Magin Parker J, Adams Jon, Sibbritt David W, Joy Elyssa, Ireland Malcolm C
Discipline of General Practice, University of Newcastle, University Drive, Callaghan, NSW 2308, Australia.
Med J Aust. 2005 Oct 3;183(7):352-6. doi: 10.5694/j.1326-5377.2005.tb07082.x.
To establish the prevalence and characteristics of occupational violence in Australian urban general practice, and examine practitioner correlates of violence.
DESIGN, SETTING AND PARTICIPANTS: Cross-sectional questionnaire survey mailed to all members (n = 1085) of three urban divisions of general practice in New South Wales in August and September 2004. The three divisions were chosen to provide a range of socioeconomic status (SES) demographics.
Occupational violence towards general practitioners during the previous 12 months.
528 GPs returned questionnaires (49% response rate). Of these, 63.7% had experienced violence in the previous year. The most common forms of violence were "low level" violence - verbal abuse (42.1%), property damage/theft (28.6%) and threats (23.1%). A smaller proportion of GPs had experienced "high level" violence, such as sexual harassment (9.3%) and physical abuse (2.7%). On univariate analysis, violence was significantly more likely towards female GPs (P < 0.001), less experienced GPs (P = 0.003) and GPs working in a lower SES status area (P < 0.001), and among practice populations encompassing greater social disadvantage (P = 0.006), mental health problems (P < 0.001), and drug- and alcohol-related problems (P < 0.001). Experience of violence was greater for younger GPs (P = 0.005) and those providing after-hours care (P = 0.033 for after-hours home visits). On multivariate analysis, a significant association persisted between high level violence and lower SES area (odds ratio [OR], 2.86), being female (OR, 5.87), having practice populations with more drug-related problems (OR, 5.77), and providing home visits during business hours (OR, 4.76). More experienced GPs encountered less violence (OR, 0.77) for every additional 5 years of practice.
Occupational violence is a considerable problem in Australian urban general practice. Formal education programs in preventing and managing violence would be appropriate for GPs and doctors-in-training.
确定澳大利亚城市全科医疗中职业暴力的发生率及特点，并研究与暴力相关的从业者因素。
设计、地点和参与者：2004年8月和9月，对新南威尔士州三个城市全科医疗部门的所有成员（n = 1085）进行横断面问卷调查。选择这三个部门是为了涵盖不同社会经济地位（SES）的人口统计学特征。
过去12个月内针对全科医生的职业暴力。
528名全科医生返回了问卷（回复率为49%）。其中，63.7%的人在前一年经历过暴力。最常见的暴力形式是“低级别”暴力——言语辱骂（42.1%）、财产损坏/盗窃（28.6%）和威胁（23.1%）。较小比例的全科医生经历过“高级别”暴力，如性骚扰（9.3%）和身体虐待（2.7%）。单因素分析显示，女性全科医生（P < 0.001）、经验较少的全科医生（P = 0.003）、在社会经济地位较低地区工作的全科医生（P < 0.001），以及在社会劣势程度更高、有心理健康问题（P < 0.001）和药物及酒精相关问题（P < 0.001）的人群中执业的全科医生，遭受暴力的可能性显著更高。年轻的全科医生（P = 0.005）和提供非工作时间护理的医生（非工作时间家访的P = 0.033）遭受暴力的经历更多。多因素分析显示，高级别暴力与社会经济地位较低地区（优势比[OR]，2.86）、女性（OR，5.87）、执业人群中药物相关问题较多（OR，5.77）以及在工作时间进行家访（OR，4.76）之间仍存在显著关联。每增加5年的执业经验，经验更丰富的全科医生遭遇暴力的可能性降低（OR，0.77）。
职业暴力在澳大利亚城市全科医疗中是一个相当严重的问题。针对全科医生和实习医生开展预防和管理暴力的正规教育项目是合适的。
