Baig Lubna, Tanzil Sana, Shaikh Shiraz, Hashmi Ibrahim, Khan Muhammad Arslan, Polkowski Maciej
Prof. Dr. Lubna Baig, MBBS, MPH, MMEd FCPS, PhD. APPNA Institute of Public Health, Jinnah Sind Medical University, Karachi, Pakistan.
Dr. Sana Tanzil, MBBS, FCPS. APPNA Institute of Public Health, Jinnah Sind Medical University, Karachi, Pakistan.
Pak J Med Sci. 2018 Mar-Apr;34(2):294-299. doi: 10.12669/pjms.342.14432.
BACKGROUND & OBJECTIVE: Considering high burden of violence against healthcare workers in Pakistan APPNA Institute of Public Health developed a training to prevent reactive violence among healthcare providers. The purpose of this training was to equip healthcare providers with skills essential to control aggressive behaviors and prevent verbal and non-verbal violence in workplace settings. This study assesses the effectiveness of training in prevention, de-escalation and management of violence in healthcare settings.
A quasi-experimental study was conducted in October, 2016 using mixed method concurrent embedded design. The study assessed effectiveness of de-escalation trainings among health care providers working in emergency and gynecology and obstetrics departments of two teaching hospitals in Karachi. Quantitative assessment was done through structured interviews and qualitative through Focus Group Discussions. Healthcare providers` confidence in coping with patient aggression was also measured using a standard validated tool".
The overall self-perceived mean score of Confidence in Coping with Patient Aggression Instrument "(CCPAI)" scale was significantly higher in intervention group (Mean= 27.49, SD=3.53) as compared to control group (Mean= 23.92, SD=4.52) (p<0.001). No statistically significant difference was observed between intervention and control groups with regard to frequency of violence faced by HCPs post training and major perpetrators of violence..
De-escalation of violence training was effective in improving confidence of healthcare providers in coping with patient aggression.
鉴于巴基斯坦医护人员遭受暴力侵害的负担较重，阿卜杜勒·拉赫曼医生协会公共卫生研究所开展了一项培训，以预防医护人员的反应性暴力。该培训的目的是使医护人员掌握控制攻击性行为以及预防工作场所言语和非言语暴力所必需的技能。本研究评估了该培训在预防、缓和及管理医疗环境中暴力行为方面的效果。
2016年10月采用混合方法并发嵌入式设计进行了一项准实验研究。该研究评估了在卡拉奇两家教学医院急诊科、妇产科工作的医护人员接受的缓和暴力培训的效果。通过结构化访谈进行定量评估，通过焦点小组讨论进行定性评估。还使用一种标准的经过验证的工具来衡量医护人员应对患者攻击行为的信心。
与对照组（均值=23.92，标准差=4.52）相比，干预组在“应对患者攻击行为信心量表”（CCPAI）上的总体自我感知平均得分显著更高（均值=27.49，标准差=3.53）（p<0.001）。在培训后医护人员面临的暴力频率以及暴力的主要肇事者方面，干预组和对照组之间未观察到统计学上的显著差异。
暴力缓和培训有效地提高了医护人员应对患者攻击行为的信心。
