Department of Socio-Health Sciences, Faculty of Medicine, University of Murcia, Murcia, Spain.
Applied Psychology Service, University of Murcia, Murcia, Spain.
Front Public Health. 2022 Jun 15;10:862896. doi: 10.3389/fpubh.2022.862896. eCollection 2022.
Some studies indicate that at least one in four cases of workplace violence occurs in the health sector, with a higher incidence in Emergency Departments, Mental Health Services or Primary Care. Unlike other professional groups, healthcare workers perceive this type of behavior mainly from users or patients. This is the reason why both the detection of conflict between users and professionals and the ways to face and reduce these conflicts has been and is one of the main fields of study in this population. The aim of this study was to delve into the sources of conflict between users and professionals in Primary Care from the perspective of the professionals themselves. In addition, the aim was to explore the proposals for intervention/prevention of this conflict that the professionals perceived as necessary to improve the work environment.
This study uses qualitative methodology conducting 8 focus groups with professionals related to Primary Health Care. The final sample was composed of 44 workers who were part of the regional management, labor unions, area coordinators, center coordinators and representatives of the professional groups of these centers (medicine, nursing and administration). Thematic analysis was used to extract topics and subtopics.
The results are divided into areas of conflict and intervention proposals. The professionals detect a lack of training or education in themselves, absence of functional multidisciplinary teams or competencies to improve the patient-professional relationship, among others. To address these shortcomings, they propose the creation of protocols for action in the face of aggression, the formation of spaces and channels of communication both among the center's own workers and between them and other organizations (e.g., hospitals), fostering a positive relationship with the user community and ongoing training in various topics such as self-safety, management of emotions, empathy or interpersonal communication.
This study allows to highlight specific areas of user-professional conflict in Primary Care. Furthermore, the inclusion of intervention proposals by the professionals allows to propose starting points for the development of complete plans.
一些研究表明，至少有四分之一的工作场所暴力事件发生在卫生部门，其中急诊部门、心理健康服务或初级保健部门的发生率更高。与其他专业群体不同，医疗保健工作者主要从用户或患者那里感知到这种行为。这就是为什么用户和专业人员之间的冲突的检测以及面对和减少这些冲突的方法一直是并且是该人群的主要研究领域之一。这项研究的目的是从专业人员自身的角度深入探讨初级保健中用户与专业人员之间冲突的根源。此外，目的是探讨专业人员认为有必要改善工作环境的干预/预防这种冲突的建议。
本研究采用定性方法，对与初级卫生保健相关的专业人员进行了 8 次焦点小组讨论。最终样本由 44 名工作人员组成，他们是区域管理层、工会、区域协调员、中心协调员和这些中心的专业人员代表（医学、护理和管理）。使用主题分析提取主题和子主题。
结果分为冲突领域和干预建议。专业人员发现自己缺乏培训或教育，缺乏职能多学科团队或改善医患关系的能力等。为了解决这些不足，他们提出了在面对攻击时制定行动方案、建立沟通空间和渠道的建议，包括中心内部工作人员之间以及他们与其他组织（如医院）之间的沟通，培养与用户社区的积极关系，并在各种主题（如自我安全、情绪管理、同理心或人际沟通）方面进行持续培训。
本研究可以突出初级保健中用户与专业人员之间具体的冲突领域。此外，专业人员提出的干预建议可以为制定完整计划提供起点。
