Hemati-Esmaeili Maliheh, Heshmati-Nabavi Fatemeh, Pouresmail Zohre, Mazlom SeyedReza, Reihani Hamidreza
Department of Mental Health and Management, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran.
Evidence Based Care Research Centre, Department of Public Health Nursing and Psychiatric Nursing, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran.
Iran J Nurs Midwifery Res. 2018 Nov-Dec;23(6):478-485. doi: 10.4103/ijnmr.IJNMR_77_17.
The level of occupational violence against nurses increases from 68.8 to 98.6 percent, which is a considerable rate among healthcare settings. To create a safe environment for patient care in the emergency department (ED), a comprehensive program for the prevention of violence is necessary. The aim of this study was to plan a workplace violence prevention program (WVPP) to reduce the level of patients' and their families' violence against nurses.
The present study is a quantitative part of a participatory action research project conducted in an 18-month period from October 2012 to May 2014 in an ED of Iran. In the diagnosing phase, we used quantitative and qualitative approaches. The second and third phases were assigned to design and implementation of WVPP involving a combination of educational and managerial interventions. In the evaluation phase, frequencies of patients' and their families' violence against nurses and nurses' fear of violence were measured.
Mc-Nemar test showed that 85.70% ( = 42) frequencies of verbal violence before implementing WVPP significantly decreased to 57.10% ( = 28) after implementing WVPP ( = 0.007). Statistical-dependent -test ( < 0.001) indicated a significant difference in the mean (SD) scores of nurses' fear of violence before 46.10 (8.3) and after intervention 34.30 (4.6).
Applying educational and managerial interventions was effective in reduction of workplace violence. Thus, it is recommended to include a combined approach in designing WVPP in cultures similar to Iran and pay attention to effective interactions with patients' family.
针对护士的职业暴力发生率从68.8%升至98.6%，在医疗环境中这一比例相当可观。为在急诊科营造安全的患者护理环境，有必要制定一项全面的暴力预防计划。本研究旨在规划一项工作场所暴力预防计划（WVPP），以降低患者及其家属对护士的暴力程度。
本研究是2012年10月至2014年5月在伊朗一家急诊科进行的为期18个月的参与式行动研究项目的定量部分。在诊断阶段，我们采用了定量和定性方法。第二和第三阶段用于设计和实施WVPP，包括教育和管理干预措施。在评估阶段，测量了患者及其家属对护士的暴力发生频率以及护士对暴力的恐惧程度。
Mc-Nemar检验显示，实施WVPP前言语暴力发生频率为85.70%（ = 42），实施后显著降至57.10%（ = 28）（ = 0.007）。统计相关 -检验（ < 0.001）表明，护士对暴力的恐惧平均（标准差）得分在干预前为46.10（8.3），干预后为34.30（4.6），存在显著差异。
应用教育和管理干预措施可有效减少工作场所暴力。因此，建议在与伊朗类似文化背景下设计WVPP时采用综合方法，并关注与患者家属的有效互动。
