| Abstract: | 本研究目的在探討精神科護理人員遭受病患身體攻擊之身心反應，以
及護理人員
身心反應與其本身性格特質、攻擊事件之間的關係。以立意取樣法選擇中
部地區四所 主要精神科醫療單位的臨床精神科護理人員為研究樣本，共
計 168人。於民國83年12 月15日至84年 1月15日，針對精神科護裡人員
印象最深刻的一次受到病患攻擊的事件 施以結構式問卷調查，包括精神
科護理人員的基本資料、攻擊事件發生情形、攻擊事 件受害者身心反應
量表及性格量表等，並加以統計分析。
研究結果顯示，有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 ；而令精神科護理人員記憶中印象最深刻的一次被病患攻擊的經
驗，以頭臉頸等部位 被攻擊（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 方法攻擊（54.2％）為最多；在該次
攻擊事件中有57.0％的護理人員受傷。 精神科護理人員對
病患攻擊行為有身心反應，強烈順序依次為心理反應最高、生 理反應次
之，人際關係的改變最輕微；經因素分析，得到各反應的因素結構分數如
下 ：(1) 心理反應：可分為『失控感』、『傷心抑鬱』、『羞愧懷疑』
、『退縮害怕』 及『自責』。(2) 生理反應：可分為『緊張疼痛感』、
『做惡夢』、『睡眠困擾』及 『腸胃困擾』。 (3)人際關係改變：可分
為『害怕和病患互動』、『害怕和他人互動 』及『和親友的互動改變』
。 精神科護
理人員對病患攻擊行為的身心反應與病患的性別、年齡無關；與護理人
員被攻擊的情境有關。其中、心理反應與被攻擊的部位、被攻擊的方法及
是否受傷有 關；生理反應與被攻擊的方法及是否受傷有關；人際關係改
變與是否受傷有關，以上 相關性均達顯著水準（ P<0.05 ）。
精神科護理人員遭受病患攻擊行為的身心反應與其本身性格特質有相關；
神經質 傾向較高之精神科護理人員對病患攻擊行為的身心反應較強烈，
護理人員外向性之性 格特質則與其遭受病患攻擊行為之身心反應的相關
性未達顯著水準。根據以上結果， 本研究並提出護理上的應用及未來研
究的建議。
The purpose of this study was to investigate the
psychophysical reactions of psychiatric nurses to
aggressive behaviors by the psychotic patients. A purposive
sampling method was used to select 168 psychiatric nursing
staffs from 2 psychiatric hospitals and 2 psychiatric wards in
general hospitals in the Middle of Taiwan. Structured
questionnaires including demographic data, the most
impressive aggressive events, psychophysical reactions
and personality traits of subjects were administered
from December 1994 to January 1995.
The results revealed that 84.5% of the subjects had been
physically attacked by the psychotic patients. Being attacked
on head (48.6%), from the front directly (51.4%), being
slapping on the face (54.2%) were the most impressive
experience of subjects. Fifty-seven percent of subjects were
injured in the aggressive events.
The psychophysical reactions uncluded three subscales: the
psychological reaction, physical reaction and the change of
interpersonal relationship. The ranks of mean scores of the
three subscales from the highest to the lowest were
psychological reaction, physical reaction and the change of
interpersonal relationship. The factors of the three
subscales of psychophysical reactions were identified by factor
analysis. The factors of psychological reaction included
feelings of out of control, sadness and depression, shame and
disbelief, withdrawal and fear, and self-blame. The factors
of physical reaction included tense and soreness, nightmare,
sleep pattern disturbance, and gastric-intestine disturbance.
The factors of change of interpersonal relationship included
fear of interaction with patients, fear of interaction
with other people, and change in relations of relatives and
friends. The psychophysical
reactions of subjects correlated significantly with the
situation of aggressive events, but not with the gender or age
of the psychotic patients. Psychological reactions correlated
significantly with the area and the way in which the subjects
were attacked, and physical injury in the aggressive
events. Physical reactions correlated significantly
with the way in which the subjects were aggressed, and
physical injury in the aggressive events. the change of
interpersonal relationships correlated significantly with
physical injury in the aggressive events.
There was significant correlation between personality traits and
the psychophysical reactions of the subjects. The more
neurotic the subjects are, the more psychophysical reactions
the subjects have. There was no significant correlation
between extroversion and psychophysical reactions of
the subjects. Recommendations for clinical application and
future research are also included. |
