Alexander Christian, Fraser John
New England Area Rural Training Unit, Dean House, Tamworth, New South Wales, Australia.
J Healthc Manag. 2004 Nov-Dec;49(6):377-90; discussion 391-2.
Occupational violence is a worldwide, multifaceted problem affecting all industries, including healthcare. We conducted a cross-sectional survey of the experiences of 158 allied health professionals, 135 doctors, and 1229 nurses working in a rural area in eastern Australia. Response rates were 72 percent for allied health professionals and 62 percent for general practitioners (GPs) and nurses. Proportionately more nurses experienced occupational violence than did allied health providers and GPs. During the past 12 months (August 2001 to July 2002), 68 percent of nurses, compared with 47 percent of allied health providers and 48 percent of GPs, reported violence. All three professional groups indicated that the most distressing occupational violence was perpetrated by patients, followed by patients' relatives. The most frequent form of occupational violence was verbal abuse, followed by threatening behavior, physical violence, and obscene behavior. No statistically significant difference in the prevalence of violence was found among the different allied health professional disciplines or fields of nursing. Health services management strategies addressing occupational violence need to be comprehensive and multidisciplinary in scope. Strategies to minimize violence need to focus on resource allocation, cultural change, and perseverance. Systems to monitor violence are a priority. Further research into the determinants of this pattern of violence is required.
职业暴力是一个全球性的、多方面的问题,影响着包括医疗保健在内的所有行业。我们对在澳大利亚东部农村地区工作的158名专职医疗人员、135名医生和1229名护士的经历进行了横断面调查。专职医疗人员的回应率为72%,全科医生(GPs)和护士的回应率为62%。与专职医疗人员和全科医生相比,经历职业暴力的护士比例更高。在过去12个月(2001年8月至2002年7月),68%的护士报告遭受过暴力,而专职医疗人员和全科医生的这一比例分别为47%和48%。所有这三个专业群体都表示,最令人苦恼的职业暴力是由患者实施的,其次是患者的亲属。职业暴力最常见的形式是言语辱骂,其次是威胁行为、身体暴力和猥亵行为。在不同的专职医疗专业学科或护理领域中,暴力发生率没有统计学上的显著差异。应对职业暴力的卫生服务管理策略需要全面且具有多学科性质。尽量减少暴力的策略需要关注资源分配、文化变革和坚持不懈。监测暴力的系统是当务之急。需要对这种暴力模式的决定因素进行进一步研究。