Institute for Social and Family Medicine, School of Medicine, Zhejiang University, Hangzhou, China.
Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK.
BMJ Open. 2019 Sep 20;9(9):e031513. doi: 10.1136/bmjopen-2019-031513.
To determine the prevalence of physical violence and threats against health workers and the aftermath in tertiary, secondary and primary care facilities in China.
A cross-sectional questionnaire study.
5 tertiary hospitals, 8 secondary hospitals and 32 primary care facilities located in both urban and rural areas of Zhejiang Province, China, were chosen as the study sites.
A total of 4862 health workers who have contact with patients completed a survey from July 2016 to July 2017.
The prevalence of physical violence, threats and Yi Nao, specific forms of physical violence and their aftermath were measured by a self-designed and verified questionnaire. Multivariable logistic regression models were used to examine the association between perceived organisational encouragement of reporting workplace violence (WPV) and physical violence, threats and Yi Nao after controlling for age, sex, level of facility, professional ranking and type of health worker.
Among all respondents, 224 (4.6%) were physically attacked and 848 (17.4%) experienced threats in the past year. Respondents in secondary hospitals were more likely to experience physical violence (AOR=3.29, 95% CI 2.21 to 4.89), threats (AOR=1.61, 95% CI 1.32 to 1.98) and Yi Nao (AOR=2.47, 95% CI 2.10 to 2.91), compared with primary care providers. Lack of organisational policies to report WPV was associated with higher likelihood of physical violence (AOR=3.64, 95% CI 2.57 to 5.18) and threats (AOR=2.21, 95% CI 1.76 to 2.78). Among physical violence cases, only 29.1% reported the attack to police mainly because most felt it useless to do so (58.8%). Only 25.7% were investigated and 72.4% of attackers received no punishment. Of all those attacked or threatened, 59.4% wanted to quit current post and 76.0% were fearful of dealing with urgent or severe cases.
Proper management of the aftermath of violence against health workers is inadequate. Formal guidelines for reporting and managing WPV are urgently needed.
确定中国三级、二级和一级医疗机构中针对卫生工作者的身体暴力和威胁的流行情况及其后果。
横断面问卷调查研究。
选择浙江省的 5 家三级医院、8 家二级医院和 32 家基层医疗机构作为研究地点。
2016 年 7 月至 2017 年 7 月，共有 4862 名接触过患者的卫生工作者完成了一项调查。
使用自行设计并验证的问卷测量身体暴力、威胁和以医闹形式的具体形式的身体暴力及其后果。多变量逻辑回归模型用于控制年龄、性别、医疗机构级别、专业职称和卫生工作者类型后，检验感知组织鼓励报告工作场所暴力（WPV）与身体暴力、威胁和以医闹之间的关联。
在所有受访者中，224 人（4.6%）在过去一年中受到人身攻击，848 人（17.4%）受到威胁。与基层医疗机构相比，二级医院的受访者更有可能经历身体暴力（比值比[OR] =3.29，95%置信区间[CI]：2.21 至 4.89）、威胁（OR=1.61，95%CI：1.32 至 1.98）和以医闹形式的身体暴力（OR=2.47，95%CI：2.10 至 2.91）。缺乏组织报告 WPV 的政策与更高的身体暴力（OR=3.64，95%CI：2.57 至 5.18）和威胁（OR=2.21，95%CI：1.76 至 2.78）发生的可能性相关。在身体暴力的情况下，只有 29.1%向警方报告了袭击事件，主要是因为大多数人觉得这样做没有用（58.8%）。只有 25.7%的案件得到调查，72.4%的袭击者没有受到惩罚。在所有受到袭击或威胁的人中，59.4%的人想辞去目前的工作，76.0%的人害怕处理紧急或严重的病例。
对卫生工作者遭受暴力的后果的妥善管理不足。迫切需要正式的报告和管理 WPV 的准则。
