School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
BMJ Open. 2020 Dec 21;10(12):e042800. doi: 10.1136/bmjopen-2020-042800.
This study aimed to assess the risk factors associated with workplace violence towards health workers (HWs) in a Chinese hospital.
We conducted a cross-sectional survey in a Chinese secondary hospital in 2019 using an international survey questionnaire, and collected valid data from 1028 HW respondents via mobile phone. Alongside analysing the potential association between exposure to violence and respondents' characteristics, we compared the workplace violence between this survey and a baseline survey in the same hospital using the same questionnaire in 2018, and investigated the existing measures.
A total of 5.45% of respondents had encountered physical violence while 41.63% had experienced psychological violence. Women (OR=3.45, 95% CI 1.87 to 6.38), those working in outpatient and emergency departments (OR=7.96, 95% CI 2.27 to 27.95), and those with extremely high concern about workplace violence (OR=7.94, 95% CI 1.04 to 60.85) were significantly more likely to suffer physical violence. Working in the outpatient and emergency department (OR=2.03, 95% CI 1.23 to 3.34), having direct physical contact/interaction with patients (OR=2.98, 95% CI 1.62 to 5.49), and extremely high worry about workplace violence (OR=6.47 95% CI 3.38 to 12.40) significantly increased the risk of psychological violence. When the results of the baseline survey were compared with those in this survey, it was shown that physical violence declined significantly from 8.79% in 2018 to 5.45% in 2019, while psychological violence declined significantly from 47.14% in 2018 to 41.63% in 2019. The most recognised measures were security measures (81.03%) while the least recognised measures were check-in procedures for staff (11.19%).
Workplace violence towards HWs is a global problem with country-specific features. In our study, workplace violence in the hospital is of great concern. While demonstrating the effectiveness of measures in some degree, there is significant room for improvement. To achieve the vision of 'zero violence' in the health sector, aligned comprehensive measures should be systematically adopted.
本研究旨在评估中国某医院卫生工作者(HWs)遭受工作场所暴力的相关风险因素。
我们于 2019 年在中国一家二级医院进行了横断面调查,使用国际调查问卷,通过移动电话收集了 1028 名 HW 应答者的有效数据。除了分析暴力暴露与应答者特征之间的潜在关联外,我们还比较了该调查与 2018 年同一医院使用相同问卷进行的基线调查之间的工作场所暴力情况,并调查了现有的措施。
共有 5.45%的应答者遭遇过躯体暴力,41.63%经历过心理暴力。女性(OR=3.45,95%CI 1.87 至 6.38)、门诊和急诊部门工作者(OR=7.96,95%CI 2.27 至 27.95)和对工作场所暴力极度担忧者(OR=7.94,95%CI 1.04 至 60.85)更易遭受躯体暴力。在门诊和急诊部门工作(OR=2.03,95%CI 1.23 至 3.34)、与患者有直接身体接触/互动(OR=2.98,95%CI 1.62 至 5.49)和对工作场所暴力极度担忧(OR=6.47,95%CI 3.38 至 12.40)显著增加心理暴力的风险。将基线调查的结果与本调查的结果进行比较后发现,2018 年的躯体暴力从 8.79%显著下降至 2019 年的 5.45%,而 2018 年的心理暴力从 47.14%显著下降至 2019 年的 41.63%。最受认可的措施是安全措施(81.03%),而最不受认可的措施是员工签到程序(11.19%)。
HWs 遭受工作场所暴力是一个具有国家特征的全球性问题。在我们的研究中,医院的工作场所暴力令人担忧。虽然在一定程度上证明了措施的有效性,但仍有很大的改进空间。为了实现卫生部门“零暴力”的愿景,应系统地采用全面的综合措施。