摘要
[目的]了解住院精神病病人保护性约束的现状及其相关因素,为进一步制定针对性的干预措施提供依据。[方法]采用自编调查表对2008年8月1日—2008年12月31日住院的631例病人在入院第1个月内的约束情况进行调查,采用多因素Logis-tic回归分析识别保护性约束的相关因素并控制可能的混杂因素。[结果]入院第1个月内经历约束的病人301例(47.7%);经历约束的病人年龄较轻、病程较短、住院次数较少;平均约束次数为2.1次,每次约束时间为(9.8±48.6)h。Logistic多因素分析:针对其他病人的攻击行为(OR=21.87),针对工作人员的攻击行为(OR=17.47),出走行为(OR=4.74),拒药行为(OR=6.07),治疗依从性差(OR=6.57)等是保护性约束的独立危险因素;第一诊断为精神分裂症(OR=0.33),使用抗抑郁剂(OR=0.22)和其他安定类药物(OR=0.15)以及消极言行(OR=0.15)为保护性约束的独立保护因素。[结论]住院精神病病人的保护性约束比例高,约束时间长,攻击行为是保护性约束最主要的危险因素,有必要进一步规范约束程序。
Objective：To know the status quo of protective restraint and its correlative factors in hospitalized psychiatric patients in order to provide some supportive information for working out corresponding intervention measures. Methods：A total of 631 psychiatric patients admitted to psychiatric wards from August 1st to December 31st in 2008 were investigated by adopting self- compiled questionnaire on protective restraint during the first month of hospitalization, was applied to identify associated factors of protective restraint and to control for potential confounding factors. Resuits：Totally 301 （47. 7%） patients were experienced protective restraint in the first month of hospitalization. Patients experiencing restraint were more likely younger, shorter duration of illness, and fewer times of hospitalization. The average frequencies of restraint were 2.1 and with an average time of（9.8±48.6）hours per restraint. Logistic regression multifaetor analysis showed that aggressive behaviors toward other patients was （OR= 21. 87）, aggressive behaviors toward staffs was （OR = 17.47）, run- away behaviors was （OR=4.74）, behaviors of refusing to take medicine was （OR=6.07）, and poor treatment compliance was （OR=6.57）. All above were independent risk factors for protective restraint of patients. Independent protective factors for protective restraint of patients included the first diagnosis of was schizophrenia （OR = 0. 33）, using antidepressants （OR = 0. 22） and other tranquilizers （OR=0.15）,and negative words and behaviors （OR= 0.15）. Conclusion：Hospitalized psychiatric patients have a high proportion and long lasting time of protective restraint. Aggressive behaviors were one of the most important risk factors for protective restraint. It is necessary to standardize the procedures of protective restraint for hospitalized psychiatric patients in further.
出处
《护理研究（中旬版）》
2009年第12期3212-3215,共4页
Chinese Nursing Researsh
基金
上海交通大学医学院附属精神卫生中心院级课题:编号08-32
关键词
保护性约束
相关因素
精神病
攻击行为
protective restraint
correlative factors
psychosis
aggressive behavior
