某二级甲等医院医务工作者对工作场所暴力感知和态度:基于定性访谈视角

Perception and attitude of the healthcare workers on workplace violence in a secondary Grade A hospital: based on the perspectives of a qualitative interview

目的了解某二级甲等医院医务工作者(HCWs)对工作场所暴力(WPV)的真实感受和态度。方法采用典型抽样方法,抽取某二级甲等医院的27名HCWs为研究对象,对其进行半结构式访谈,收集其对WPV的类型、影响以及HCWs处理措施、工作压力等感知和态度的相关信息,分析医院WPV的发生特征。结果受访者认为HCWs遭受最多的暴力类型是语言侮辱,护士和女性是WPV的主要受害对象,同事之间的横向暴力以及性骚扰也不容忽视;导致患者及家属出现WPV的常见原因有治疗费用、医患沟通、患者情绪、患者醉酒和治疗结果未达到患者的要求。约半数受访者表示WPV会对HCWs的心理产生严重影响;对于WPV的后续处理大多为对患者进行安抚,HCWs无条件道歉。超半数受访者认为其工作负荷可以接受,部分受访者认为自己的工作压力大。受访者建议通过改善医患沟通方式和医院制度、提高HCWs专业知识等预防和控制WPV。结论该医院HCWs对WPV的感知和态度相对分散。WPV的原因复杂、后果严重、处理难度大,医院、HCWs和社会各界需要综合施策予以防范。

Objective To understand the true perception and attitude of the healthcare workers(HCWs) on the workplace violence(WPV) in a secondary Grade A hospital.Methods A total of 27 HCWs in a secondary Grade A hospital were selected as study subjects using a typical sampling method. Semi-structured interviews were conducted to collect the information of their perception and attitude on the types and effects of WPV, as well as on the coping measures and the work stress. The characteristics of WPV in the hospital were analyzed. Results The interviewees believed that verbal abuse was the most common type of WPV received by HCWs. Nurses and female workers were the main victims of WPV. Horizontal violence among colleagues and sexual harassment should not be ignored. Common causes of violent incidents for patients and their family members against HCWs included the fees for treatment, doctor-patient communication, patients alcohol abuse and treatment outcomes not meeting patients′ expectation. About half of the interviewees said that WPV had serious impact on their mental health. The follow-up coping measures to violent incidents were mostly to reassurance to patients with unconditional apology from the HCWs. More than half of the interviewees considered that they had acceptable workload, while some interviewees considered their work to be stressful. The interviewees suggested that improving doctor-patient communication, hospital systems, and the professional knowledge of HCWs were the recommended means to prevents and control the WPV. Conclusion The perception and attitude of HCWs on WPV in this hospital are relatively scattered. Considering the complex causes, the serious consequences, and difficult coping measures, the hospitals, HCWs and all sectors of society need to take comprehensive measures to prevent WPV towards HCWs.