Peel Regional Paramedic Services, 1600 Bovaird Drive East, Brampton, ON L6V 4R5, Canada.
Faculty of Health Sciences, Queen's University, 99 University Avenue, Kingston, ON K7L 3N6, Canada.
Int J Environ Res Public Health. 2024 Mar 19;21(3):363. doi: 10.3390/ijerph21030363.
Violence against paramedics is increasingly recognized as an important occupational health problem, but pervasive and institutionalized underreporting hinders efforts at risk mitigation. Earlier research has shown that the organizational culture within paramedicine may contribute to underreporting, and researchers have recommended involving paramedics in the development of violence prevention policies, including reporting systems. Eighteen months after the launch of a new violence reporting system in Peel Region, Ontario, Canada, we surveyed paramedics about their experiences reporting violent encounters. Our objectives were to assess their willingness to report violence and explore factors that influence their decisions to file a report. Between September and December 2022, a total of 204 (33% of eligible) paramedics chose to participate, of whom 67% (N = 137) had experienced violence since the launch of the new reporting process, with 83% (N = 114) reporting the incidents at least some of the time. After thematically analyzing free-text survey responses, we found that the participants cited the accessibility of the new reporting process and the desire to promote accountability among perpetrators while contributing to a safer workplace as motivating factors. Their decisions to file a report, however, could be influenced by the perceived 'volitionality' and severity of the violent encounters, particularly in the context of (un)supportive co-workers and supervisors. Ultimately, the participants' belief that the report would lead to meaningful change within the service was a key driver of reporting behavior.
针对医护人员的暴力行为日益被视为一个重要的职业健康问题,但普遍存在且制度化的漏报现象阻碍了风险缓解工作的开展。早期的研究表明,急救医学领域内的组织文化可能导致漏报现象,研究人员建议让急救人员参与制定暴力预防政策,包括报告制度。在加拿大安大略省皮尔地区推出新的暴力报告系统 18 个月后,我们调查了医护人员报告暴力遭遇的经历。我们的目的是评估他们报告暴力事件的意愿,并探讨影响他们报告决定的因素。在 2022 年 9 月至 12 月期间,共有 204 名(符合条件的 33%)医护人员选择参与,其中 67%(N=137)自新报告流程启动以来经历过暴力事件,83%(N=114)至少有时报告了这些事件。在对自由文本调查回复进行主题分析后,我们发现,参与者提到新报告流程的可及性以及希望在促进肇事者问责制的同时为更安全的工作场所做出贡献,这是他们报告的动机因素。然而,他们报告的决定可能会受到暴力遭遇的感知“意愿性”和严重程度的影响,特别是在同事和主管不支持的情况下。最终,参与者认为报告将导致服务内部发生有意义的变化,这是报告行为的一个关键驱动因素。