自殺病人接受精神醫療照護的住院經驗

The Experiences of Receiving Psychiatric Nursing Care during Hospitalization for Patients Who Had Suicidal Ideas or Attempts

近年來臺灣的自殺率逐年攀高，本研究的目的是由自殺病患在住院期間所感受的主觀經驗中，發展自殺護理相關的描述性理論。採茁根理論(grounded theory)研究法，以訪談和觀察法對15位有自殺意念或企圖自殺的住院病人進行資料收集。資料的分析採用持續重複比較並藉用QSRNUD*IST電腦軟體協助分析。研究結果發現：「感受被動的接受保護與關懷」為最重要的核心類別。病人因為「活著沒意義」而想自殺，然後他們被送入精神科病房接受治療與照顧，在整個住院過程中病人感受到「被保護」如“被觀察”、“東西被檢查”、“被陪伴整天”、“入保護室”、和“訊息被傳遞”；亦感受到「被關懷」如護士“經常探視”、“陪伴”、“注意基本需要”、“幫助”、“傾聽”、“安慰”、“開導”、及“鼓勵”他們。最後，他們會有「重獲對生命的渴望」抑或「仍有自殺意念或行為」。護理自殺的病人之過程中，由於病人是處於被動的被保護與關懷，因此，護士的主動及敏銳的觀察與照護，更形重要及必備的條件。

Recently, the suicide rate in Taiwan has been increasing. The purpose of this paper was to develop a nursing care theory through the experiences of psychiatric nursing care for patients who had suicidal ideas or attempts. A grounded theory approach was used. Fifteen patients who had either suicidal ideas or had attempted suicide were interviewed and observed. Data was analyzed using the constant comparative method by the qualitative software program QSR NUD*IST. The core category that emerged from the data collected was “passive acceptance of protection and care”. Patients who felt life was meaningless and had suicidal attempts were then transferred to psychiatric wards for treatment and care. In the caring process, they felt being protected, as they were being observed, their possessions were being inspected, being accompanied all day, being kept in protective rooms, and their thoughts were being shared. They also felt being cared for through being seen, accompanied, helped, listened, consoled, advised, and encouraged by nurses. Their basic needs were attended. At the end, some patients regained the desire to live while others still had suicide ideas and attempts. In the suicide caring process, patients passively accepted protection and care from psychiatric nurses. It is becoming more and more important that psychiatric nurses make active and vigilant observations and care.