目的 : 探討精神科護理人員遭受住院精神病患者身體攻擊之經驗與其身心反應。方法 : 以中部地區四所主要精神科醫療單位臨床精神科護理人員，針對其中曾被病患暴力攻擊之護理人員，施以結構式問卷調查，依其印象最深刻的一次受攻擊事件為主，內容包括研究樣本之基本資料、攻擊事件發生情形、攻擊事件受害者身心反應量表等。結果 : 84.5%的精神科護理人員曾在工作中遭到精神病患的身體攻擊﹔令精神科護理人員印象最深刻的一次被病患暴力攻擊的經驗中，以頭臉頸等部位攻擊 ( 48.6% )、病患由前方攻擊 ( 51.4% ) 及病患以打耳光、掐脖子或以拳頭等方式攻擊 ( 54.2% ) 為最多見﹔在該次攻擊事件中有57.0%的護理人員曾受傷。精神科護理人員遭受病患攻擊後，在心理反應方面，以「覺得自己得趕緊採取某些防範措施，以免再次發生」最強烈，其次為「震驚」及「生氣」﹔在生理反應方面，以「身體有緊張感」最強烈，其次為「身體曾被攻擊的部位常感到疼痛」及「驚嚇反應」﹔而在社交人際關係改變方面以「和攻擊我的病患互動時感到害怕」最為強烈，其次為「對其他病患感到害怕」、「返回工作感到有困難」及「對陌生人有害怕感」。結論 : 精神病患的攻擊行為是大部分精神科護理人員面對的護理問題，而遭受病患暴力攻擊的精神科護理人員可能產生心理、生理及人際關係改變等三方面的身心反應，其中以心理反應最為強烈﹔如何預測與防範病患的攻擊行為，以及復原護理人員受傷後的心理創傷，是很重要的課題。
Objective: The purpose of this study was to do a preliminary survey of the psychophysiological reactions among the psychiatric nurses to aggressive behaviors by psychotic inpatients in the central Taiwan area. Methods: Using purposive sampling, 142psychiatric nursing staff members from 2 psychiatric hospitals and 2 general hospitals in the central Taiwan area were recruited for this self-administered questionnaire survey between December 1994 and January 1995. The questionnaires queried the nurses about their demographic data, most memorableevents reactions toward their past experience of being assaulted on duty. Results: The results showed that 84.5% of the subjects had experienced some physical assault by their psychotic inpatients. The most memorable experiences included being attacked on the head (48.6%) and from the front (51.4%) and being slapped facially (54.2%). Fifty-seven percent of the subjects had received some degree of injury from the patient's aggressive behaviors. The most common post-assault psychological reactions of the subjects were ’you should have done something to prevent the assault, ’followed by ’shock’and ’angry’reaction. The most common physiological reaction included ’body tension,’followed by ’body soreness in the area where hit’and ’startle reaction.’the most common change of interpersonal relationship was ’fear of the patient who assaulted you,’followed by ’fear of other patients,’’difficulty returning to work and fear of strangers.’Conclusion: Psychiatric nursing staff members are frequently assaulted physically by the psychotic inpatients on duty. The psychophysiological reactions in the psychotiatric nurses who were assaulted by the psychotic inpatients are intense. How to detect and prevent risk of aggressive behaviors and treat psychological reaction to being assault are an important issue. (Full Text in Chinese)
