Heymanova lestvica odnosa zaposlenih v zdravstveni negi do posebnih varovalnih ukrepov v Sloveniji
DOI:
https://doi.org/10.14528/snr.2019.53.1.275Ključne besede:
zdravstvena nega, medicinske sestre, prisilni ukrepi, psihiatrija, nasiljePovzetek
Uvod: Odnos zaposlenih v zdravstveni negi do posebnih varovalnih ukrepov je povezan z njihovo pojavnostjo. Namen raziskave je bil raziskati odnos zaposlenih v zdravstveni negi do posebnih varovalnih ukrepov.
Metode: Izvedena je bila presečna raziskava z uporabo Heymanove lestvice o odnosu do posebnih varovalnih ukrepov med vsemi zaposlenimi v zdravstveni negi (n = 367) v psihiatričnih bolnišnicah v Sloveniji.
Rezultati: Med slovenskimi psihiatričnimi bolnišnicami so ugotovljene razlike v trajanju posebnih varovalnih ukrepov (χ2 = 43,770, p < 0,001). Zaposleni se najpogosteje strinjajo, da pacient med posebnim varovalnim ukrepom čuti jezo (n = 328, 89,4 %). Kljub temu večina anketirancev verjame, da so posebni varovalni ukrepi lahko učinkovito terapevtsko orodje (n = 343, 91,6 %). Ženske (U = 11450,50, p = 0,025) in višje izobraženi zaposleni (U = 9527,00, p = 0,002) izražajo statistično bolj negativna čustva in manj odobravajo posebne varovalne ukrepe.
Diskusija in zaključek: Ob raziskovanju pojavnosti prisilnih ukrepov je jasno, da poleg dejavnikov, raziskovanih v naši študiji, obstajajo tudi drugi, bolj vplivni dejavniki. Zaradi razlik med bolnišnicami bi bilo treba pregledati obstoječo klinično prakso. Predvideva se, da je management zdravstvenih inštitucij pomemben dejavnik pri zmanjšanju pojavnosti posebnih varovalnih ukrepov.
Prenosi
Metrike
Literatura
Bergk, J., Flammer, E. & Steinert, T., 2010. "Coercion Experience Scale" (CES): validation of a questionnaire on coercive measures. BMC Psychiatry, 10, p. 5. https://doi.org/10.1186/1471-244X-10-5
Bergk, J., Einsiedler, B., Flammer, E. & Steinert, T., 2011. A randomized controlled comparison of seclusion and mechanical restraint in inpatient settings. Psychiatric services, 62(11), pp. 1310–1317. https://doi.org/10.1176/appi.ps.62.11.1310 PMid:22211210
Berzlanovich, A.M., Schöpfer, J. & Keil, W., 2012. Deaths due to physical restraint. Deutsches Ärzteblatt International, 109(3), pp. 27–32. https://doi.org/10.3238/arztebl.2012.0027
Bowers, L., Alexander, J., Simpson, A., Ryan, C. & Carr-Walker, P., 2004. Cultures of psychiatry and the professional socialization process: the case of containment methods for disturbed patients. Nurse Education Today, 24(6), pp. 435–442. https://doi.org/10.1016/j.nedt.2004.04.008 PMid:15312952
Bregar, B. & Možgan, B., 2012. Provision patient's safety in psychiatry - nursing view. In: B. Skela-Savič, S. Hvalič Touzery, K. Skinder Savić, J. Joca, I. Avberšek-Lužnik, et al., eds. 5th International Scientific Conference Quality Health Care Treatment in the Framework of Education, Research and Multiprofessional Collaboration - Towards the Health of Individuals and the Society, 7th - 8th June 2012, Ljubljana, Slovenia. Jesenice: College of Nursing, pp. 444–450.
Bregar, B., Skela-Savič, B. & Kores Plesničar, B., 2018. Crosssectional study on nurses' attitudes regarding coercive measures: the importance of socio-demographic characteristics, job satisfaction, and strategies for coping with stress. BMC psychiatry, 18(1), p. 171. https://doi.org/10.1186/s12888-018-1756-1 PMid: 29866142; PMCid: PMC5987471
Declaration of Helsinki – Ethical Principles for Medical Research Involving Human Subjects, 2013. Fortaleza: The World Medical Association.
Ejneborn Looi, G.M., Engström, Å. & Sävenstedt, S., 2015. A self-destructive care: self-reports of people who experienced coercive measures and their suggestions for alternatives. Issues in Mental Health Nursing, 36(2), pp. 96–103. https://doi.org/10.3109/01612840.2014.951134
Espinosa, L., Harris, B., Frank, J., Armstrong-Muth, J., Brous, E., Moran, J., et al., 2015. Milieu improvement in psychiatry using evidence-based practices: the long and winding road of culture change. Archives of Psychiatric Nursing, 29(4), pp. 202–207. https://doi.org/10.1016/j.apnu.2014.08.004
Fariña-López, E., Estévez-Guerra, G.J., Gandoy-Crego, M., Polo-Luque, L.M., Gómez-Cantorna, C. & Capezuti, E.A., 2014. Perception of Spanish nursing staff on the use of physical restraints. Journal of Nursing Scholarship, 46(5), pp. 322–330. https://doi.org/10.1111/jnu.12087
Gates, D.M., Gillespie, G.L. & Succop, P., 2011. Violence against nurses and its impact on stress and productivity. Nursing Economics, 29(2), pp. 59–66. PMid:21667672
Gelkopf, M., Roffe, Z., Behrbalk, P., Melamed, Y., Werbloff, N. & Bleich, A., 2009. Attitudes, opinions, behaviours, and emotions of the nursing staff toward patient restraint. Issues in Mental Health Nursing, 30(12), pp. 758–763. https://doi.org/10.3109/01612840903159777
Happell, B., Dares, G., Russell, A., Cokell, S., Platania-Phung, C. & Gaskin, C. J., 2012. The relationships between attitudes toward seclusion and levels of burnout, staff satisfaction, and therapeutic optimism in a district health service. Issues in Mental Health Nursing, 33(5), pp. 329–336. https://doi.org/10.3109/01612840.2011.644028 PMid:22545640
Happell, B. & Koehn, S., 2010. Attitudes to the use of seclusion: has contemporary mental health policy made a difference. Journal of Clinical Nursing, 19(21/22), pp. 3208–3217. https://doi.org/10.1111/j.1365-2702.2010.03286.x
Heyman, E., 1987. Seclusion. Journal of Psychosocial Nursing and Mental Health Services, 25(11), pp. 9–12. PMid:3694565
Hollins, L. & Stubbs, B., 2011. Managing the risk associated with physical intervention: a discussion paper. The British Journal of Forensic Practice, 13(4), pp. 257–263. https://doi.org/10.1108/14636641111190015
Janssen, W.A., van de Sande, R., Noorthoorn, E.O., Nijman, H.L., Bowers, L., Mulder, C.L., et al., 2011. Methodological issues in monitoring the use of coercive measures. International Journal of Law and Psychiatry, 34(6), pp. 429–438. https://doi.org/10.1016/j.ijlp.2011.10.008
Knutzen, M., Bjørkly, S., Eidhammer, G., Lorentzen, S., Helen Mjøsund, N., Opjordsmoen, S., et al., 2013. Mechanical and pharmacological restraints in acute psychiatric wards: why and how are they used. Psychiatry Research, 209(1), pp. 91–97. https://doi.org/10.1016/j.psychres.2012.11.017
Kodeks etike v zdravstveni negi in oskrbi Slovenije, 2014. Ljubljana: Zbornica zdravstvene in babiške nege Slovenije – Zveza strokovnih društev medicinskih sester, babic in zdravstvenih tehnikov Slovenije.
McCabe, D.E., Alvarez, C.D., McNuty, S.R. & Fitzpatrick, J.J., 2011. Perceptions of physical restraints use in the elderly among registered nurses and nurse assistants in a single acute care hospital. Geriatric Nursing, 32(1), pp. 39–45. https://doi.org/10.1016/j.gerinurse.2010.10.010 PMid:21146901
Mental Health Act. Official Gazette of the RS nr. 77/2008.
Migon, M.N., Coutinho, E.S., Huf, G., Adams, C.E., Cunha, G.M. & Allen, M.H., 2008. Factors associated with the use of physical restraints for agitated patients in psychiatric emergency rooms. General Hospital Psychiatry, 30(3), pp. 263–268. https://doi.org/10.1016/j.genhosppsych.2007.12.005
Morgan, S., 2011. Ethical issues in patient restraint. Nursing Times, 107(9), pp. 22–25.
Moylan, L.B. & Cullinan, M., 2011. Frequency of assault and severity of injury of psychiatric nurses in relation to the nurses'decision to restrain. Journal of Psychiatric and Mental Health Nursing, 18(6), pp. 526–534. https://doi.org/10.1111/j.1365-2850.2011.01699.x
Muir-Cochrane, E.C., Baird, J. & McCann, T.V., 2015. Nurses' experiences of restraint and seclusion use in short-stay acute old age psychiatry inpatient units: a qualitative study. Journal of Psychiatric and Mental Health Nursing, 22(2), pp. 109–115. https://doi.org/10.1111/jpm.12189
Raboch, J., Kalisová, L., Nawka, A., Kitzlerová, E., Onchev, G., Karastergiou, A., et al., 2010. Use of coercive measures during involuntary hospitalization: findings from ten European countries. Psychiatric Services, 61(10), pp. 1012–1017. https://doi.org/10.1176/appi.ps.61.10.1012
Roberts D., Crompton D., Milligan, E. & Groves, A., 2009. Reflections on the use of seclusion in an acute mental health facility. Journal of Psychosocial Nursing and Mental Health Services, 47(10), pp. 25–31. https://doi.org/10.3928/02793695-20090902-01 PMid:19835317
Soininen, P., Putkonen, H., Joffe, G., Korkeila, J. & Välimäki, M., 2014. Methodological and ethical challenges in studying patients' perceptions of coercion: a systematic mixed studies review. BMC Psychiatry, 14, p. 162. https://doi.org/10.1186/1471-244X-14-162 PMid:24894162; PMCid:PMC4051960
Steinert, T., Birk, M., Flammer, E. & Bergk, J., 2013. Subjective distress after seclusion or mechanical restraint: one-year followup
of a randomized controlled study. Psychiatric Services, 64(10), pp. 1012–1017. https://doi.org/10.1176/appi.ps.201200315 PMid:23771400
Stewart, D., Van der Merwe, M., Bowers, L., Simpson, A. & Jones, J., 2010. A review of interventions to reduce mechanical restraint and seclusion among adult psychiatric inpatients. Issues in Mental Health Nursing, 31(6), pp. 413–424. https://doi.org/10.3109/01612840903484113 PMid:20450344
Strout, D.T., 2010. Perspectives on the experience of being physically restrained: an integrative review of the qualitative literature. International Journal of Mental Health Nursing, 19(6), pp. 416–427. https://doi.org/10.1111/j.1447-0349.2010.00694.x PMid:21054728
Van der Merwe, M., Muir-Cochrane, E., Jones, J., Tziggili, M. & Bowers, L., 2013. Improving seclusion practice: implications of a review of staff and patient views. Journal of Psychiatric and Mental Health Nursing, 20(3), pp. 203–215. https://doi.org/10.1111/j.1365-2850.2012.01903.x PMid:22805615
Whitecross, F., Seeary, A. & Lee, S., 2013. Measuring the impacts of seclusion on psychiatry inpatients and the effectiveness of a pilot single-session post-seclusion counselling intervention. International Journal of Mental Health Nursing, 22(6), pp. 512–521. https://doi.org/10.1111/inm.12023 PMid:23682907
World Medical Association, 2013. World Medical Association Declaration of Helsinki: ethical principles for medical research involving human subjects. Journal of the American Medical Association, 310(20), pp. 2191–2194. https://doi.org/10.1001/jama.2013.281053
Prenosi
Objavljeno
Kako citirati
Številka
Rubrike
Licenca
Na Obzornik zdravstvene nege, Ob železnici 30A, 1000 Ljubljana, prenašam naslednje materialne avtorske pravice: pravico reproduciranja v neomejeni količini, in sicer v vseh poznanih oblikah reproduciranja, kar obsega tudi pravico shranitve in reproduciranja v kakršnikoli elektronski obliki (23. čl. Zakona o avtorski in sorodnih pravicah – v nadaljevanju ZASP); pravico distribuiranja (24. čl. ZASP); pravico dajanja na voljo javnosti vključno z dajanjem na voljo javnosti prek svetovnega spleta oz. računalniške mreže (32.a čl. ZASP); pravico predelave, zlasti za namen prevoda (33. čl. ZASP). Prenos pravic velja za članek v celoti (vključno s slikami, razpredelnicami in morebitnimi prilogami). Prenos je izključen ter prostorsko in časovno neomejen.
