目的:精神病患者的攻击行为并不少见。社区为精神病患者提供的服务使非正式护理人员在他们的护理中发挥更大的作用。然而,很少有研究探讨心理健康护理关系中患者引发的暴力与护理人员功能之间的联系。我们的研究调查了护理人员关于其亲属患有精神病的攻击性行为的报告,以及它们与护理人员对护理关系和护理人员结果的评估的联系。
方法:最近精神病复发患者的照顾者,被招募到心理治疗试验中,在基线时完成了录音的坎伯韦尔家庭访谈。这个半结构化的访谈包括关于护理人员和病人之间关系质量的问题,和病人的暴力史。评估了72份访谈记录,以了解患者引发的暴力行为。
结果:一半的护理人员样本(52.9%)在访谈中报告了患者发起的暴力事件;其中62.2%涉及对自己的暴力行为,和24.3%用于房地产。患者暴力的报告与护理人员对患者表达的敌意评级相关,较低的自尊,以情感为中心的应对。独自照顾的人更有可能报告患者暴力事件。年轻的患者,男性,住院患者更经常被认为有这种暴力史。
结论:我们的研究结果表明,护理人员报告患者在精神病中引发的暴力并不少见。精神卫生工作人员需要意识到这种暴力对精神病患者的照顾者的风险,并考虑将其最小化的适当程序。
OBJECTIVE: Aggressive behaviour in psychosis is not uncommon. Community provision for people with psychosis has left informal caregivers to take on a greater role in their care. However, few studies have explored links between patient-initiated violence in mental health caregiving relationships and caregiver functioning. Our study investigated caregiver
reports of aggressive acts committed by their relative with psychosis and their links to caregiver appraisals of the caregiving relationship and caregiver outcomes.
METHODS: Caregivers of patients with a recent relapse of psychosis, recruited to a psychological therapy trial, completed the audiotaped Camberwell Family Interview at baseline. This semi-structured interview includes questions on the quality of the relationship between caregiver and patient, and patient history of violence. Seventy-two transcripts of interviews were assessed for
reports of patient-initiated violence.
RESULTS: One-half of the caregiver sample (52.9%) reported an incident of patient-initiated violence during their interview; 62.2% of these involved violence toward themselves, and 24.3% toward property.
Reports of patient violence were associated with caregiver ratings of
hostility expressed toward patients, lower self-esteem, and emotion-focused coping. People caring on their own were more likely to report incidents of patient violence. Younger patients, males, and inpatients were more frequently identified as having a history of this kind of violence.
CONCLUSIONS: Our findings suggested that caregiver
reports of patient-initiated violence in psychosis are not uncommon. Mental health staff need to be aware of the risks of such violence for caregivers of people with psychosis, and consider appropriate procedures for minimizing it.