Faculty of Medicine, Research Unit of Nursing Science and Health Management, Medical Research Center, University of Oulu Finland, Oulu, Finland.
University Hospital of Oulu, Oulu, Finland.
J Psychiatr Ment Health Nurs. 2021 Aug;28(4):706-720. doi: 10.1111/jpm.12723. Epub 2020 Dec 17.
WHAT IS KNOWN ON THE SUBJECT?: There is a scarcity of studies concerning violence in psychiatric outpatient settings in the 2010s in spite of the deinstitutionalization of psychiatric services. Previous research on violence in psychiatric outpatient settings has failed to consider the association between the psychological consequences of violence, exposures to violence and background factors. WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE?: It has been known for some time that exposures to violence are harmful for psychiatric inpatient nurses; the paper demonstrates that psychiatric outpatient nurses are also at risk. The psychological consequences of exposure to violence are highly individualized and influenced by background factors. Nurses who face harassment have a greater risk of suffering psychological symptoms. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: De-escalation interventions should be implemented in psychiatric outpatient settings. Organizations should consider the possibility of internal violence occurring when planning preventive interventions to manage and reduce workplace violence. Education targeted at violence prevention, management and debriefing should be organized systematically in psychiatric outpatient units and be taken into consideration in the mental health nursing curriculum. ABSTRACT: Introduction There is a scarcity of studies concerning violence and its consequences in psychiatric outpatient setting. Aim This study aimed to explore the occurrence of workplace violence and the psychological consequences of exposure to violence among nurses working in psychiatric outpatient settings. Method Research followed a cross-sectional survey design. Data were collected with the VIA-Q instrument. Results During the 12 months prior to the study, nurses (n = 181) had most often experienced psychological violence, with fatigue being the most common consequence. Harassment most often caused feelings of violated integrity, whereas physical violence most often caused insomnia. Significant relationships between exposure to violence and psychological consequences were identified. Discussion Workplace violence can manifest in a broad array of psychological symptoms and be harmful for nurses in psychiatric outpatient settings. It is important to discuss the subject of workplace violence and its place in the nursing curriculum and to reflect on how nurses are educated and trained to face violence in psychiatric nursing. Implications for Practice De-escalation interventions should be implemented in psychiatric outpatient settings. Organizations should take steps to abolish internal violence. Nurses need appropriate education in order to prepare them to manage workplace violence.
尽管精神科服务已经去机构化,但 21 世纪 10 年代仍缺乏有关精神科门诊环境中暴力的研究。先前关于精神科门诊环境中暴力的研究未能考虑暴力的心理后果、暴力暴露和背景因素之间的关联。
一段时间以来,人们已经知道,暴露于暴力对精神科住院护士是有害的;该论文表明,精神科门诊护士也有风险。暴露于暴力的心理后果高度个体化,并受背景因素的影响。面临骚扰的护士遭受心理症状的风险更大。
应在精神科门诊环境中实施降级干预。在规划旨在管理和减少工作场所暴力的预防干预措施时,组织应考虑发生内部暴力的可能性。应系统地在精神科门诊单位组织以预防暴力、管理和汇报为重点的教育,并在精神科护理课程中加以考虑。
介绍 精神科门诊环境中暴力及其后果的研究很少。 目的 本研究旨在探讨精神科门诊护士工作场所暴力的发生情况以及暴露于暴力的心理后果。
方法 研究采用横断面调查设计。使用 VIA-Q 工具收集数据。
结果 在研究前的 12 个月期间,护士(n=181)最常经历心理暴力,疲劳是最常见的后果。骚扰最常导致侵犯完整性的感觉,而身体暴力最常导致失眠。确定了暴露于暴力与心理后果之间的显著关系。
讨论 工作场所暴力可能表现为广泛的心理症状,对精神科门诊护士有害。讨论工作场所暴力及其在护理课程中的地位并反思如何对护士进行教育和培训以应对精神科护理中的暴力问题非常重要。
对实践的影响 应在精神科门诊环境中实施降级干预。组织应采取措施消除内部暴力。护士需要接受适当的教育,以便为他们管理工作场所暴力做好准备。