University of California San Francisco, San Francisco, California, USA.
Int J Ment Health Nurs. 2021 Feb;30(1):27-46. doi: 10.1111/inm.12812. Epub 2020 Nov 4.
The purpose of this systematic review is to determine the frequency of violent or aggressive behaviour towards healthcare workers in inpatient psychiatric settings in the United States. To achieve this aim, five databases were searched to find English-language quantitative studies reporting prevalence or incidence data of violence or aggression directed towards staff members in inpatient psychiatric settings. No limitations were set based on publication date, and intervention studies were included only if baseline data were provided. Of 335 total studies found, 38 full-text articles were suitable for full-text analysis based on inclusion and exclusion criteria, and 14 were included in the final review. Years of data collection ranged from 1986 to 2018, and a range of psychiatric facilities were represented, from small, private hospital units to large forensic institutions. Researchers utilized surveys, real-time incident reporting tools, and government databases, or a combination of strategies, to collect data related to workers' experiences on the job. Included research indicates that workplace violence in the U.S. inpatient psychiatric setting is a widespread problem, with 25-85% of survey respondents reporting an incident of physical aggression within the year prior to survey, and statewide workers' compensation findings indicating 2-7 claims due to assault per 100 000 employee hours. There are substantial differences between findings based on measurement strategy, making it difficult to arrive at a single estimate of prevalence nationally. As management of this persistent problem receives continued attention from stakeholders, it becomes increasingly important to define and measure the problem with the most appropriate tools.
本系统评价的目的是确定美国住院精神病学环境中针对医护人员的暴力或攻击行为的频率。为了实现这一目标,检索了五个数据库,以查找报告住院精神病学环境中针对工作人员的暴力或攻击行为的流行率或发生率数据的英文定量研究。未根据出版日期设置任何限制,并且仅在提供基线数据的情况下才纳入干预研究。在总共 335 项研究中,根据纳入和排除标准,有 38 篇全文文章适合全文分析,最终有 14 篇被纳入综述。数据收集的年限范围为 1986 年至 2018 年,代表了各种精神病学设施,从小型私人医院到大型法医机构。研究人员利用调查、实时事件报告工具和政府数据库,或结合使用多种策略,收集与工作人员工作相关的经验数据。纳入的研究表明,美国住院精神病学环境中的工作场所暴力是一个普遍存在的问题,25%-85%的调查受访者报告在调查前一年内发生过身体攻击事件,全州范围内的工人赔偿调查结果表明,每 100000 名员工每小时因袭击而提出 2-7 项索赔。基于测量策略的研究结果存在很大差异,因此很难得出全国范围内流行率的单一估计值。由于利益相关者继续关注这一持续存在的问题,因此使用最合适的工具来定义和衡量这一问题变得越来越重要。