中国北方地区医师和住院医师规范化培训医师遭受心理暴力的程度和危险因素。
Extent and risk factors of psychological violence towards physicians and Standardised Residency Training physicians: a Northern China experience.
机构信息
President's Office of Qingdao Women and Children's Hospital, Qingdao, 266011, China.
Department of Health, Policy and Hospital Management, School of Public Health, Harbin Medical University, Harbin, 150081, China.
出版信息
Health Qual Life Outcomes. 2020 Oct 7;18(1):330. doi: 10.1186/s12955-020-01574-y.
PURPOSE
Physicians and Standardised Residency Training physicians (SRTPs) have relatively high exposure to psychological violence. Its adverse effects are far greater than those of physical violence. However, no previous research has paid attention to the problem of psychological violence among them. This study aims to evaluate the extent, characteristics, and risk factors of psychological violence among SRTPs in comparison to physicians, and also to highlight the psychological violence experienced by SRTPs and suggest preventive measures.
METHODS
A cross-sectional survey was conducted in northern China. 884 physicians and 537 SRTPs completed a questionnaire which compiled by the ILO, ICN, WHO and PSI in 2003 to measure violence in the workplace. Descriptive statistics and logistic regression analysis were used to analyse results.
RESULTS
The effective response rates of physicians and SRTPs were 63.1%(884/1400) and 86.3%(537/622) respectively. 73.0%(645/884) of physicians and 24.8%(133/537) of SRTPs suffered psychological violence in the past year. Compared to physicians (29/645, 4.5%), SRTPs (42/133, 31.6%) experience more internal violence. Further, after experiencing psychological violence, physicians are willing to talk to family and friends, but SRTPs generally take no action. Shift work was a risk factor for both physicians (OR 1.440, 95% CI 1.014-2.203) and SRTPs (OR 1.851, 95% CI 1.217-2.815) suffering from psychological violence. In contrast, no anxiety symptoms protected physicians (OR 0.406, 95% CI 0.209-0.789) and SRTPs (OR 0.404, 95% CI 0.170-0.959) against psychological violence.
CONCLUSIONS
SRTPs and physicians in northern China have a high risk of experiencing psychological violence, and physicians experience more. Meanwhile, there are obvious differences in responses to psychological violence and risk factors between them. Therefore, medical institutions should pay more attention to psychological violence, especially among SRTPs, such as supporting the reporting of psychological violence, strengthening team relationships, and providing psychological comfort and counselling. Trial registration number (Project Identification Code: HMUIRB20160014), Registered May 10, 2016.
目的
医生和标准化住院医师培训医师（SRTP）接触心理暴力的程度相对较高。其不良影响远远大于身体暴力。然而，以前的研究都没有关注他们中间存在的心理暴力问题。本研究旨在评估与医生相比，SRTP 中心理暴力的程度、特征和危险因素，并强调 SRTP 所经历的心理暴力，并提出预防措施。
方法
在中国北方进行了一项横断面调查。884 名医生和 537 名 SRTP 完成了一份问卷，该问卷由 ILO、ICN、WHO 和 PSI 于 2003 年编制，用于测量工作场所的暴力行为。采用描述性统计和逻辑回归分析进行分析。
结果
医生和 SRTP 的有效应答率分别为 63.1%（884/1400）和 86.3%（537/622）。过去一年，73.0%（645/884）的医生和 24.8%（133/537）的 SRTP 遭受过心理暴力。与医生（29/645，4.5%）相比，SRTP（42/133，31.6%）经历了更多的内部暴力。此外，经历心理暴力后，医生愿意与家人和朋友交谈，但 SRTP 通常不采取任何行动。轮班工作是医生（OR 1.440，95%CI 1.014-2.203）和 SRTP（OR 1.851，95%CI 1.217-2.815）遭受心理暴力的危险因素。相比之下，没有焦虑症状可以保护医生（OR 0.406，95%CI 0.209-0.789）和 SRTP（OR 0.404，95%CI 0.170-0.959）免受心理暴力。
结论
中国北方的 SRTP 和医生遭受心理暴力的风险很高，而医生的风险更高。同时，他们对心理暴力的反应和风险因素存在明显差异。因此，医疗机构应更加关注心理暴力，尤其是 SRTP 所面临的心理暴力，例如支持报告心理暴力、加强团队关系，以及提供心理安慰和咨询。试验注册号（项目识别码：HMUIRB20160014），于 2016 年 5 月 10 日注册。
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