精神科急症：流行病学分析与医护人员的经验
Psychiatric emergencies: epidemiological analysis and healthcare professionals' experiences.
作者信息
Degirmenci Selim, Mercan Nese
机构信息
Department of Emergency Medicine, Faculty of Medicine, Bilecik Seyh Edebali University, Bilecik, Türkiye.
Psychiatric Nursing Department, Faculty of Health Sciences, Bilecik Seyh Edebali University, Bilecik, Türkiye.
出版信息
BMC Emerg Med. 2025 Jul 1;25(1):109. doi: 10.1186/s12873-025-01268-y.
BACKGROUND
Emergency departments ensure the safety of patients with mental health disorders and initiate psychiatric treatment. However, emergency workers experience several challenges in approaching patients with mental health disorders. It is essential to describe the epidemiological characteristics of cases and determine healthcare workers' opinions to identify the conditions that affect interventions. This study aimed to examine the epidemiology of patients evaluated for psychiatric emergencies in the emergency department and reveal healthcare professionals' experiences with emergency psychiatric cases.
METHODS
The study comprised two parts. First, patients who attended Bilecik Training and Research Hospital's Emergency Department with psychiatric emergencies between January 1, 2022, and December 31, 2023, were retrospectively examined. Second, using a phenomenological design and qualitative methodology, healthcare professionals were interviewed about their experiences and opinions regarding approaching patients who attended the emergency department with psychiatric emergencies and their diagnosis, treatment, and outcome processes.
RESULTS
In the first part of the study, 1621 patients were evaluated during the study period: 163 were aged < 18 years and 1458 were aged ≥ 18 years, while 1079 were female (67.0%). In terms of diagnoses, 1417 (87.4%) were evaluated for anxiety and 74 (4.6%) for suicide attempts. In the second part, four themes and 11 categories emerged from the analysis of the interviews conducted with healthcare professionals. These themes were the path from fear to stigmatization, the necessity of therapeutic relationships, the necessity of change in intervention conditions, and the factors that change the meaning of the experience.
CONCLUSIONS
This study stresses the importance of considering healthcare professionals' experiences and highlights the necessity for change in the emergency department. It is anticipated that fulfilling these needs will reduce acute distress and improve the safety and recovery of patients presenting with psychiatric emergencies.
背景
急诊科负责确保精神疾病患者的安全并启动精神科治疗。然而，急救人员在接诊精神疾病患者时面临诸多挑战。描述病例的流行病学特征并确定医护人员的意见对于识别影响干预措施的情况至关重要。本研究旨在调查急诊科接受精神科急诊评估的患者的流行病学情况，并揭示医护人员处理急诊精神科病例的经验。
方法
本研究包括两个部分。首先，对2022年1月1日至2023年12月31日期间因精神科急诊前往比莱吉克培训与研究医院急诊科就诊的患者进行回顾性检查。其次，采用现象学设计和定性方法，就医护人员对接诊因精神科急诊前往急诊科的患者的经验和意见以及这些患者的诊断、治疗和转归过程进行访谈。
结果
在研究的第一部分中，研究期间共评估了1621例患者：163例年龄小于18岁，1458例年龄≥18岁，其中1079例为女性（67.0%）。在诊断方面，1417例（87.4%）接受了焦虑评估，74例（4.6%）接受了自杀未遂评估。在第二部分中，对医护人员访谈的分析产生了四个主题和11个类别。这些主题是从恐惧到污名化的过程、治疗关系的必要性、干预条件改变的必要性以及改变体验意义的因素。
结论
本研究强调了考虑医护人员经验的重要性，并突出了急诊科进行改变的必要性。预计满足这些需求将减少急性痛苦，并改善精神科急诊患者的安全性和康复情况。
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