Department of Psychosis, Sahlgrenska University Hospital, Gothenburg, Sweden.
Department of Addiction and Dependency, Sahlgrenska University Hospital, Gothenburg, Sweden.
J Psychiatr Ment Health Nurs. 2024 Dec;31(6):1083-1092. doi: 10.1111/jpm.13066. Epub 2024 May 26.
WHAT IS KNOWN ON THE SUBJECT?: In inpatient wards, there is a risk that conflicts occur when nursing staff interact with psychotic patients. The Interactive Approach (IA) model is an action-based model, used in psychiatric settings, to manage conflict situations. WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE?: The IA model can be used to improve communication between nursing staff and patients in numerous critical situations. Using a structured risk scale to evaluate a conflict can be an effective way to guide action and sort out the different aspects of communication between nursing staff and psychotic patients. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: The clarity of an action-based model will help sort out which interventions are most likely to succeed in each conflict situation. The IA model highlights the importance of understanding and strengthening the patient's perspective, being flexible for each individual patient, and providing the patient with clear information about the situation. ABSTRACT: Introduction The Interactive Approach (IA) model is a structured management tool used to improve communication between caregivers and patients in psychiatric care settings. Aim/Question To examine the nursing staff's experiences of the IA model. How do they use the interventions in conflict situations with psychotic patients? Method A sample of nursing staff (n = 11) was recruited from three psychosis inpatient care units. Semi-structured questions covered staff experiences of working with the problem-solving interventions in the IA model. Transcribed data were analysed by qualitative content analysis. Results Three categories were defined: (1) 'To apply a flexible approach' describes how staff tried to adapt to each patient and situation; (2) 'Try to understand the person's inner world' describes the importance of active listening and exploring the patient's concerns; and (3) 'To communicate clearly' relates to experiences of clear communication and the setting up of boundaries. Discussion The risk scale and training in communication skills helped the interaction between staff and patients in conflict situations. Different interventions were used with a focus on maintaining patient alliance. Implications for Practice The findings highlight the importance of educational efforts and practical training, to prevent violence and the use of coercive measures.
在住院病房中，护理人员与精神病患者互动时存在发生冲突的风险。互动方法（IA）模型是一种基于行动的模型，用于精神科环境中，以管理冲突情况。本文增加了哪些新知识：IA 模型可用于改善护理人员与患者在许多危急情况下的沟通。使用结构化的风险量表评估冲突是指导行动并梳理护理人员与精神病患者之间沟通的不同方面的有效方法。对实践的意义：基于行动的模型的清晰度将有助于梳理在每种冲突情况下最有可能成功的干预措施。IA 模型强调了理解和加强患者视角、对每个患者灵活处理以及向患者提供有关情况的明确信息的重要性。摘要：引言互动方法（IA）模型是一种结构化的管理工具，用于改善精神科护理环境中护理人员与患者之间的沟通。目的/问题研究护理人员对 IA 模型的经验。他们如何在与精神病患者的冲突情况下使用干预措施？方法从三个精神病住院护理单位招募了一组护理人员（n=11）。半结构化问题涵盖了工作人员在 IA 模型中使用解决问题的干预措施的经验。转录数据通过定性内容分析进行分析。结果定义了三个类别：（1）“应用灵活的方法”描述了工作人员如何尝试适应每个患者和情况；（2）“尝试理解人的内心世界”描述了积极倾听和探索患者关注点的重要性；（3）“清晰沟通”涉及到清晰沟通和设置界限的经验。讨论风险量表和沟通技巧培训有助于在冲突情况下护理人员与患者之间的互动。根据侧重点不同，使用了不同的干预措施，以维持患者联盟。对实践的影响研究结果强调了教育工作和实践培训的重要性，以预防暴力和使用强制措施。
