Centre Max Weber (UMR 5283), University Lumière Lyon 2, F-69007 Lyon, France.
Public Health Department, Hospices Civils de Lyon, F-69003 Lyon, France.
BMJ Open. 2021 Feb 8;11(2):e042362. doi: 10.1136/bmjopen-2020-042362.
Identify the strategies implemented by emergency care professionals when facing tension and interpersonal violence from patients and their friends and family.
Descriptive qualitative study based on 38 semidirective interviews.
Doctors, nurses, nursing assistants and administrative staff.
Four emergency departments (EDs) from three French university hospitals.
According to the medical professionals interviewed, the difficulties that they encounter with patients or their accompanying family members can be explained by a lack of understanding of the functioning of EDs, by a general increase in individualistic behaviours leading to a lack of civility or by deviant behaviours (related to toxic substance abuse or mental illness). While managing deviant behaviours may sometimes require a collective intervention, ED staff also implement what are essentially individual communication strategies (with the use of rational explanation, seduction and empathy), confrontation or flight to deal with interpersonal difficulties.
Strategies used by staff members tend to be individualised for the most part, and some, such as confrontational or escape strategies, may not be adapted to all situations. In the face of difficulties between staff and patients, mediators, specialised in resolving conflict, could entrust some cases to professionals.
ClinicalTrials.gov Registry (NCT03139110).
确定急诊医护人员在面对患者及其朋友和家属的紧张和人际暴力时所采取的策略。
基于 38 次半定式访谈的描述性定性研究。
医生、护士、护理助理和行政人员。
来自三家法国大学医院的四个急诊部（ED）。
根据接受采访的医疗专业人员的说法，他们在与患者或其陪同的家属打交道时遇到的困难可以用对 ED 运作的理解不足、个人主义行为的普遍增加导致缺乏礼貌或异常行为（与有毒物质滥用或精神疾病有关）来解释。在处理异常行为时，有时可能需要集体干预，急诊部工作人员还实施了本质上是个人沟通策略（使用理性解释、诱惑和同理心）、对抗或逃避来应对人际困难。
工作人员使用的策略在很大程度上是个体化的，有些策略，如对抗或逃避策略，可能并不适应所有情况。在工作人员和患者之间出现困难时，专门解决冲突的调解人可以将一些案件委托给专业人员。
ClinicalTrials.gov 注册（NCT03139110）。
