Landau Simha F, Bendalak Judy, Amitay Gila, Marcus Ohad
Mildred and Benjamin Berger Professor Emeritus of Criminology at the Institute of Criminology, Faculty of Law, Hebrew University, Mt. Scopus, 91905, Jerusalem, Israel.
Department of Criminology, Western Galilee Academic College, Acre and Institute of Criminology, Faculty of Law, Hebrew University of Jerusalem, Jerusalem, Israel.
Isr J Health Policy Res. 2018 Jan 4;7(1):6. doi: 10.1186/s13584-017-0200-1.
Studies on hospital violence have emphasized the importance of staff- service recipient interaction in leading to violent incidents. These incidents are the extreme result of service recipients' frustration and anger in their interaction with staff. The aim of this study was to analyze factors related to negative experiences of emergency department (ED) patients and accompanying persons in Israeli hospitals.
Structured interviews with 692 participants in seven major general Israeli hospitals: 322 patients and 370 accompanying persons.
Negative feelings while in the ED were reported by 23.6% of patients and 20.5% of accompanying persons. Eight aggregate variables relating to staff-patients/accompanying persons interaction were identified: 1. General attitudes of staff and quality of ED experience; 2. Staff attitudes towards patients; 3. Staff attitudes towards accompanying persons; 4. Waiting; 5. Quality of perceived medical care; 6. Information provided to patients and accompanying persons; 7. Information provided to patients, as reported by accompanying persons; and 8. Severity of medical problem. Among patients, the only significant aggregate variable related to anger and frustration was perceived quality of care. Among accompanying persons, the three significant contributors to negative feelings were: 1. Staff's general attitudes; 2. Attitudes towards patients; and 3. Severity of patients' medical problem. Analysis of specific items within the variables revealed that, whereas patients' negative feelings were related to nurses' perceived negative attitudes those of accompanying persons were related to the doctors' perceived negative attitudes. In addition, patients' negative feelings were related to low severity of medical problem, whereas accompanying persons' negative feelings were related to patients' low severity of pain.
The study reveals the importance of including both patients and accompanying persons in the analysis of staff-service recipient interactions in EDs. The results are discussed in terms of patients' and accompanying persons' different perspectives. Three practical implications of the results are put forward, aiming at reducing patients/accompanying persons-staff frictions in the EDs, thus decreasing the potential of violent outbursts against ED staff: (1) implementing a framework based on "patient-centeredness" for the restoration of patient's sense of agency and empowerment; (2) broadening the scope of laws concerning patient's rights to include their families and other accompanying persons; and (3) implementing courses on interpersonal and human service skills, as well as teaching skills of handling emotional stressors experienced by both the staff and service recipients.
关于医院暴力的研究强调了工作人员与服务对象互动在引发暴力事件中的重要性。这些事件是服务对象在与工作人员互动中沮丧和愤怒的极端表现。本研究的目的是分析以色列医院急诊科患者及其陪同人员负面体验的相关因素。
对以色列七家主要综合医院的692名参与者进行结构化访谈，其中包括322名患者和370名陪同人员。
23.6%的患者和20.5%的陪同人员报告在急诊科时有负面情绪。确定了与工作人员-患者/陪同人员互动相关的八个综合变量：1. 工作人员的总体态度和急诊科体验质量；2. 工作人员对患者的态度；3. 工作人员对陪同人员的态度；4. 等待；5. 感知到的医疗护理质量；6. 向患者和陪同人员提供的信息；7. 陪同人员报告的向患者提供的信息；8. 医疗问题的严重程度。在患者中，与愤怒和沮丧相关的唯一显著综合变量是感知到的护理质量。在陪同人员中，导致负面情绪的三个重要因素是：1. 工作人员的总体态度；2. 对患者的态度；3. 患者医疗问题的严重程度。对变量内具体项目的分析表明，患者的负面情绪与护士感知到的负面态度有关，而陪同人员的负面情绪与医生感知到的负面态度有关。此外，患者的负面情绪与医疗问题的低严重程度有关，而陪同人员的负面情绪与患者的低疼痛严重程度有关。
该研究揭示在分析急诊科工作人员与服务对象互动时纳入患者及其陪同人员的重要性。从患者和陪同人员的不同角度对结果进行了讨论。提出了该结果的三个实际意义，旨在减少急诊科患者/陪同人员与工作人员之间的摩擦，从而降低针对急诊科工作人员暴力爆发的可能性：（1）实施基于“以患者为中心”的框架，以恢复患者的自主感和权能；（2）扩大有关患者权利的法律范围，将其家庭和其他陪同人员包括在内；（3）开展人际和人类服务技能课程，以及教授应对工作人员和服务对象所经历的情绪压力源的技能。
