercive measures (PCMs) in psychiatric hospitals remains a global concern. There is a gap in the understanding of staff's characteristics that may affect their attitudes and perceptions towards PCMs. This study used a cross-sectional design to examine the attitudes and perceptions of staff working at a mental health centre in Israel regarding the use of PCMs and to explore whether staff attitudes differed depending on their professional and demographic background. This study also sought to explore staff willingness to accept a policy of reducing the use of PCMs. The data were collected from 149 staff members (nurses, physicians, and auxiliary staff) working at mental health centre, using a questionnaire developed for this study. The findings indicate a low degree of support for use of PCMs among participants who were older, female, more qualified psychiatric nurses, with longer duration of employment, and those who have not participated in coercive intervention in the past year. The majority of the sample reported a low willingness to reduce the use of PCMs, and a lack of institutional support after participating in a coercive event. High hospital occupancy and insufficient staffing were perceived as contributing factors to coercive incidents. Therefore, availability of trained and experienced staff, elimination of organizational barriers, along with creating and maintaining a safe clinical environment should be a priority. Alternative non-coercive interventions should further be taught and used for managing aggressive and violent behaviour in the psychiatric clinical settings.
在精神病院中大幅减少身体强制手段（PCMs）使用的努力失败，这仍是一个全球关注的问题。对于可能影响工作人员对PCMs态度和看法的自身特征，目前还存在认识上的差距。本研究采用横断面设计，调查了以色列一家心理健康中心工作人员对使用PCMs的态度和看法，并探讨工作人员的态度是否因其专业和人口统计学背景而有所不同。本研究还试图探究工作人员接受减少PCMs使用政策的意愿。数据收集自该心理健康中心的149名工作人员（护士、医生和辅助人员），使用的是为本研究编制的问卷。研究结果表明，年龄较大、女性、资质更高的精神科护士、工作年限较长以及过去一年未参与强制干预的参与者，对使用PCMs的支持程度较低。大多数样本表示减少PCMs使用的意愿较低，且在参与强制事件后缺乏机构支持。医院高入住率和人员配备不足被视为导致强制事件的因素。因此，优先事项应是提供训练有素且经验丰富的工作人员、消除组织障碍，以及营造和维护安全的临床环境。应进一步传授并使用替代性非强制干预措施，以管理精神科临床环境中的攻击和暴力行为。
