| Abstract | Postoji niz bolesti i stanja koje mogu kulminirati agresivnim ponašanjem spram okoline. Agresivno ponašanje se svodi na namjeru u kojoj se nekome ili nečemu nanosi šteta, neugoda, povreda. Način reagiranja pojedinca u sukobu te suočavanje s njim ovisi hoće li ili ne doći do eskalacije situacije i mirnog i nenasilnog razrješenja situacije. Najčešće, najefikasniji postupak prevencije agresivnosti i smirivanja bolesnika je terapijska komunikacija. Ako ponašanje pacijenta postaje prijeteće i nije moguća uspostava dijaloga, tada se pristupa korištenju mjera prisile u svrhu sigurnosti bolesnika, zaštite zdravlja i okoline. Postoje razni oblici prisile a mogu diferencirati na formalne, neformalne i subjektivne prisile. U ovom radu istaknute su formalne metode prisile. Medicinske sestre na psihijatrijskom odjelu učestalo su izložene agresiji pacijenata i moraju upravljati agresivnim situacijama. Da bi u tome bile uspješne služe se: metodama deeskalacije, procjenom rizika pomoću skala kao i poznavanjem ranih znakova upozorenja za mogući agresivni ispad a sve u svrhu da do eskalacije situacije ne dođe.
Ovaj rad je nastao nakon istraživanja literature i konstruiranja kraćeg upitnika za potrebe istraživanja stavova, upućenosti o agresiji i intervencijama za upravljanje agresijom, mišljenja o radu s agresivnim pacijentom i korištenju metoda sputavanja kod sudionika zdravstvene i nezdravstvene struke. U istraživanju je sudjelovalo 257 osoba, 245 sudionika 95,3% pripada zdravstvenoj struci i 12 sudionika 4,7% pripada nezdravstvenoj struci. Dobiveni rezultati ukazuju da se 98,1% sudionika susrelo s terminom agresije. 96,1% sudionika prepoznaje definiciju agresije dok 12,5% sudionika navodi definiciju nasilja. Mali broj sudionika 1,6% se nije susreo s agresijom. Susret s agresivnim pacijentom kod sudionika istraživanja izaziva različite emocionalne reakcije. Najviše sudionika 56,8% navodi da su osjećali strah, odnosno da su bili uplašeni, a 72,4% sudionika navodi da su imali potrebu izmaknuti se iz takve situacije. Tehniku upravljanja agresivnim pacijentom 52,9% sudionika ne poznaje. 97,3% sudionika smatra da nije lako upravljati agresivnim pacijentom. S mjerama prisile se susrelo 84% sudionika.
Stjecanjem potrebnih kompetencija, znanja i vještina, za rad s agresivnim i agitiranim pacijentima kod zdravstvenog osoblja doprinijet ćemo korištenje prisilnih mjera na najmanju moguću mjeru, a edukacijom pacijenata i članova njihovih obitelji ublažiti negativne stavove prema prisilnim mjerama i zdravstvenim djelatnicima koji ih provode u svrhu zaštite pacijenata i osoba iz njihove okoline. |
| Abstract (english) | There are a number of diseases and conditions that can culminate in aggressive behavior toward the environment. Aggressive behavior comes down to the intention in which someone, something is harmed, embarrassed, injured. The way an individual reacts in a conflict and how to deal with it depends on whether or not the situation escalates and the situation is resolved peacefully and non-violently. Most often, the most effective procedure for preventing aggression and calming patients is therapeutic communication. If the patient's behavior becomes threatening and dialogue is not possible, then coercive measures are used for the purpose of patient safety, health and the environment. There are various forms of coercion and they can be differentiated into formal, informal and subjective coercion. In this paper, formal methods of coercion are highlighted. Nurses in the psychiatric ward are frequently exposed to patient aggression and must manage aggressive situations. In order to be successful in this, they use: de-escalation methods, risk assessment using scales as well as knowledge of early warning signs for a possible aggressive outburst, all with the aim of preventing the situation from escalating.
This paper was created after researching the literature and constructing a short questionnaire for research on attitudes, knowledge of aggression and interventions to manage aggression, opinions on working with aggressive patients and the use of restraint methods in participants in the health and non-health professions. 257 people participated in the research, 245 participants 95,3% belong to the health profession and 12 participants 4,7% belong to the non-health profession. The results obtained indicate that 98,1% of participants encountered the term aggression. 96,1% of participants recognize the definition of aggression while 12,5% of participants state the definition of violence. A small number of participants 1,6% did not encounter aggression. Encountering an aggressive patient provokes different emotional reactions in the research participants. Most participants, 56,8%, stated that they felt afraid, ie that they were scared, and 72,4% of participants stated that they needed to get out of such a situation. The technique of managing an aggressive patient is unknown to 52,9% of participants. 97,3% of participants find it difficult to manage an aggressive patient. Coercive measures were encountered by 84% of participants.
By acquiring the necessary competencies, knowledge and skills to work with aggressive and agitated patients in health care staff, we will contribute to the use of coercive measures to a minimum, and by educating patients and their families to alleviate negative attitudes towards coercive measures and health professionals. patients and people around them. |
