Ashton Rebecca Angharad, Morris Lucy, Smith Ian
Furness College, Lancaster University, Lancaster LA1 4YG, UK.
Merseycare NHS Foundation Trust, Whalley, Lancashire BB7 9PE, UK.
Int Emerg Nurs. 2018 Jul;39:13-19. doi: 10.1016/j.ienj.2017.12.004. Epub 2018 Jan 8.
Patient and visitor violence or aggression against healthcare workers in the Emergency Department (ED) is a significant issue worldwide. This review synthesises existing qualitative studies exploring the first-hand experiences of staff working in the ED to provide insight into preventing this issue.
A meta-ethnographic approach was used to review papers.
Four concepts were identified: 'The inevitability of violence and aggression'; 'Staff judgments about why they face violence and aggression'; 'Managing in isolation'; and 'Wounded heroes'.
Staff resigned themselves to the inevitability of violence and aggression, doing this due to a perceived lack of support from the organisation. Staff made judgements about the reasons for violent incidents which impacted on how they coped and subsequently tolerated the aggressor. Staff often felt isolated when managing violence and aggression. Key recommendations included: Staff training in understanding violence and aggression and clinical supervision.
Violence and aggression in the ED can often be an overwhelming yet inevitable experience for staff. A strong organisational commitment to reducing violence and aggression is imperative.
急诊科患者及访客对医护人员的暴力或攻击行为是一个全球性的重大问题。本综述综合了现有的定性研究，探讨急诊科工作人员的第一手经验，以深入了解如何预防这一问题。
采用元民族志方法对论文进行综述。
确定了四个概念：“暴力和攻击行为的必然性”；“工作人员对自身遭受暴力和攻击原因的判断”；“孤立应对”；以及“受伤的英雄”。
工作人员认为暴力和攻击行为不可避免，之所以如此是因为他们感觉组织缺乏支持。工作人员对暴力事件的原因进行了判断，这影响了他们应对的方式以及随后对攻击者的容忍度。在应对暴力和攻击行为时，工作人员常常感到孤立无援。主要建议包括：对工作人员进行关于理解暴力和攻击行为的培训以及临床督导。
急诊科的暴力和攻击行为对工作人员来说往往是压倒性的，但又不可避免。组织必须坚定致力于减少暴力和攻击行为。
