急診護理人員對企圖自殺病人的照護困難

Diffculties in Care of Attempted Suicide Patients Encountered by Nurses in Emergency Department

本研究目的在探討急診護理人員照護企圖自殺病人及家屬的困難情形與相關因素。以台灣南部三所醫學中心及五所區域醫院急診室全體護理人員198 人為研究對象，有效問卷回收率達98% （N= 194） 。依企圖自殺模擬案例在急診室的護理過程所設計之結構式問卷，收集研究資料，結果發現： （一）急診護理人員認為照護企圖自殺病人與家屬的困難程度屬中等；但有36 .1%的研究對象在企圖自殺病人整體照護困難及33 .5%的研究對象在家屬整體照護困難得分高於75 分（滿分為100 分）。照護困難度最高的前三項護理措施為：「提供憂鬱症治癒案例」、「協助處理造成此次自殺行為的問題J 及「主動與個案談論此次自殺的原因」 0 （二）研究對象的年齡、護理總年資及急診年資與割腕自殺案例照護困難度呈顯著負相關；接受過自殺護理訓練的護理人員對割腕自殺案例照護困難度顯著低於沒有接受過自殺護理訓練者。（三）造成照護困難主要原因為個案躁動不合作與沉默拒絕會談，以及護理時間與人力不足。The aim of this study was to explore the difficulties in caring for attempted suicide patients encountered by nurses in the emergency department. By purposive sampling, a total of 198 participants from eight general hospitals in southern Taiwan were invited to participate in this study. Each participant was requested to answer an anonymous structured questionnaire and a response rate with 98 % was achieved. The results of this study indicated that the difficulties in caring for attempted suicide patients was at medium level. The three most difficult nursing interventions were: (1). to present successful cases who were cured from diagnosis of depression, (2). to help solve problems contributing to patient’s suicide attempts, and (3). to take initiatiative in discussing the causes with the patients. It was also found that nurses who were more mature, had more general and emergency nursing experiences, and had received more training for caring suicide attempts, had significantly lower difficulties in caring for the patients who attempted cutting wrists. Meanwhile, patient noncompliance, lack of nursing time and shortage of staff were identified as major factors contributing to the difficulties in caring for the subjects. The results of this study could be help developing an effective training program for care of suicide attempts and improving the quality of emergency nursing practice.