Department of Public Health and Paediatrics, University of Torino, Via Santena 5bis, 10126 Turin, Italy.
Int J Environ Res Public Health. 2022 Feb 18;19(4):2357. doi: 10.3390/ijerph19042357.
This systematic review and meta-analysis aimed to determine the prevalence of violence perpetrated by healthcare workers (HCWs) against patients in long-term care (LTC). For this purpose, five relevant databases were searched. Two reviewers extracted data from the included articles independently and assessed their quality. Overall and subgroup random-effects pooled prevalence meta-analyses were performed. A series of meta-analyses stratified by study quality were also performed due to high heterogeneity. Nineteen articles were included, physical restraint (22%; CI: 15-29), verbal abuse (22%; CI: 16-28), and neglect (20%; CI: 15-26) attained the highest overall prevalence, while sexual abuse was less reported (2%; CI: 1-3). The prevalence of witnessed violence is generally higher than those reported by HCWs, and patients and their relatives reported fewer cases of violence than HCWs. Differences in violence perpetrated among LTC settings were found. Neglect (64%; CI: 56-72) and financial abuse (7%; CI: 3-12) reported by HCWs were higher in home care, while verbal abuse (21%; CI: 7-39) reported by patients or their families was higher in nursing homes. Our findings highlight that violence perpetrated by HCWs toward patients represents a significant concern in LTC, suggesting the adoption of reliable monitoring approaches and provision of assistance to victims in reporting abuse.
本系统评价和荟萃分析旨在确定长期护理(LTC)中医疗保健工作者(HCWs)对患者实施暴力的普遍程度。为此,搜索了五个相关数据库。两位审稿人独立从纳入的文章中提取数据并评估其质量。对整体和亚组进行了随机效应汇总流行率荟萃分析。由于存在高度异质性,还对研究质量进行了分层的一系列荟萃分析。共纳入 19 篇文章,身体约束(22%;置信区间:15-29%)、言语虐待(22%;置信区间:16-28%)和忽视(20%;置信区间:15-26%)的总体流行率最高,而性虐待的报告较少(2%;置信区间:1-3%)。目睹暴力的普遍程度通常高于 HCWs 报告的程度,患者及其亲属报告的暴力事件少于 HCWs。还发现了 LTC 环境中实施的暴力行为存在差异。在家中护理中,HCWs 报告的忽视(64%;置信区间:56-72%)和财务虐待(7%;置信区间:3-12%)较高,而患者或其家属报告的言语虐待(21%;置信区间:7-39%)在养老院中较高。我们的研究结果表明,HCWs 对患者实施的暴力行为是 LTC 中一个重大问题,这表明需要采用可靠的监测方法,并为受害者提供报告虐待的援助。