Erasmus School of Health Policy and Management, Erasmus University Rotterdam, Rotterdam, The Netherlands.
School of International and Public Affairs, Shanghai Jiao Tong University, Shanghai, China.
Hum Resour Health. 2024 May 27;22(1):34. doi: 10.1186/s12960-024-00914-z.
Aggression and violence by patient (and their relatives/friends) is widely acknowledged as a serious occupational hazard, with physicians being particularly susceptible to witnessing and experiencing such incidents within hospitals. Research has shown that the negative consequences of such aggression and violence are not only felt at the individual level, but also at the team and organizational levels. Understanding how to prevent and manage this behavior towards physicians in hospitals is urgent and not fully researched. While there are many potentially effective interventions, it is unclear which ones would be valuable and feasible for Chinese hospitals. Because patient aggression and violence may occur more frequently in Chinese hospitals than in other countries, this suggests that cultural differences play a role and that tailored interventions may be needed.
We conducted a Delphi study to reach a consensus on the importance and feasibility of hospital interventions to prevent and manage patient (and their relatives/friends) aggression and violence against physicians in Chinese hospitals. Seventeen experts in China were invited to complete online questionnaires over three rounds.
After three rounds, consensus was achieved concerning 44 interventions, five other interventions were rejected, and no consensus was reached on another two. These interventions were clustered into eight categories: environment design, access and entrance, staffing and working practices, leadership and culture, training and education, support, during/after-the-event actions, and hospital policy. Each category is considered important in preventing and managing patient (and their relatives/friends) aggression and violence towards physicians in Chinese hospitals. This study also investigated the feasibility of the suggested interventions and found that 36 of the 44 interventions were considered not only relevant, but also feasible for implementation in Chinese hospitals.
This study provides an overview of interventions that can be implemented in Chinese hospitals to prevent and manage patient (and their relatives/friends) aggression and violence before, during, and after a violent incident occurs.
患者（及其亲属/朋友）的攻击和暴力行为被广泛认为是一种严重的职业危害，医生尤其容易在医院目睹和经历此类事件。研究表明，这种攻击和暴力的负面影响不仅在个人层面感受到，而且在团队和组织层面也感受到。了解如何预防和管理医院内针对医生的此类行为是当务之急，而且尚未得到充分研究。虽然有许多潜在的有效干预措施，但尚不清楚哪些对中国医院有价值和可行。由于患者的攻击和暴力行为在中国医院可能比在其他国家更为频繁，这表明文化差异发挥了作用，可能需要量身定制的干预措施。
我们进行了一项德尔菲研究，以就中国医院预防和管理患者（及其亲属/朋友）针对医生的攻击和暴力行为的医院干预措施的重要性和可行性达成共识。邀请了中国的 17 名专家在三轮在线问卷中完成了调查。
三轮过后，有 44 项干预措施达成共识，另外 5 项干预措施被拒绝，还有 2 项干预措施未达成共识。这些干预措施被分为八类：环境设计、准入和入口、人员配备和工作实践、领导力和文化、培训和教育、支持、事件发生时/之后的行动以及医院政策。每一类都被认为在预防和管理中国医院内针对医生的患者（及其亲属/朋友）的攻击和暴力行为方面很重要。本研究还调查了所建议的干预措施的可行性，发现 44 项干预措施中有 36 项不仅被认为相关，而且在中国医院实施也是可行的。
本研究概述了可以在中国医院实施的干预措施，以在暴力事件发生之前、期间和之后预防和管理患者（及其亲属/朋友）的攻击和暴力行为。
