三甲医院医务人员遭受工作场所暴力情况及评估
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摘要
目的分析医务人员工作场所暴力的人口社会学影响因素,探讨医务人员在工作场所遭受的暴力形式与程度,研究与评估工作场所暴力对医务人员的影响。方法本研究于2015年7月开始实地调查,以整群抽样的方法选取山西省10个地市15所三甲医院共3 663名医务人员作为调查对象,以已有问卷为模板设计本次工作场所暴力问卷并展开调查。结果单因素分析结果显示,工作年限、最高学历、职称、聘用形式、科室等是医院工作场所遭受暴力的影响因素。医院急诊科室遭受暴力发生率最高,为89.84%;最高学历是本科的医务人员遭受暴力发生率最高,为67.43%;医务人员遭受暴力形式主要为语言暴力且暴力主要发生于病房、医生办公室和护理站;工作场所暴力的施暴者主要为患者家属,占68.72%,且男性比例占到76.77%,施暴者年龄多在30～40岁;因不满意医生的治疗或手术方案,认为病情无好转而施暴的占42.94%,未满足病人无理要求而施暴的占44.46%;应对医院暴力的方式中,忍让回避与耐心解释占比分别为52.10%、67.48%。结论医院工作场所遭受暴力中最常见的是责骂、辱骂,在暴力发生后,医务人员往往感到委屈、气愤,导致其工作态度发生变化,产生离职意愿,严重影响其心理健康,因此有关部门和社会各界应重点关注医务人员心理健康,做好心理健康的评估、干预,预防和减少心理障碍。
Objective To analyze the prevalence and sociological influence factors of workplace violence(WPV) against medical staff and the impacts of MPV upon medical staff. Methods We conducted a survey among 3 663 physicians and nurses recruited with random cluster sampling in 15 tertiary grade A hospitals located in 10 prefectures or municipalities of Shanxi province between January and July 2015. We used a self-modified existing questionnaire on medical staff′s exposure to WPV in the study. Results The results of univariate factor analysis revealed following influencing factors of WPV against medical staff: years of working, high education backgroud, professional title, employment form, and working department. The medical staff in emergency department were most frequently(89.84%) exposed to WPV and those with undergraduate education reported a higher rate(67.43%) of WPV exposure. Verbal violence was a major form of WPV reported and most of the MPV occurred at wards, doctor′s offices, and nurse stations. Of the reported WPV perpetrators,68.72% were family members of patients; 76.77% were male; and 63.32% were aged 30 – 49 years. Based on the medical staff′s reporting, major origins of the WPV incidents included dissatisfaction for doctors′ therapeutic regimen or surgical option and treatment outcome(42.94%) and no response to patients′ unreasonable requirements(44.46%). The major strategies for coping with the WPV were tolerance or avoidance(reported by 52.10% of the medical staff) and patient explanation(67.48%). Conclusion Verbal attack is a most common workplace violence in hospitals and has serious impact on medical staff′s mental health and could induce medical staff′s turnover intention. Relevant measures should be adopted to reduce workplace violence in hospitals.
Objective To analyze the prevalence and sociological influence factors of workplace violence(WPV) against medical staff and the impacts of MPV upon medical staff. Methods We conducted a survey among 3 663 physicians and nurses recruited with random cluster sampling in 15 tertiary grade A hospitals located in 10 prefectures or municipalities of Shanxi province between January and July 2015. We used a self-modified existing questionnaire on medical staff′s exposure to WPV in the study. Results The results of univariate factor analysis revealed following influencing factors of WPV against medical staff: years of working, high education backgroud, professional title, employment form, and working department. The medical staff in emergency department were most frequently(89.84%) exposed to WPV and those with undergraduate education reported a higher rate(67.43%) of WPV exposure. Verbal violence was a major form of WPV reported and most of the MPV occurred at wards, doctor′s offices, and nurse stations. Of the reported WPV perpetrators,68.72% were family members of patients; 76.77% were male; and 63.32% were aged 30 – 49 years. Based on the medical staff′s reporting, major origins of the WPV incidents included dissatisfaction for doctors′ therapeutic regimen or surgical option and treatment outcome(42.94%) and no response to patients′ unreasonable requirements(44.46%). The major strategies for coping with the WPV were tolerance or avoidance(reported by 52.10% of the medical staff) and patient explanation(67.48%). Conclusion Verbal attack is a most common workplace violence in hospitals and has serious impact on medical staff′s mental health and could induce medical staff′s turnover intention. Relevant measures should be adopted to reduce workplace violence in hospitals.
引文
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[11]王超,孙春华.护士工作能力、心理健康即应对方式对医院暴力事件发生影响[J].中国公共卫生,2015,31(7):941-945.
[12]陈祖辉,王声湧,卢业成,等.医院工作场所暴力的流行病学特征及危险因素分析[J].中华流行病学志,2004,25(1):3-5.
[13]陈奇策.温州市两所综合性医院医务人员工作场所暴力现状的调查分析[D].合肥:安徽医科大学,2012.
[14]杨筱多.深圳市综合医院护士遭受工作场所暴力现状调查及影响因素分析[D]北京:北京协和医学院2008.
[15]彭瑛.长沙市某综合医院护士遭受工作场所暴力行为现状及其影响因素分析[D].长沙:中南大学,2012.
[16]杨筱多,姜亚芳,陈麦秋,等.医院临床护士经历医院场所暴力现状调查[J].护理管理杂志,2009,9(10):19-21.
[17]杨洋,刘彦慧,张洪福,等.三甲医院护理人员遭受职场暴力现状及影响因素[J].中国公共卫生,2015,31(9):155-1159.
[18]Gillespie GL,Gates DM,Miller M,et al.Workplace violence in healthcare settings:risk factors and protective strategies[J].Rehabit Nurs,2010,35(5):177-184.
[19]Hahna S,Zellerb A,Needhamc I,et al.Patient and visitor violence in general hospitals,a systematic review of the literature[J].Aggress Violent Behave,2008,13(6):431-441.
[20]陈姣,李继平.精神科护士遭受工作场所暴力的研究进展[J].中华护理杂志,2013,48(12):1138-1141.
[21]樊立华,周辰宇.医院工作场所暴力现状、影响及应对策略探讨[J].中国公共卫生管理,2013,29(1):33-35.
[22]余泳琛,邹芳亮,蔡一凡,等.医护人员遭受工作场所暴力后应激反应的深度体验[J].中国实用护理杂志,2014,30(10):6-9.
[2]陈祖辉.广州市医院工作场所暴力流行病学研究[D].广州:南方医科大学,2011.
[3]潘红英.急诊护理人员工作场所暴力应对策略的研究[D].杭州:浙江大学,2011.
[4]王培席.护理场所暴力调查及理论模型研制[D].成都:四川大学华西公共卫生学院,2006.
[5]王珂,朱伟,杨力沣,等.郑州市综合医院义务场所暴力与医务人员工作倦怠的关系[J].中国卫生事业管理,2012,05:391-393.
[6]苏天照,丁美超.太原市综合医院护士遭受“医暴”现状及防控策略[J].中国卫生法制,2015,23(5):89-93.
[7]Jackson D,Clare J,Mannix J.Who would want to be a nurse?Violence in the workplace-a factor in recruitment and retention[J].Journal of Nursing Management,2002,10(1):13-20.
[8]Maguire J,Ryan D.Aggression and violence in mental health services:categorizing the experiences of Irish nurses[J].Psychiatry Mental Health Nurse,2007,14(2):120-127.
[9]Chen WC,Hwu HG,Kung SM,et al.Prevalence and determinants of workplace violence of health care workers in a psychiatric hospital in Taiwan[J].Int Arch Occup Environ Health,2010,83(7):823-832.
[10]钱铭怡,武国城,朱荣春,等.艾森克人格问卷简式量表中国版(EPQ-RSC)的修订[J].心理学报,2000,32(3):317-323.
[11]王超,孙春华.护士工作能力、心理健康即应对方式对医院暴力事件发生影响[J].中国公共卫生,2015,31(7):941-945.
[12]陈祖辉,王声湧,卢业成,等.医院工作场所暴力的流行病学特征及危险因素分析[J].中华流行病学志,2004,25(1):3-5.
[13]陈奇策.温州市两所综合性医院医务人员工作场所暴力现状的调查分析[D].合肥:安徽医科大学,2012.
[14]杨筱多.深圳市综合医院护士遭受工作场所暴力现状调查及影响因素分析[D]北京:北京协和医学院2008.
[15]彭瑛.长沙市某综合医院护士遭受工作场所暴力行为现状及其影响因素分析[D].长沙:中南大学,2012.
[16]杨筱多,姜亚芳,陈麦秋,等.医院临床护士经历医院场所暴力现状调查[J].护理管理杂志,2009,9(10):19-21.
[17]杨洋,刘彦慧,张洪福,等.三甲医院护理人员遭受职场暴力现状及影响因素[J].中国公共卫生,2015,31(9):155-1159.
[18]Gillespie GL,Gates DM,Miller M,et al.Workplace violence in healthcare settings:risk factors and protective strategies[J].Rehabit Nurs,2010,35(5):177-184.
[19]Hahna S,Zellerb A,Needhamc I,et al.Patient and visitor violence in general hospitals,a systematic review of the literature[J].Aggress Violent Behave,2008,13(6):431-441.
[20]陈姣,李继平.精神科护士遭受工作场所暴力的研究进展[J].中华护理杂志,2013,48(12):1138-1141.
[21]樊立华,周辰宇.医院工作场所暴力现状、影响及应对策略探讨[J].中国公共卫生管理,2013,29(1):33-35.
[22]余泳琛,邹芳亮,蔡一凡,等.医护人员遭受工作场所暴力后应激反应的深度体验[J].中国实用护理杂志,2014,30(10):6-9.
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