精神科医护人员遭受工作场所暴力攻击的危险因素分析

Analysis of risk factors of psychiatric medical staff being subjected to workplace violence

目的调查精神科医护人员遭受工作场所暴力攻击(WPV)现状并分析其危险因素。方法抽取154名精神科医护人员和152名非精神科医护人员,采用一般资料调查问卷及WPV调查问卷进行调查。比较精神科与非精神科医护人员的WPV发生情况,采用单因素与logistic回归分析精神科医护人员遭受WPV的危险因素。结果154名精神科医护人员中,有135名医护人员表示曾经遭受过至少1次WPV,发生率为87.66%,其中,语言暴力发生率为79.87%,威胁恐吓发生率为50.65%,躯体攻击发生率为26.62%,性骚扰发生率为5.84%。非精神科医护人员的语言暴力、威胁恐吓、躯体攻击发生率依次为48.68%、30.92%、11.18%,明显低于精神科医护人员(P<0.05);非精神科医护人员的性骚扰发生率为7.24%,与精神科医护人员比较,差异无统计学意义(P>0.05)。经单因素及logistic回归分析结果显示,学历(OR=1.203)、工龄(OR=0.465)、封闭病房(OR=1.719)、每月夜班数(OR=1.465)、接受相关培训(OR=0.510)、遭遇后上报(OR=0.461)是精神科医护人员遭受WPV的独立影响因素(P<0.05)。结论精神科医护人员遭受WPV的发生率较高,发生危险因素主要与学历、工龄、夜班数、是否接受相关培训及遭遇WPV后是否上报有关。针对WPV发生危险因素制定持续性WPV防护培训,改善医护人员工作环境与患者就医环境,建立WPV防护规范与应急处理预案等是降低WPV发生风险的重要举措。

Objective To investigate the status of workplace violence attack(WPV)on psychiatric medical staff and to analyze its risk factors.Methods A total of 154 psychiatric medical staff and 152 non-psychiatric medical staff were selected to conduct the survey using the General information questionnaire and the WPV Questionnaire.The WPV incidence of psychiatric and non-psychiatric medical staff was compared.Univariate and logistic regression were used to analyze the risk factors of psychiatric medical staff being subjected to violent attack in the workplace.Results Among the 154 psychiatric medical staff,135 medical staff said that they had suffered from WPV at least once,with detection rate of 87.66%,among which,the detection rate of verbal violence was 79.87%,threats and intimidation 50.65%,physical assault 26.62%,and sexual harassment 5.84%.The detection rate of verbal violence,threat and physical assault among non-psychiatric medical staff was 48.68%,30.92%and 11.18%,respectively,which were significantly lower than those of psychiatric medical staff(P<0.05).The detection rate of sexual harassment among non-psychiatric medical staff was 7.24%,which was not statistically significant compared with psychiatric medical staff(P>0.05).Univariate and logistic regression analysis showed that educational background(OR=1.203),length of service(OR=0.465),closed ward(OR=1.719),number of night shift per month(OR=1.465),relevant training(OR=0.510),and report after encounter(OR=0.461)were independent influencing factors for psychiatric medical staff to suffer WPV(P<0.05).Conclusions The detection rate of WPV among psychiatric medical staff is relatively high,and the risk factors are mainly related to education background,length of service,number of night shift,whether to receive relevant training,and whether to report the occurrence of WPV.It is an important measure to reduce the risk of WPV to develop continuous WPV protection training,improve the working environment of medical staff and patients,and establish WPV protection specifications and emergency response plans.