Spencer Cara, Loehr Kelsey, Byrd Abby
UCHealth, Aurora, CO, USA.
Children's Hospital Colorado, Aurora, CO, USA.
SAGE Open Nurs. 2023 Mar 9;9:23779608231158970. doi: 10.1177/23779608231158970. eCollection 2023 Jan-Dec.
Verbal violence may manifest in written form as cyber incivility within patient portal communications. As a form of digital technology, patient portal messages create a physical and emotional distance leading the sender to be disinhibited and disassociated from the recipient nurse. Written patient portal messages may contain uncivil language deemed verbally violent when the content escalates beyond professional standards. When these messages are encountered as part of patient care, they may lead to nurses' psychological distress. Although cyber-incivility has been studied within social media and business, little is known about cyber-incivility within healthcare.
The purpose of the study was to define cyber-incivility as it manifests within healthcare compared to business, determine sender demographics, and quantify the impact on nurses.
A cross-sectional descriptive study was conducted to analyze portal communications. Nurses forwarded aggressive messages to leadership and quantified their level of distress after receiving the message. Sender demographics were tracked, and content was analyzed using Braun and Clarke's Thematic Analysis.
Of the 31 included messages, senders were of varying ages, genders, and marital statuses. Messages rarely related to medications and rarely contained expletives. The most distressing messages were ad hominem, demanding, accusatory, or contained threats. These messages illustrated how healthcare cyber-incivility manifested and deviated from appropriate professional standards to become a form of verbal workplace violence. Message content also identified antecedents; related to unmet expectations, patient accountability, or difficulty navigating healthcare.
Written incivil/uncivil/aggressive patient portal messages contained personal attacks and professionally degrading content, which were distressing to nurses. A healthcare-specific framework was created and provided context to understand the difficult and aggressive messages nurses received while providing digital patient care. Awareness of cyber-incivility within healthcare allows for better support of nurses who are exposed to this form of workplace violence and is foundational to future intervention development.
言语暴力可能以网络不文明的书面形式出现在患者门户网站通信中。作为一种数字技术形式，患者门户网站消息造成了身体和情感上的距离，导致发送者不受抑制，并与接收消息的护士脱节。当书面的患者门户网站消息内容升级到超出专业标准时，可能包含被视为言语暴力的不文明语言。当这些消息作为患者护理的一部分出现时，可能会导致护士的心理困扰。尽管网络不文明行为已在社交媒体和商业领域得到研究，但对于医疗保健领域的网络不文明行为却知之甚少。
本研究的目的是将医疗保健领域中出现的网络不文明行为与商业领域中的进行定义区分，确定发送者的人口统计学特征，并量化其对护士的影响。
进行了一项横断面描述性研究，以分析门户网站通信。护士将攻击性消息转发给领导层，并在收到消息后对他们的困扰程度进行量化。跟踪发送者的人口统计学特征，并使用布劳恩和克拉克的主题分析法对内容进行分析。
在纳入的31条消息中，发送者的年龄、性别和婚姻状况各不相同。消息很少与药物相关，也很少包含咒骂语。最令人困扰的消息是人身攻击、苛求、指责或包含威胁的消息。这些消息说明了医疗保健领域的网络不文明行为是如何表现出来的，以及如何偏离适当的专业标准而成为一种言语工作场所暴力形式。消息内容还确定了前因；与未满足的期望、患者责任或医疗保健导航困难有关。
书面的不文明/攻击性患者门户网站消息包含人身攻击和专业上有辱人格的内容，这让护士感到困扰。创建了一个针对医疗保健领域的框架，并提供了背景信息，以理解护士在提供数字患者护理时收到的困难和攻击性消息。对医疗保健领域网络不文明行为的认识有助于更好地支持遭受这种工作场所暴力形式的护士，并且是未来干预措施发展的基础。
