急診護理人員對精神病患的處理自信

Emergency Department Nurses' Confidence in Caring for Patients with Mental Disorders

本研究之目的主要在探討急診護理人員對就診精神病患的處理自信及其相關因素。採立意取樣，選取南部醫學中心及區域醫院各三所，以其急診室護理人員為研究對象，採不記名自填結構式問卷方式進行資料收集，有效樣本共178名，所得資料以描述性及推論性統計進行資料分析。研究結果發現：（1）急診護理人員對精神病患的整體處理自信標準化得分為70.12分，在四個處理過程的標準化自信得分，分佈由68.09分至80.58分，以「檢傷後護理」的得分最低；其中最低的三項為：提供病患「精神症狀因應方法」、「睡眠問題之衛教」、「可利用之情緒抒發管道」；對精神病人就診問題提供衛教指導的自信最待加強的三項依序為幻聽妄想，情緒困擾及暴力行為；（2）在影響因素方面：較年長、護理年資和急診年資較久或已婚者在檢傷站的評估自信得分較高；曾參與精神病患照護相關教育者，在檢傷後護理自信得分明顯高於未參與者；（3）急診護理人員在病人具暴力傾向或不合作情形下執行醫療行為時最需被協助。.本研究結果可做為急診護理人員臨床實務與相關在職教育安排之參考，以增進對精神病患之處理自信*提昇急診精神科病患之照護品質。The purpose of this study was to explore emergency department (ED) nurses, level of confidence in providing care for patients with mental disorders. Purposive sampling was used to recruit 178 emergency nurses from three medical centers and three district hospitals in southern Taiwan. The participants were asked to anonymously complete a questionnaire. The study found that the mean score of the nurses’ confidence level was 70.12 and ranged from 68.09 to 80.58 in the four stages of providing care. The three items of lowest score confidence were, “teaching patients how to cope with their psychiatric symptoms, ” “psychoeducation for sleep disturbances among patients, ” and “introducing methods to relieve patients’ emotional suffering.” The care skills that needed to be reinforced were methods of managing auditory hallucination and delusion, emotional distress, and violent behavior. We concluded that nurses in the emergency department who were elderly, married, and experienced in nursing care or emergency care were more likely to have higher confidence scores in the study’s assessment stage at the ED. We also found that the emergency department nurses with more training in psychiatric nursing care had higher confidence scores in providing post triage nursing care. The most urgent need for help among emergency department nurses was in the case of violent or non-compliant patients. The results of this study could be used as a reference in developing psychiatric nursing training programs for emergency department nurses, to increase the confidence and the quality of care for patients with mental disorders in EDs.