住院精神疾病患者幻听症状管理的专家共识  

Expert consensus on the management of auditory hallucinations in inpatients with mental illness

作　　者：屈燕花 许冬梅[1] 邵静[1] 张珊 张梦倩 谷嘉宁 叶晓露 李菲菲[1] 罗薇 李婉婷 王丽 史方竹 冯晓玉 周茜 赵娟[10] Qu Yanhua;Xu Dongmei;Shao Jing;Zhang Shan;Zhang Mengqian;Gu Jianing;Ye Xiaolu;Li Feifei;Luo Wei;Li Wanting;Wang Li;Shi Fangzhu;Feng Xiaoyu;Zhou Qian;Zhao Juan(Nursing Department,Beijing Huilongguan Hospital,Beijing 102208,China;Clinical Department 1,Beijing Huilongguan Hospital,Beijing 102208,China;Department of Psychology,Bejing Huilongguan Hospital,Beijing 102208,China;Department of Rehabilitation,Bejing Huilongguan Hospital,Beijing 102208,China;Department of Geriatrics,Bejing Huilongguan Hospital,Bejing 102208,China;Nursing Department,Xianyue Hospital of Xiamen,Xiamen 361012,China;Clinical Department 3,Beijing Huilongguan Hospital,Bejing 102208,China;Department of Psychiatry,Brain Hospital of Guangxi Zhuang Autonomous Region,Nanning 545005,China;Nursing Department,Shenyang Jing'an Mental Health Hospital,Shenyang l10163,China;Department of Mental Health,First Hospital of Shanxi Medical University,Taiyuan 030001,China)

机构地区：[1]北京回龙观医院护理部,北京102208 [2]北京回龙观医院临床一科,北京102208 [3]北京回龙观医院心理科,北京102208 [4]北京回龙观医院康复科,北京102208 [5]北京回龙观医院老年科,北京102208 [6]厦门市仙岳医院护理部,厦门361012 [7]北京回龙观医院临床三科,北京102208 [8]广西脑科医院精神科五病区,南宁545005 [9]沈阳静安精神卫生医院护理部,沈阳110163 [10]山西医科大学第一医院精神卫生科,太原030001

出　　处：《中国实用护理杂志》2024年第14期1080-1090,共11页Chinese Journal of Practical Nursing

基　　金：北京市属医院科研培育计划项目(PX2023069)。

摘　　要：目的规范住院精神疾病患者幻听症状管理, 制订住院精神疾病患者幻听症状管理专家共识。方法 2023年3-7月, 中华护理学会精神卫生专业委员会针对住院精神疾病患者幻听症状管理的关键问题, 以临床实践为基础, 运用文献分析法结合精神卫生专家的工作经验, 形成住院精神疾病患者幻听症状管理专家共识(简称共识)初稿。通过3轮专家函询及3次专家论证会, 对初稿进行调整、修改和完善。结果共纳入函询专家37名, 男1名, 女36名, 年龄39~67(51.48 ± 6.61)岁。3轮函询专家积极系数均为100%, 专家权威系数为0.924、0.938、0.949, 各条目重要性赋值均分>4.00分, 且变异系数均<0.25, 专家Kendall协调系数分别为0.179、0.195和0.198(均P<0.05)。论证会纳入专家第1轮15名, 第2轮12名, 第3轮12名。最终对共识的幻听评估、管理形式、症状管理实施、注意事项4部分内容达成一致意见。结论该专家共识内容涵盖住院精神疾病患者幻听症状管理的各个部分, 具有较强的实用性和科学性, 有助于指导精神卫生专业人员规范执行幻听管理, 提高护理质量, 保证患者安全。Objective To standardize the management of auditory hallucination symptoms in inpatients with mental illness and develop an expert consensus on the management of auditory hallucinations in hospitalized psychiatric patients.Methods From March 2023 to July 2023,the Mental Health Committee of the Chinese Nursing Association focused on the key issues in the management of auditory hallucinations symptoms in inpatients with mental illness,based on clinical practice,using literature analysis combined with the work experience of mental health experts,and formed the first draft of the expert consensus on the management of auditory hallucinations in inpatients with mental llness(hereinafter referred to as the consensus).Through 3 rounds of expert consultation and 3 rounds of expert demonstration meeting,the draft was adjusted,revised,and improved.Results 37 experts were included in the Delphi expert consultation,1 male and 36 females with 39-67(51.48±6.61)years old.The positive coefficients of experts in 3 rounds of Delphi expert consultations were all 100%,and the degrees of expert authority were 0.924,0.938 and 0.949,respectively.The average importance value of each item was higher than 4.00,the variation coefficient of each item was less than 0.25.The Kendall harmony coefficient of the experts were 0.179,0.195 and 0.198,respectively(all P<0.05).There were 15,12,12 experts in the first,seeond,third rounds of expert demonstration meeting.Finally,a consensus was reached on the recommendation of 4 parts,included auditory hallucination assessment,management format,symptom management implementation,and precautions.ConclusionTshe consensus covers all parts of the management of auditory hallucination symptoms in hospitalized patients with mental disorders,which is practical and scientific.It is helpful to guide mental health professionals to standardize the management of auditory hallucination symptoms,improve the quality of nursing and ensure the safety of patients.

关 键 词：精神疾病 幻听 症状管理 专家共识 

分 类 号：R473.74[医药卫生—护理学]