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干预措施对健康和支持专业人员遭受工作场所暴力的有效性:一项荟萃分析。

Effectiveness of the interventions against workplace violence suffered by health and support professionals: A meta-analysis.

机构信息

Universidade Federal do Paraná, Complexo Hospital de Clínicas, Unidade Cirúrgica, Curitiba, PR, Brasil.

Universidade Estadual de Londrina, Departamento de Enfermagem, Londrina, PR, Brasil.

出版信息

Rev Lat Am Enfermagem. 2022;30:e3638. doi: 10.1590/1518-8345.5923.3638.

Abstract

OBJECTIVE

to assess the effectiveness of the interventions targeted at preventing and reducing the workplace violence suffered by health and support professionals.

METHOD

a systematic review with meta-analysis conducted in eight databases and in the gray literature. Risk of bias was assessed by means of the Cochrane tools and certainty of the evidence, through Grading of Recommendations Assessment, Development and Evaluation. The analysis was performed in a descriptive manner and through the meta-analysis, including a heterogeneity assessment.

RESULTS

a total of 11 randomized and quasi-randomized studies were eligible, of which six (54.5%) implemented individual skills, four used a multiple approach (36.4%) and one (9.1%) resorted to governmental actions. Four studies (36.4%) exerted a positive and significant effect on reducing violence. Risk of bias was classified as high or uncertain. The meta-analysis was performed with two studies that tested individual skill (intervention group) versus individual skill (comparator group), although there was no scientific evidence (95% CI: -0.41 - 0.25, p=0.64) for the violence prevention/reduction outcome.

CONCLUSION

this review did not obtain a high level of evidence in the prevention or reduction of workplace violence. The reduced number of randomized trials, the lack of studies with low risk of bias and the high consistency may have been factors that hindered recommending effective interventions.

摘要

目的

评估针对预防和减少卫生和支持专业人员遭受工作场所暴力的干预措施的有效性。

方法

在八个数据库和灰色文献中进行系统评价和荟萃分析。通过 Cochrane 工具评估偏倚风险,并通过推荐评估、制定和评估分级评估证据的确定性。分析以描述性方式进行,并通过荟萃分析进行,包括异质性评估。

结果

共有 11 项随机和准随机研究符合条件,其中 6 项(54.5%)实施了个体技能,4 项采用了多种方法(36.4%),1 项(9.1%)采取了政府行动。四项研究(36.4%)对减少暴力产生了积极和显著的影响。偏倚风险被归类为高或不确定。荟萃分析使用了两项研究,测试了个体技能(干预组)与个体技能(对照组),尽管没有科学证据(95%置信区间:-0.41-0.25,p=0.64)表明干预措施可以预防/减少暴力。

结论

本综述在预防或减少工作场所暴力方面没有获得高水平的证据。随机试验数量减少、低偏倚风险研究缺乏以及高一致性可能是阻碍推荐有效干预措施的因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/70a9/9364778/f6b182a083c3/1518-8345-rlae-30-e3638-gf4.jpg

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