Provincial Health Department, Niassa Operational Research Unit, Niassa Province, Lichinga, Mozambique.
Research Center on Global Health and Tropical Medicine, Instituto de Higiene e Medicina Tropical, Universidade Nova de Lisboa, Lisbon, Portugal.
Int J Health Plann Manage. 2022 Sep;37(5):2822-2835. doi: 10.1002/hpm.3506. Epub 2022 Jul 6.
Recognition of the relevance of violence against health workers in their work place has been growing around the world. In Mozambique, workplace violence in the health sector needs better documentation. Therefore, this article is part of a study that describes the typology and the perceived impact of violence against health care workers in their workplace at the Lichinga Provincial Hospital and at the Health Centre of the City of Lichinga in 2019.
This was an observational, descriptive, cross-sectional study. The study was carried out in a simple random sample of health workers victims of violence at the Provincial Hospital and the Health Centre of the City of Lichinga, in the Province of Niassa in northern Mozambique. The questionnaire applied was adapted from the original developed by the International Labour Organization, the International Council of Nurse, the World Health Organization and Public Services International and applied in Maputo, Mozambique during 2002. Statistical analysis was carried out with Statistical Package for the Social Sciences 20.0 and WinPepi 11.65.
Two hundred and 60 healthcare workers (HCW) were selected to participate, 180 agreed, 145 had inclusion criteria and five gave up participating in the study during the consent procedure. Thus, a total of 140 HCW answered the questionnaire. Predominant types of violence were: verbal threat/aggression 34% (n = 62/180); moral pressure/bullying/mobbing 30% (n = 54/180); ethnic discrimination 9% (n = 16/180); against personal property 6% (n = 10/180); physical 4% (n = 8/180); sexual harassment 4% (n = 8/180). One hundred and 37 victims reported 154 episodes of violence, where 7% (n = 13/180) reported more than one type of violence. Most victims reported no reaction (55%, n = 76/137) and few said that they confronted the offender (16%, n = 22/137, particularly victims of sexual harassment, 38%, n = 3/8). Most HCW reported non-existence (39%, n = 54/137) or unawareness (32%, n = 44/137) of procedures to report violence within the Institution. Most (80%, n = 33/41) of those knowing about the procedures, knew how to use them. More than half (55%; n = 76/137) of HCW said that they were discouraged to report acts of violence.
Like for previous studies in Mozambique and elsewhere in Africa, the study confirms: a relatively high prevalence, a reluctance to talk about the issue and unawareness about procedures on how to report incidents. The findings reconfirm the necessity for the development and implementation of procedures to address violence incidents towards HCW, to develop support services for victims of health workplace violence. Like elsewhere in Africa, successive health workforce plans in Mozambique have failed to address this issue.
在世界各地，人们对工作场所暴力侵害卫生工作者这一问题的认识正在不断提高。在莫桑比克，需要更好地记录卫生部门的工作场所暴力事件。因此，本文是 2019 年在楠普拉省立医院和利欣加市卫生中心对卫生工作者在工作场所遭受暴力侵害的类型和感知影响进行描述的研究的一部分。
这是一项观察性、描述性、横断面研究。研究对象是在楠普拉省立医院和利欣加市卫生中心工作的卫生工作者，他们是暴力的受害者，这些受害者是在莫桑比克楠普拉省北部的利欣加市的简单随机样本中选出的。应用的问卷是由国际劳工组织、国际护士理事会、世界卫生组织和国际公共服务协会开发的原始问卷改编而来，并于 2002 年在莫桑比克马普托应用。统计分析使用社会科学统计软件包 20.0 和 WinPepi 11.65 进行。
共选择了 260 名卫生保健工作者（HCW）参加，180 人同意，145 人符合纳入标准，5 人在同意过程中放弃参加研究。因此，共有 140 名 HCW 回答了问卷。主要类型的暴力行为有：言语威胁/攻击 34%（n=62/180）；道德压力/欺凌/骚扰 30%（n=54/180）；族裔歧视 9%（n=16/180）；侵犯个人财产 6%（n=10/180）；身体暴力 4%（n=8/180）；性骚扰 4%（n=8/180）。137 名受害者报告了 154 起暴力事件，其中 7%（n=13/180）报告了不止一种类型的暴力。大多数受害者没有反应（55%，n=76/137），少数人表示他们与犯罪者对质（16%，n=22/137，特别是性骚扰的受害者，38%，n=3/8）。大多数 HCW 报告说（39%，n=54/137）或不知道（32%，n=44/137）在机构内报告暴力的程序。那些了解这些程序的人中，大多数（80%，n=33/41）知道如何使用这些程序。超过一半（55%；n=76/137）的 HCW 表示，他们报告暴力行为的积极性受挫。
与莫桑比克和非洲其他地方的先前研究一样，这项研究证实：相对较高的发生率、不愿谈论这个问题以及对如何报告事件的程序缺乏认识。调查结果再次证实，有必要制定和实施处理卫生工作者遭受暴力侵害事件的程序，为卫生工作场所暴力侵害的受害者提供支持服务。与非洲其他地方一样，莫桑比克的连续卫生人力计划都未能解决这个问题。
