护士工作场所暴力高危情境的质性研究

Qualitative Study on High-risk Scenarios of Workplace Violence among Nurses

目的探索护士日常工作中遭受工作场所暴力的高危情境。方法运用质性研究中的现象学分析方法,对18名遭受过工作暴力的护士进行面对面的深度访谈。访谈提纲包括6个问题:(1)可以简单地描述一下您遭受过的、印象最深刻或最近一次的工作场所暴力经历吗?(2)此次暴力发生时周围环境是怎样的(包括客观物理环境和社会环境)?(3)您认为患者或家属对您实施暴力的目的是什么?在具体暴力情境中是如何实施的?(4)从患者角度出发,您认为他们为什么会实施此次暴力行为?(5)暴力发生前后的具体情境中,患者或家属的情绪是如何变化的?(6)回顾此次暴力,具体暴力情境中,哪些特征可帮助护士提前识别暴力的发生?结果采用Claizzi现象学分析方法,提炼出患方是酗酒或者精神疾病的患者时、患方多次寻医生或护士未果时、患方对护士的解释沟通和服务态度不满意时等8个情境为护士工作场所暴力高危情境。结论医院管理层应关注暴力发生的高危情境,针对高危情境制定有效应对策略,降低医院暴力事件的发生率。

Objective To explore the high-risk scenarios of workplace violence among nurses.Methods Guided by the phenomenological research method,we performed in-depth interviews in 18 nurses suffering workplace violence.Six questions were included in the interview as described as follows:(1)Can you describe the most impressive or latest violent experience you have suffered recently?(2)What was the surrounding when the violence occurred?(including objective physical and social environment)(3)What was the purpose of the patients or their relatives to carry out the violence against you?How did they implement it in a specific situation?(4)From the perspective of the patients,why did they implement this violent behavior?(5)How did the emotion of the patients or families change in the specific situation before and after the violence?(6)What characteristics in specific situations of violence can help nurses identify the occurrence of violence in advance?Results With Claizzi phenomenological analysis,we identified 8 high-risk scenarios such as when the patients suffered from alcohol or mental illness;when the patients cannot communicate with the doctors or nurses for many times;when the patients were not satisfied with nurses’explanations or service,etc.Conclusion Great emphasis should be attached to the high-risk scenarios of hospital violence and effective coping strategies should be implemented to decrease the incidence of hospital violence.