精神疾病患者急危状态的防范与护理.ppt

精神疾病患者急危状态的防范与护理.ppt精神疾病患者急危状态的防范与护理
李静芝
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什么是急危状态？
可能突然发生的
可能危及生命（自身或他人）或环境安全的一种状态
例如：暴力行为、自伤***、出走、噎食、木僵等。
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急危状态的管理
精神科护士必须预见、防止和处理紧急状况和危险 (Psychiatric nurses must anticipate，prevent and manage emergencies and crises）
工作人员必须能够使病人稳定下来 (The staff must be able to stabilize the patient)
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Crisis and crisis intervention are based on certain assumption:
A crisis is usually resolved within 4 to 6 weeks.
Crisis intervention therapy is short term, from 1 to 6 weeks, and focus on the present problem only.
Resolution of a crisis takes three forms: a person emerges at a higher level, at pre-crisis level, or at a lower level of function.
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Social support and intervention can maximize successful resolution.
Crisis therapists take an active and directive approach with the client in crisis.
The client takes an active role in setting goals and planning possible solutions
Crisis and crisis intervention are based on certain assumption:
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stress
Perception of the event
anxiety
Usual coping mechanisms
ineffective
Error solutions
Severe anxiety
Personality
Disorganization
(crisis)
New and unusual solutions and support
Anxiety
Pre-crisis level of function
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第一节 暴力行为的防范与护理
暴力行为（violence）：直接伤害另一人的躯体或某一物体的严重破坏性攻击行为，如伤人毁物。
精神疾病患者的暴力行为发生率高！
分裂症，躁狂症，人格障碍，脑器质性障碍，药物依赖等常见。
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一、护理评估
（一）危险因素的评估：
: 幻觉（命令性幻听）
妄想（被害妄想）
躁狂状态
意识障碍
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一、护理评估
（一）危险因素的评估：
：
心理发展：情感剥夺、暴力环境
性格特征：多疑、固执、缺乏同情心；情绪不稳定、易产生挫折感；缺乏自信自尊、人际交往差
:环境等
:年龄、性别、婚姻状态、
工作、暴力史
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（二）暴力行为发生的征兆评估
行为评估
情感评估
意识状态评估
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