主题游戏在精神科护士对患者攻击行为管理培训中的应用研究

doi:10.3761/j.issn.1672-9234.2025.10.011

摘要/Abstract

摘要：

目的探讨主题游戏在精神科护士对患者攻击行为管理培训中的应用效果。方法 2024年10月，采用便利抽样法，选择来自浙江省某三级甲等精神专科医院10个病区的60名精神科护士为研究对象，以病区为单元将其随机分为对照组（n=30）和试验组（n=30），围绕患者攻击行为管理，对照组接受理论授课与现场实操、微视频教学相结合的培训，试验组接受基于主题游戏的培训，比较两组培训前后患者攻击行为管理理论知识考核成绩、工作场所暴力应对资源、自信得分。结果培训后，试验组的患者攻击行为管理理论知识考核成绩、工作场所暴力应对资源、自信得分优于对照组（t=5.794、4.943、5.877，均P<0.001）。结论主题游戏能提高精神科护士对患者攻击行为管理培训的效果，提升护士的工作场所暴力应对资源、自信水平，值得推广。

关键词: 主题游戏, 精神科护士, 攻击行为管理, 培训

Abstract:

Objective To explore the application effect of theme-based games in the training of psychiatric nurses on the management of patients’ aggressive behaviors. Methods In October 2024，60 psychiatric nurses from ten wards of a tertiary A-level psychiatric hospital in Zhejiang Province were selected as the participants by convenience sampling. They were divided into a control group（n=30） and an experimental group（n=30）. Regarding the management of patients’ aggressive behaviors，the control group received training combining theoretical lectures and on-site practical training，while the experimental group received training based on theme-based games. The scores of theoretical knowledge assessment on patients’ aggressive behavior management，workplace violence response resources，and self-confidence scores of the two groups before and after training were compared. Results After the training，the scores of theoretical knowledge assessment on patients’ aggressive behavior management，workplace violence response resources，and self-confidence scores of the experimental group were better than those of the control group（t=5.794，4.943，5.877，all P<0.001）. Conclusion Theme-based games can improve the effect of training for psychiatric nurses on the management of patients’ aggressive behaviors，and enhance nurses’ workplace violence response resources and self-confidence levels，which is worthy of promotion.

Key words: Theme-baesd games, Psychiatric nurses, Management of aggressive behavior, Training

王飞, 陈海勤, 张娜, 徐晨, 沈银萍. 主题游戏在精神科护士对患者攻击行为管理培训中的应用研究[J]. 中华护理教育, 2025, 22(10): 1219-1224.

WANG Fei, CHEN Haiqin, ZHANG Na, XU Chen, SHEN Yinping. Application of theme-based games in the training for psychiatric nurses on managing patients’ aggressive behaviors[J]. Chinese Journal of Nursing Education, 2025, 22(10): 1219-1224.

图/表 6

表1

图1

表2

表3

表4

表5

参考文献 22

[1]	贾艳楠, 周郁秋, 孙玉静, 等. 中国住院精神分裂症患者攻击行为相关因素的meta分析[J]. 中国心理卫生杂志, 2024, 38(8):654-659.
[2]	Moriconi S, Balducci PM, Tortorella A. Aggressive behavior:nurse-patient relationship in mental health setting[J]. Psychiatr Danub, 2020, 32(Suppl 1):207-209. pmid: 32890391
[3]	陈怿婷, 李玉华, 张杰, 等. 精神科护士工作场所暴力暴露现况调查[J]. 健康教育与健康促进, 2021, 16(2):181-183,204.
[4]	Sun YJ, Jiang WL, Yu H, et al. Construction and verification of aggressive behavior risk prediction model in stable patients with schizophrenia[J]. BMC Psychiatry, 2023, 23(1):800. doi: 10.1186/s12888-023-05296-5 pmid: 37919744
[5]	韩电, 邓意志, 王小平. 精神分裂症患者攻击攻击行为行为研究的文献计量与知识图谱分析[J]. 中国临床心理学杂志, 2023, 31(5):1132-1139.
	Han D, Deng YZ, Wang XP. Bibliometric and knowledge-map analysis of the research on aggression and violence in schizophrenia[J]. Chin J Clin Psychol, 2023, 31(5):1132-1139.
[6]	刘同巍, 仲照希, 武伟丽, 等. 医疗失效模式与效应分析综合干预对男性精神障碍患者攻击行为的影响[J]. 临床心身疾病杂志, 2023, 29(6):165-168.
[7]	Pagnucci N, Ottonello G, Capponi D, et al. Predictors of events of violence or aggression against nurses in the workplace:a scoping review[J]. J Nurs Manag, 2022, 30(6):1724-1749.
[8]	Pimentel J, López P, Correal C, et al. Educational games created by medical students in a cultural safety training game jam:a qualitative descriptive study[J]. BMC Med Educ, 2022, 22(1):805. doi: 10.1186/s12909-022-03875-w pmid: 36419048
[9]	Lee M, Shin S, Lee MJ, et al. Educational outcomes of digital serious games in nursing education:a systematic review and meta-analysis of randomized controlled trials[J]. BMC Med Educ, 2024, 24(1):1458.
[10]	Nylén-Eriksen M, Stojiljkovic M, Lillekroken D, et al. Game-thinking;utilizing serious games and gamification in nursing education-a systematic review and meta-analysis[J]. BMC Med Educ, 2025, 25(1):140. doi: 10.1186/s12909-024-06531-7 pmid: 39881301
[11]	Xie P, Li HQ, Tao L, et al. Eliciting psychiatric nurses’ prefe-rences for workplace violence prevention:a protocol for discrete choice experiment[J]. Front Public Health, 2024, 12:1296525.
[12]	Navarro-Abal Y, Climent-Rodríguez JA, Vaca-Acosta RM, et al. Workplace violence:impact on the commitment and involve-ment of nurses at work[J]. J Nurs Manag, 2023, 2023:9987092.
[13]	张帮峰, 朱要国, 张太栋, 等. 精神科暴力行为风险管理的研究进展[J]. 护理研究, 2018, 32(10):1516-1521.
[14]	王培席. 医务场所暴力调查及理论模型研制[D]. 成都: 四川大学, 2006.
[15]	Chen L, Zhang AH, Feng XQ. Interns’ and junior nurses’ work-place-violence perceptions,coping confidence and attitudes towards violence management:a structural equation model analysis[J]. J Clin Nurs, 2025, 34(9):3734-3744.
[16]	Pimentel J, Cockcroft A, Andersson N. Impact of game jam learning about cultural safety in Colombian medical educa-tion:a randomised controlled trial[J]. BMC Med Educ, 2021, 21(1):132. doi: 10.1186/s12909-021-02545-7 pmid: 33632194
[17]	Steinert T, Baumgardt J, Bechdolf A, et al. Implementation of guidelines on prevention of coercion and violence(PreVCo) in psychiatry:a multicentre randomised controlled trial[J]. Lancet Reg Health Eur, 2023, 35:100770.
[18]	祖凤英, 张燕红, 陈兆红, 等. 基于HFMEA模型预防住院精神分裂症患者暴力行为的效果评价[J]. 中国护理管理, 2020, 20(5):780-786.
	Zu FY, Zhang YH, Chen ZH, et al. Prevention of violent beha-viors in patients with schizophrenia in closed wards based on HFMEA mode[J]. Chin Nurs Manag, 2020, 20(5):780-786.
[19]	蔡建政, 王海芳, 胡秀英, 等. 反复遭受工作场所攻击行为的护士人群特征分析[J]. 中华护理教育, 2023, 20(8):919-924.
	Cai JZ, Wang HF, Hu XY, et al. Analysis on the characte-ristics of nurses who suffer from workplace violence repea-tedly[J]. Chin J Nurs Educ, 2023, 20(8):919-924.
[20]	夏志春, 叶君荣, 李思珏, 等. 应用缓和技巧防范精神科工作场所暴力的研究进展[J]. 中华护理杂志, 2018, 53(11):1391-1394.
	Xia ZC, Ye JR, Li SJ, et al. Literature review of de-escalation in violence prevention in psychiatric inpatients[J]. Chin J Nurs, 2018, 53(11):1391-1394.
[21]	覃凤琼. 精神科护士应对攻击行为行为能力培训研究进展[J]. 中国护理管理, 2016, 16(3):401-403.
[22]	Al-Jumaili AA, Abbood SK, Abbas AN, et al. Organization factors influencing nurse ability to prevent and detect adverse drug events in public hospitals using a patient safety model[J]. Saudi Pharm J, 2021, 29(10):1216-1222. doi: 10.1016/j.jsps.2021.09.003 pmid: 34703374