Kowalenko Terry, Walters Bradford L, Khare Rahul K, Compton Scott
Department of Emergency Medicine, University of Michigan Medical Center, Ann Arbor, MI 48109-0305, USA.
Ann Emerg Med. 2005 Aug;46(2):142-7. doi: 10.1016/j.annemergmed.2004.10.010.
We seek to determine the amount and type of work-related violence experienced by Michigan attending emergency physicians.
A mail survey of self-reported work-related violence exposure during the preceding 12 months was sent to randomly selected emergency physician members of the Michigan College of Emergency Physicians. Work-related violence was defined as verbal, physical, confrontation outside of the emergency department (ED), or stalking.
Of 250 surveys sent, 177 (70.8%) were returned. Six were blank (3 were from retired emergency physicians), leaving 171 (68.4%) for analysis. Verbal threats were the most common form of work-related violence, with 74.9% (95% confidence interval [CI] 68.4% to 81.4%) of emergency physicians indicating at least 1 verbal threat in the previous 12 months. Of the emergency physicians responding, 28.1% (95% CI 21.3% to 34.8%) indicated that they were victims of a physical assault, 11.7% (95% CI 6.9% to 16.5%) indicated that they were confronted outside of the ED, and 3.5% (95% CI 0.8% to 6.3%) experienced a stalking event. Emergency physicians who were verbally threatened tended to be less experienced (11.1 versus 15.1 years in practice; mean difference -4.0 years [95% CI -6.4 to -1.6 years]), as were those who were physically assaulted (9.5 versus 13.1 years; mean difference -3.6 years [95% CI -5.9 to -1.3 years]). Urban hospital location, emergency medicine board certification, or on-site emergency medicine residency program were not significantly associated with any type of work-related violence. Female emergency physicians were more likely to have experienced physical violence (95% CI 1.4 to 5.8) but not other types of violence. Most (81.9%; 95% CI 76.1% to 87.6%) emergency physicians were occasionally fearful of workplace violence, whereas 9.4% (95% CI 5.0% to 13.7%) were frequently fearful. Forty-two percent of emergency physicians sought various forms of protection as a result of the direct or perceived violence, including obtaining a gun (18%), knife (20%), concealed weapon license (13%), mace (7%), club (4%), or a security escort (31%).
Work-related violence exposure is not uncommon in EDs. Many emergency physicians are concerned about the violence and are taking measures, including personal protection, in response to the fear.
我们试图确定密歇根州急诊内科医生所经历的与工作相关暴力的数量和类型。
对密歇根急诊医师学院随机抽取的急诊内科医生成员进行邮件调查，了解他们在过去12个月内自我报告的与工作相关的暴力暴露情况。与工作相关的暴力被定义为言语、身体暴力、急诊科（ED）外的冲突或跟踪骚扰。
共发出250份调查问卷，177份（70.8%）被退回。6份为空白问卷（3份来自退休急诊内科医生），剩余171份（68.4%）用于分析。言语威胁是与工作相关暴力最常见的形式，74.9%（95%置信区间[CI]68.4%至81.4%）的急诊内科医生表示在过去12个月内至少遭受过1次言语威胁。在回复的急诊内科医生中，28.1%（95%CI 21.3%至34.8%）表示曾遭受身体攻击，11.7%（95%CI 6.9%至16.5%）表示在急诊科外遭遇过冲突，3.5%（95%CI 0.8%至6.3%）经历过跟踪骚扰事件。遭受言语威胁的急诊内科医生往往经验较少（从业11.1年与15.1年；平均差异-4.0年[95%CI -6.4至-1.6年]），遭受身体攻击的医生也是如此（9.5年与13.1年；平均差异-3.6年[95%CI -5.9至-1.3年]）。城市医院所在地、急诊医学委员会认证或现场急诊医学住院医师项目与任何类型的与工作相关暴力均无显著关联。女性急诊内科医生遭受身体暴力的可能性更高（95%CI 1.4至5.8），但其他类型暴力的情况并非如此。大多数（81.9%；95%CI 76.1%至87.6%）急诊内科医生偶尔会担心工作场所暴力，而9.4%（95%CI 5.0%至13.7%）则经常担心。42%的急诊内科医生因直接或感知到的暴力而寻求各种形式的保护，包括获取枪支（18%）、刀具（20%）、隐蔽武器许可证（13%）、胡椒喷雾（7%）、棍棒（4%）或安保护送（31%）。
在急诊科，与工作相关的暴力暴露并不罕见。许多急诊内科医生担心暴力情况，并正在采取措施，包括个人保护，以应对这种担忧。
