住院精神病患者暴力行為原因分析及護理對策

周慧蘭

[摘要] 目的 研究住院精神病患者暴力行為發(fā)生的原因，采取相應的護理對策，盡量降低暴力行為發(fā)生率。 方法 對65例發(fā)生暴力行為的住院精神病患者臨床資料進行回顧分析，找到暴力行為發(fā)生的主要原因，并提出相應的護理對策；然后再統(tǒng)計對策實施后的精神病患者暴力行為發(fā)生情況，以檢驗實施效果。 結果 發(fā)生暴力行為疾病多見于精神分裂癥和雙相情感障礙。在采取針對性防范措施后，暴力攻擊行為發(fā)生率由2.6%下降到1.0%，差異有統(tǒng)計學意義（P<0.05）。兩組暴力攻擊率、精神分裂、雙向情感等，拳擊、腳踢等比較差異有統(tǒng)計學意義（P<0.05），抓傷無統(tǒng)計學意義（P>0.05）。 結論 多數(shù)暴力攻擊行為由精神癥狀所致，盡早對精神病患者的癥狀進行控制，并采取對新入院患者予暴力風險評估、加強醫(yī)護溝通、加強對患者的宣教、提升護士的防暴能力培訓和建立良好的護患關系等措施，可有效降低暴力行為發(fā)生率。

[關鍵詞] 精神病；暴力行為；原因；護理

[中圖分類號] R473.74 [文獻標識碼] B [文章編號] 1673-9701（2017）36-0158-03

[Abstract] Objective To study the causes of violence in inpatients with psychosis and to minimize the incidence of violence by taking corresponding nursing measures. Methods The clinical data of 65 hospitalized patients with psychosis were retrospectively analyzed to find out the main causes of violence and the corresponding nursing measures were proposed. Then， the number of violence in psychiatric patients after the implementation of countermeasures was counted to test the implementation effect. Results The violent diseases were more common in schizophrenia and bipolar disorder. After taking targeted precautionary measures， the incidence of violent attacks decreased from 2.6% to 1.0% with a significant difference（P<0.05）. There were statistically significant differences in violence attack rate， schizophrenia， bipolar disorder， boxing and kick between the two groups. There was no significant difference in scratch between the two groups（P>0.05）. Conclusion Most violent attacks are caused by psychiatric symptoms. The symptoms of patients with psychosis should be controlled as soon as possible. Measures such as assessing the risk of violence in newly admitted patients， strengthening medical communication， strengthening patient education， enhancing training of nurses in riot prevention and establishing a good nurse-patient relationship can effectively reduce the incidence of violence.

[Key words] Psychosis； Violence； Causes； Nursing

精神病患者的暴力行為是指直接傷害到他（她）人的身體或物品的各種行為[1]。暴力行為類型包括語言攻擊、身體攻擊、損壞物品和自我攻擊等形式。在精神科，住院精神病患者由于各種原因會產生暴力行為，對醫(yī)護工作人員和其他患者造成人身傷害，給醫(yī)院安全管理帶來了較大隱患。本文通過回顧分析本院發(fā)生的精神病患者暴力行為，以找到發(fā)生暴力行為的主要原因，并提出相應的護理對策，然后再統(tǒng)計護理措施實施后的精神病患者暴力行為發(fā)生情況，以檢驗護理措施實施后的效果。……