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首页> 外文期刊>International journal of nursing studies >Mental health nurses’ emotions, exposure to patient aggression, attitudes to and use of coercive measures: Cross sectional questionnaire survey
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Mental health nurses’ emotions, exposure to patient aggression, attitudes to and use of coercive measures: Cross sectional questionnaire survey

机译：心理健康护士的情感，接触患者侵略，矫揉性措施的态度：横断面调查问卷调查

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Abstract Background Mental health nurses are exposed to patient aggression, and required to manage and de-escalate aggressive incidents; coercive measures such as restraint and seclusion should only be used as a last resort. An improved understanding of links between nurses’ exposure to aggression, attitudes to, and actual involvement in, coercive measures, and their emotions (anger, guilt, fear, fatigue, sadness), could inform preparation and education for prevention and management of violence. Objectives To identify relationships between mental health nurses’ exposure to patient aggression, their emotions, their attitudes towards coercive containment measures, and their involvement in incidents involving seclusion and restraint. Design Cross-sectional, correlational, observational study. Settings Low and medium secure wards for men and women with mental disorder in three secure mental health hospitals in England. Participants N =Sixty eight mental health nurses who were designated keyworkers for patients enrolled into a related study. Methods Participants completed a questionnaire battery comprising measures of their exposure to various types of aggression, their attitudes towards seclusion and restraint, and their emotions. Information about their involvement in restraint and/or restraint plus seclusion incidents was gathered for the three-month period pre- and post- their participation. Linear and logistic regression analyses were performed to test study hypotheses. Results Nurses who reported greater exposure to a related set of aggressive behaviours, mostly verbal in nature, which seemed personally derogatory, targeted, or humiliating, also reported higher levels of anger-related provocation. Exposure to mild and severe physical aggression was unrelated to nurses’ emotions. Nurses’ reported anger was significantly positively correlated with their endorsement of restraint as a management technique, but not with their actual involvement in restraint episodes. Significant differences in scores related to anger and fatigue, and to fatigue and guilt, between those involved/not involved in physical restraint and in physical restraint plus seclusion respectively were detected. In regression analyses, models comprising significant variables, but not the variables themselves, predicted involvement/non-involvement in coercive measures. Conclusions Verbal aggression which appears targeted, demeaning or humiliating is associated with higher experienced anger provocation. Nurses may benefit from interventions which aim to improve their skills and coping strategies for dealing with this specific aggressive behaviour. Nurse-reported anger predicted approval of coercive violence management interventions; this may have implications for staff deployment and support. However, anger did not predict actual involvement in such incidents. Possible explanations are that nurses experiencing anger are sufficiently self-aware to avoid involvement or that teams are successful in supporting colleagues who they perceive to be ‘at risk’. Future research priorities are considered.
机译：摘要背景心理健康护士面临患者侵略，并要求管理和脱升升级的侵略事件;强制措施如克制和隐居，应该只用作最后的手段。提高了对护士之间接触侵略，态度和实际参与，强制措施及其情绪（愤怒，内疚，恐惧，疲劳，悲伤）的侵略性，态度和实际参与之间的联系的理解可以为预防和管理暴力的准备和教育提供信息。目的，以确定心理健康护士接触患者侵略，情绪，他们对强制遏制措施的态度，以及他们参与涉及隐居和克制的事件的关系。设计横截面，相关性，观测研究。在英格兰的三个安全心理健康医院的男性和女性中的环境和中等安全病房。参与者n =六十八个心理健康护士，被指定为注册相关研究的患者的关键工作者。方法参与者完成了调查问卷电池，包括其暴露于各种类型的侵略的措施，他们对隐居和克制的态度及其情绪。关于他们参与克制和/或克制加密事件的信息被聚集在为期三个月的时间和后参与。对测试研究假设进行线性和逻辑回归分析。结果报告称，据报道更多地接触对相关的侵略性行为，大多是口头在自然界中，似乎个人贬义，有针对性或羞辱，也报告了更高水平的愤怒相关的挑衅。暴露于温和和严重的身体侵略与护士的情绪无关。护士报告的愤怒与其克制的认可作为管理技术的认可显着相关，但并非他们实际参与克制剧集。检测到与愤怒和疲劳有关的分数和疲劳和内疚的分数分别的显着差异分别检测到/不参与物理克制和物理克制加密。在回归分析中，包含显着变量的模型，但不是变量本身，预测受胁迫措施的参与/不参与。结论似乎有针对性，贬低或羞辱的言语侵略与经验丰富的愤怒挑衅有关。护士可以从干预措施中受益，该干预措施旨在提高他们的技能和应对策略，以处理这种特定的攻击行为。护士报告的愤怒预测强制性暴力管理干预措施的批准;这可能对员工部署和支持有影响。然而，愤怒没有预测这种事件的实际参与。可能的解释是，遇到愤怒的护士充分意识到避免参与或球队成功地支持他们认为“危险”的同事。考虑了未来的研究优先事项。

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