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1993年至2014年间挪威所有医学专业针对医生的工作场所暴力发生率变化:一项重复横断面调查。

Changes in prevalence of workplace violence against doctors in all medical specialties in Norway between 1993 and 2014: a repeated cross-sectional survey.

作者信息

Johansen Ingrid Hjulstad, Baste Valborg, Rosta Judith, Aasland Olaf G, Morken Tone

机构信息

National Centre for Emergency Primary Health Care, Uni Research Health, Bergen, Norway.

Institute for Studies of the Medical Profession, Oslo, Norway.

出版信息

BMJ Open. 2017 Aug 11;7(8):e017757. doi: 10.1136/bmjopen-2017-017757.

Abstract

OBJECTIVES

The aim of this study was to investigate whether reported prevalence of experienced threats, real acts of violence and debilitating fear of violence among Norwegian doctors have increased over the last two decades.

DESIGN

Repeated cross-sectional survey.

SETTING

All healthcare levels and medical specialties in Norway.

PARTICIPANTS

Representative samples of Norwegian doctors in 1993 (n=2628) and 2014 (n=1158).

MAIN OUTCOME MEASURES

Relative risk (RR) of self-reported prevalence of work-time experiences of threats and real acts of violence, and of being physically or psychologically unfit during the last 12 months due to fear of violence, in 2014 compared with 1993, adjusted by age, gender and medical specialty.

RESULTS

There were no differences in self-reported threats (adjusted RR=1.01, 95% CI 0.95 to 1.08) or real acts (adjusted RR=0.90, 95% CI 0.80 to 1.03) of violence when comparing 2014 with 1993. The proportion of doctors who had felt unfit due to fear of violence decreased from 1993 to 2014 (adjusted RR=0.53, 95% CI 0.39 to 0.73). Although still above average, the proportion of doctors in psychiatry who reported real acts of violence decreased substantially from 1993 to 2014 (adjusted RR=0.75, 95% CI 0.60 to 0.95).

CONCLUSIONS

A substantial proportion of doctors experience threats and real acts of violence during their work-time career, but there was no evidence that workplace violence has increased over the last two decades. Still, the issue needs to be addressed as part of the doctors' education and within work settings.

摘要

目的

本研究旨在调查挪威医生报告的经历威胁、实际暴力行为以及使人衰弱的暴力恐惧的发生率在过去二十年中是否有所增加。

设计

重复横断面调查。

地点

挪威所有医疗级别和医学专科。

参与者

1993年(n = 2628)和2014年(n = 1158)挪威医生的代表性样本。

主要观察指标

2014年与1993年相比,经年龄、性别和医学专科调整后,自我报告的工作时间内经历威胁和实际暴力行为的患病率,以及过去12个月因暴力恐惧导致身体或心理不适的相对风险(RR)。

结果

将2014年与1993年相比,自我报告的暴力威胁(调整后RR = 1.01,95%CI 0.95至1.08)或实际暴力行为(调整后RR = 0.90,95%CI 0.80至1.03)没有差异。1993年至2014年,因暴力恐惧而感到不适的医生比例有所下降(调整后RR = 0.53,95%CI 0.39至0.73)。虽然仍高于平均水平,但1993年至2014年,报告实际暴力行为的精神科医生比例大幅下降(调整后RR = 0.75,95%CI 0.60至0.95)。

结论

相当一部分医生在其工作生涯中经历过威胁和实际暴力行为,但没有证据表明过去二十年来工作场所暴力有所增加。尽管如此,该问题仍需作为医生教育的一部分并在工作环境中加以解决。

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