基于挫折攻击理论的急诊工作场所暴力成因分析及预防对策探讨

Causes and prevention of workplace violence in emergency departments:an analysis based on frustration-aggression theory

我国急诊科工作场所暴力发生率高、持续存在、防范难度大,对医务人员造成严重的伤害。为解决这一问题,基于挫折攻击理论,探究患者遭遇医源性挫折后发动攻击的心理动因,发现医源性挫折来源、受挫患方的特征、急诊硬环境刺激、社会情境是引发急诊科工作场所暴力的重要原因。因此,建议医疗机构从医疗风险沟通、医方人文关怀、暴力高风险人群管理、急诊环境的基础设施、维权渠道、媒体报道入手,利用多元化措施预防和治理急诊科工作场所暴力,从而缓解医患矛盾。

In China,workplace violence in emergency departments is featured by high incidence,high persistence,and difficulty in prevention,causing serious harm to medical staff.Based on the frustration-aggression theory,this paper examines the psychological motivation of patients who become violent after experiencing iatrogenic frustration and finds that workplace violence in the emergency departments may be caused by the sources of iatrogenic frustration,the personal characteristics of the frustrated patients and/or their families,the hard environmental stimulation at the emergency department,and the social situations.Therefore,it is suggested that medical institutions should use diversified measures to prevent and manage workplace violence in emergency departments through medical risk communication,humanistic care from hospitals,management of individuals with high risk of violence,optimized infrastructure at the emergency settings,smooth right protection channels,and adequate media coverage,so as to alleviate doctor-patient conflicts.