台灣病人和護士對人們企圖自殺的觀點

Patients' and Nurses' Perceptions of Reasons Why People Attempt Suicide in Taiwan

自殺在臺灣是一個嚴重的公共衛生問題。在2005年自殺比率為每10萬人口有18.84人，這自殺比率已增加在2000年每10萬人口為11.14人。本研究的目的在調查15位精神科護士和15位自殺傾向病患有關人們為什麼要企圖自殺的原因。本研究使用質性研究之茁根理論。資料收集採會談法和觀察法。資料分析使用開放性譯碼、主軸譯碼、和選擇性譯碼，和採用QRS NUD*IST電腦軟體程式。研究的結果顯示人為何要企圖自殺的原因為病人過去遭受到壓力和過去生活經驗的創傷、疾病、和產生放棄自我的感覺導致他們無法調適生活而出現自殺意念，然而病人自殺意念和企圖的頻率取決於他們的認知過程。因此，精神科護士的角色可透過有效溝通技巧去灌輸希望給病人，以幫助病人紓解情緒上的痛苦和減輕他們的自殺意念。Suicide is a major public health problem in Taiwan. In 2005, the suicide rate was approximately 18.84 per 100, 000. This rate had risen from 11.14 per 100, 000 in the year 2000. The purpose of this study was to examine 15 psychiatric nurses' and 15 patients' views on reasons why people might attempt suicide. A grounded theory approach was used. Observation and interview were used as the data collection strategies. Data were analyzed using a tried and tested data analysis framework comprising open, axial and selective coding. The qualitative software programme QRS NUD(superscript *)IST was also used to sort the data collected. Findings demonstrated that the reasons why people might attempt suicide were: patients' stress-history and past traumatic life experiences, illness, and feelings of abandonment, which led to inability to cope with life. Further, findings revealed that frequencies of patients' suicidal ideas and attempt depended on their cognitive processes. In response, psychiatric nurses have a role to play in helping patients to resolve their emotional pain and reduce their suicidal ideas through using effective therapeutic communication skills and instilling hope.