患者の自殺・自殺企図に直面した精神科看護師の心的ストレス反応とその経過に関する研究

Mental Stress Responses in Psychiatric Nurses Confronting Their Patients' Suicides or Suicide Attempts, the Progression of Those Responses

要旨

　目的：本研究は，患者の自殺・自殺企図に直面した精神科看護師の心的ストレス反応およびその経過，対処行動を明らかにすることを目的とした．

　方法：対象は，中国地方の精神科病院に勤務する看護師で患者の自殺・自殺企図に直面した経験のある267人に無記名自記式質問紙を用いた．調査内容は，年齢，性別，勤務年数，患者の自殺・自殺企図に直面した経験の有無と回数，心的ストレス反応の有無と持続期間，対処行動とした．

　結果：1）看護師の心的ストレス反応として，自責感や緊張，不安，無気力が挙げられ，自責感，無気力に関しては，10年以上ももち続ける看護師が多く存在した．2）性別による対処行動の違いでは，男性が「嗜好品（飲酒・喫煙）」，女性は「人に話を聞いてもらう」が有意に多かった．

　結論：患者の自殺・自殺企図に直面した看護師の心的ストレス反応に留意し，適切に対処行動がとれるよう長期的なサポートが必要であることが示唆された．

Abstract

　Purpose: This study investigated mental stress responses in psychiatric nurses confronting their patients' suicides or suicide attempts, the progression of those responses, and the coping behaviors used by the nurses.

　Method: An anonymous questionnaire survey was conducted among 267 nurses who worked in psychiatric clinics and had the experience of confronting suicides or suicide attempts among their patients. The study was conducted in the Chugoku region the nurses were asked about their age, gender, service years, the presence/absence and frequency of encountering suicides or suicide attempts among their patients, the presence/absence and duration of mental stress responses to these experiences, and the details of their coping behavior.

　Results: 1) Nurses showed mental stress responses including remorse, tension, anxiety, and loss of spirit. Especially, some nurses had feelings of remorse and/or lethargy, for 10 or more years in some cases. 2) Among gender differences in coping behavior, alcohol or tobacco use and the presence of someone who would listen to them were significantly more common in men and women, respectively.

　Conclusion: It is recommended that nurses who have confronted suicides or suicide attempts among their patients should be observed for any suspected responses, and these findings should be applied to long term support to help these nurses develop appropriate coping behaviors.