A Concept Analysis of Restlessness in Schizophrenia Patients Perceived by Psychiatric Nurses in Literature

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  • 精神科看護師が用いる統合失調症の「不穏」に関する概念検討
  • セイシンカ カンゴシ ガ モチイル トウゴウ シッチョウショウ ノ 「 フオン 」 ニ カンスル ガイネン ケントウ

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<p>The term “restlessness” is used in contexts such as “conscription medicine for restlessness” or “intervention to relieve severe behavior under conditions of restlessness” in the clinical setting of psychiatric nursing. However, there are differences in the perception of “restlessness” among nurses even in the same situation.</p><p>The purpose of this study was to assess how psychiatric nurses perceive restlessness in schizophrenia patients based on the concept analysis method developed by Rodgers.</p><p>The original nursing articles published between 1987 and 2016 by the Japan Medical Abstracts Society were extracted with the following keywords: “restlessness” and “schizophrenia”. From the pool of articles, 31 with clear descriptions of restlessness that were written by psychiatric nurses were selected for the analysis. The descriptions of restlessness were extracted along time axes.</p><p>‘Antecedent', ‘attribute' and ‘consequence' were paraphrased into the ‘sign', the ‘symptom' and the ‘outcome' for easy use in the clinical setting.</p><p>The ‘sign' comprised the following six elements: ‘unsatisfied with the physiological appetite', ‘distrustful of or dissatisfied with the current situation', ‘behavior affected by delusions', ‘limited coping ability', ‘discomfort sensed by nurses' and ‘change in the physical condition'. The ‘symptom' comprised the following five elements: ‘exacerbation of hallucinations and delusions', ‘unexpected behavior', ‘psychomotor excitement', ‘harming themselves' and ‘harming others'. The ‘outcome' comprised the following two elements: ‘activity restrictions or confinement in a protected room' and ‘adjustment of oral medication'.</p><p>The concept of restlessness in schizophrenia patients as assessed by psychiatric nurses defined as “showing dissatisfaction with the physiological appetite, being distrustful of and dissatisfied with their situation, showing discomfort, having their behavior affected by delusions, having a limited coping ability and showing a change in their physical condition, accompanied by the exacerbation of hallucination and delusions, unexpected behavior, excitement and harm to themselves or others, ultimately requiring activity restrictions or confinement in a protected room and adjustment of oral medication.”</p>

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