Kılıç-Demir Barış, Kızılpınar Selma Çilem
Department of Psychiatry, Ministry of Health Adana City Training & Research Hospital, Adana, Türkiye.
Front Psychiatry. 2024 Aug 15;15:1440917. doi: 10.3389/fpsyt.2024.1440917. eCollection 2024.
Forensic psychiatric patients require specialized care due to the unique challenges in forensic settings. Negative attitudes and beliefs towards mentally disordered offenders can lead to discrimination against patients and are related to worse outcomes. Forensic psychiatric nurses play a crucial role in the treatment of these patients.
This study aimed to investigate the perceptions, attitudes, and beliefs of forensic psychiatric nurses and general medicine nurses towards psychiatric patients and to compare them between nurse groups.
The study was conducted with 46 nurses working in the High-Security Forensic Psychiatry Clinic (Mean age: 35.46, SD= 7.16) and 58 nurses working in other inpatient settings (Mean age:36.28, SD=8.78) aged between 18-65 between December 2020 and April 2021 in Turkey. Nurses in the forensic psychiatry clinic were required to have at least 6 months of experience in the clinic.
Forensic psychiatric nurses exhibited more positive attitudes towards patients (p<.0001), showing lower tendency to be socially distant (p=.009), higher trust (p<.0001), higher willingness to treat (p<.0001), lower tendency to perceive patients as threatening (p=.004), and more general positive attitudes. Significant relationships were found between some of the stigma-related scales we used and certain factors. For forensic nurses, being male (p=0.043) and single (p=,025), working long hours (p=.047), and having fewer children (p=.005) were related to more negative perceptions about delinquents. Insufficient knowledge about forensic psychiatry was linked to negative beliefs about mental disorders (p=0.017) and specifically the curability of mental disorders (p=0.008). Having more siblings was related to higher embarrassment about mental disorders (p=.043). For general nurses, having first-degree relatives who receive psychiatric treatment was related to perceiving patients as threatening (p=.021)) and negative perceptions about delinquents (p=.007). Being older was related to more positive beliefs about mental patients' dangerousness (p=.026). Having more siblings was associated with higher trust toward patients (p=0.002).
These findings emphasize the importance of addressing stigmatization among healthcare professionals, particularly forensic psychiatry nurses and general nurses. Providing comprehensive training about mental disorders and forensic psychiatry and promoting empathy and understanding can enhance the quality of care for patients with mental illnesses and contribute to better mental health outcomes for society.
由于法医精神病学环境中的独特挑战，法医精神病患者需要专门护理。对精神错乱罪犯的消极态度和信念会导致对患者的歧视，并与更差的结果相关。法医精神病护士在这些患者的治疗中起着至关重要的作用。
本研究旨在调查法医精神病护士和普通内科护士对精神病患者的看法、态度和信念，并在护士群体之间进行比较。
2020年12月至2021年4月在土耳其对46名在高安全法医精神病诊所工作的护士（平均年龄：35.46，标准差=7.16）和58名在其他住院环境工作的护士（平均年龄：36.28，标准差=8.78）进行了研究，年龄在18 - 65岁之间。法医精神病诊所的护士需要在诊所至少有6个月的工作经验。
法医精神病护士对患者表现出更积极的态度（p<.0001），表现出较低的社交距离倾向（p=.009）、较高的信任度（p<.0001）、较高的治疗意愿（p<.0001）、较低的将患者视为威胁的倾向（p=.004）以及更普遍的积极态度。我们使用的一些与污名相关的量表与某些因素之间存在显著关系。对于法医护士来说，男性（p=0.043）、单身（p=0.025）、工作时间长（p=.047）以及孩子较少（p=.005）与对违法者的更多负面看法有关。对法医精神病学知识不足与对精神障碍的负面信念（p=0.017），特别是与精神障碍的可治愈性（p=0.008）有关。有更多的兄弟姐妹与对精神障碍更高的尴尬感有关（p=.043）。对于普通护士来说，有接受精神病治疗的一级亲属与将患者视为威胁（p=.021）以及对违法者的负面看法（p=.007）有关。年龄较大与对精神病人危险性的更积极信念有关（p=.026）。有更多的兄弟姐妹与对患者更高的信任度有关（p=0.002）。
这些发现强调了解决医疗保健专业人员，特别是法医精神病护士和普通护士中的污名化问题的重要性。提供关于精神障碍和法医精神病学的全面培训以及促进同理心和理解可以提高对精神疾病患者的护理质量，并为社会带来更好的心理健康结果。
