Mental Health Center of West China Hospital, Sichuan University, No. 28 South Dianxin Street, Chengdu, 610041, China.
West China School of Nursing, Sichuan University, Chengdu, China.
BMC Psychiatry. 2024 Sep 27;24(1):629. doi: 10.1186/s12888-024-06064-9.
The incidence of non-suicidal self-injury (NSSI) is high and often occurs repeatedly. Psychiatric nurses play a vital role in the care and treatment of NSSI patients, as they have the most frequent contact with patients. The experiences and attitudes of nurses has a direct affect on the quality of care they provide to patients. Negative care experiences and attitudes of patient aversion on behalf of nurses may delay the observation and treatment of changes in the patient's condition, leading to irreversible risks. Although cross-sectional studies have investigated the attitudes of medical staff toward NSSI patients, quantitative research results cannot comprehensively reflect the emotional experiences and complex psychological changes of the study subjects. A few studies have focused on the psychiatric nurses' care experiences and attitudes toward patients with repeated NSSI.
This study aimed to explore psychiatric nurses' care experiences and attitudes toward patients during repeated NSSI.
A thematic analysis qualitative study was used. Using purposive sampling, 18 psychiatric nurses were recruited from a mental health center in Chengdu, China. Semi-structured interviews were conducted and audio-recorded. Audio-recordings were transcribed verbatim and analyzed using six-phase thematic analysis.
Four themes emerged from the analysis: psychiatric nurses' care experiences, perceptions, care attitudes and coping style toward repeated NSSI patients. Psychiatric nurses have experienced negative care experiences and severe career burnout during the patient's repeated NSSI. Nurses' attitudes toward NSSI patients changed during repeated NSSI, from understanding to indifference to anger and resentment. At the same time, it was found that nurses' coping style with NSSI patients could be divided into three stages, namely, active coping, neglect and perfunctory, and criticism and punishment.
The findings have implications for health care systems regarding interventions to improve nurses' care experiences and attitudes toward repeated NSSI patients. These findings suggest that enhancing nurses' understanding of NSSI, establishing standardized emergency response and intervention programs, guiding positive professional values and responsibility, and improving nurses' caring attitudes can promote the early detection and timely intervention of NSSI.
非自杀性自伤（NSSI）的发生率很高，且常反复发作。精神科护士在 NSSI 患者的护理和治疗中起着至关重要的作用，因为他们与患者的接触最频繁。护士的经验和态度直接影响他们为患者提供的护理质量。护士对患者的负面护理体验和厌恶态度可能会延迟对患者病情变化的观察和治疗，导致不可逆转的风险。尽管横断面研究已经调查了医务人员对 NSSI 患者的态度，但定量研究结果不能全面反映研究对象的情感体验和复杂的心理变化。一些研究关注精神科护士对反复 NSSI 患者的护理体验和态度。
本研究旨在探讨精神科护士在患者反复 NSSI 时的护理体验和态度。
采用主题分析定性研究。采用目的抽样法，从中国成都某精神卫生中心招募 18 名精神科护士。进行半结构式访谈并录音。将录音逐字转录，并采用六阶段主题分析进行分析。
分析得出 4 个主题：精神科护士对反复 NSSI 患者的护理体验、认知、护理态度和应对方式。护士在患者反复 NSSI 时经历了消极的护理体验和严重的职业倦怠。护士对 NSSI 患者的态度在反复 NSSI 时发生了变化，从理解到冷漠，再到愤怒和怨恨。同时，研究发现护士对 NSSI 患者的应对方式可以分为三个阶段，即积极应对、忽视敷衍和批评惩罚。
研究结果对医疗保健系统干预以改善护士对反复 NSSI 患者的护理体验和态度具有启示意义。这些发现表明，增强护士对 NSSI 的理解，建立标准化的应急响应和干预方案，引导积极的专业价值观和责任感，改善护士的关爱态度，可以促进 NSSI 的早期发现和及时干预。
