Faculty of Social Sciences, University of Stirling, Stirling, UK.
Medical Mediation Foundation, London, UK.
Arch Dis Child. 2019 Apr;104(4):328-332. doi: 10.1136/archdischild-2018-315647. Epub 2018 Aug 28.
To test a new conflict management framework (CMF) to help staff identify and de-escalate conflict between staff and patients/families.
Before/after study that reports staff quality of life, frequency/severity of conflicts and qualitative interviews on using the framework. Data were collected from May 2017 to September 2017.
A paediatric oncology department day-patient and 23-bed inpatient ward.
A two-stage CMF used by staff during daily handovers to identify and then manage conflict cases with families.
Staff found the CMFto be helpful in identifying and de-escalating conflicts. The number of conflicts reported decreased by 64% from baseline to follow-up. Communication regarding conflict identification improved. Reports of staff burn-out decreased between the two time-points (n=55 at baseline, n=31 at follow-up; p=0.001). Scores on compassion and secondary traumatic stress did not change.
The CMF substantially reduces the incidence of conflicts and is an acceptable approach for staff. Continued use of the framework would require it to be fully integrated into the working of the ward, which would need to include senior medical buy-in. Further refinements to the framework have been made and will be tested in four UK sites in 2018/2019.
测试一种新的冲突管理框架（CMF），以帮助工作人员识别和缓解医患/家属之间的冲突。
在报告工作人员生活质量、冲突频率/严重程度以及使用框架的定性访谈之前/之后的研究。数据收集于 2017 年 5 月至 2017 年 9 月。
儿科肿瘤日间病房和 23 张病床的住院病房。
工作人员在日常交接班期间使用两阶段 CMF 识别和管理与家属的冲突案例。
工作人员发现 CMF 有助于识别和缓解冲突。从基线到随访，报告的冲突数量减少了 64%。关于冲突识别的沟通有所改善。在两个时间点（基线 55 例，随访 31 例；p=0.001）报告的工作人员倦怠减少。同情和二次创伤性应激的评分没有变化。
CMF 大大降低了冲突的发生率，是工作人员可接受的方法。要继续使用该框架，需要将其完全融入病房的工作中，这需要包括高级医疗人员的认可。已经对框架进行了进一步的改进，并将在 2018/2019 年在英国的四个地点进行测试。
