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探索护士报告患者及访客暴力行为的障碍与促进因素:一项中国的横断面研究。

Exploring barriers and facilitators in nurses' reporting of patient and visitor violence: a cross-sectional study in China.

作者信息

Cai Jianzheng, Ying Yajie, Wang Haifang, Yu Weixia, Wu Sisi, Zhang Yingying, Wang Yalan

机构信息

Department of Nursing, First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China.

School of Nursing, Soochow University Medical College, Suzhou, Jiangsu, China.

出版信息

BMJ Open. 2024 Dec 9;14(12):e091232. doi: 10.1136/bmjopen-2024-091232.

Abstract

OBJECTIVES

The current status of patient and visitor violence (PVV) reporting among nurses has proven insufficient. Therefore, we explored the barriers and facilitators in nurses' reporting of PVV.

DESIGN

Cross-sectional study.

SETTING

General and specialised hospitals in Jiangsu Province, China.

PARTICIPANTS

A convenience sampling of 3363 nurses in Jiangsu Province was collected between January and July 2023.

MAIN OUTCOME MEASURE

The reporting rate of PVV was assessed by the hospital workplace violence questionnaire-revised version; multivariable logistic regression analyses were performed to determine factors associated with PVV reporting at the 5% significance level.

RESULTS

Out of the 3363 surveyed nurses, 1813 (53.9%) reported experiencing PVV within the past year. Notably, only 16.1% of these nurses proactively reported PVV incidents after encountering them. Factors that facilitated reporting of PVV comprised being male (OR 1.832, 95% CI 1.083 to 3.101), working in specialised hospitals (OR 2.335, 95% CI 1.517 to 3.594), serving in emergency (OR 1.788, 95% CI 1.105 to 2.892), outpatient (OR 3.153, 95% CI 1.697 to 5.860), paediatrics (OR 3.808, 95% CI 1.976 to 7.338), possessing agreeableness personality (OR 2.112, 95% CI 1.140 to 3.911), prior hearing of PVV (OR 1.749, 95% CI 1.305 to 2.346) and having hospitals that actively encouraged reporting (OR 2.700, 95% CI 1.848 to 3.946) while safeguarding staff interests (OR 2.072, 95% CI 1.010 to 4.248) and emphasising nurses more (OR 2.109, 95% CI 1.123 to 3.958). Conversely, factors impeding nurses from reporting PVV included having night shifts 5-9 times per month (OR 0.481, 95% CI 0.282 to 0.819) and selectively reporting based on the severity of the violence (OR 0.550, 95% CI 0.344 to 0.878).

CONCLUSION

The reporting rate of PVV among nurses was notably low. Nursing managers should consider implementing comprehensive measures that address both the facilitating and blocking factors identified in the study. This strategic approach aims to enhance the reporting rate of PVV incidents among nurses, fostering a safer and more supportive environment within healthcare settings.

摘要

目的

事实证明,护士报告患者及访客暴力行为(PVV)的现状并不理想。因此,我们探讨了护士报告PVV行为的障碍和促进因素。

设计

横断面研究。

地点

中国江苏省的综合医院和专科医院。

参与者

2023年1月至7月间,对江苏省3363名护士进行便利抽样。

主要观察指标

采用医院工作场所暴力问卷修订版评估PVV报告率;进行多变量逻辑回归分析,以确定在5%显著性水平下与PVV报告相关的因素。

结果

在3363名接受调查的护士中,1813名(53.9%)报告在过去一年中遭遇过PVV。值得注意的是,这些护士中只有16.1%在遭遇PVV事件后主动报告。促进PVV报告的因素包括男性(比值比[OR]1.832,95%置信区间[CI]1.083至3.101)、在专科医院工作(OR 2.335,95%CI 1.517至3.594)、在急诊科工作(OR 1.788,95%CI 1.105至2.892)、门诊工作(OR 3.153,95%CI 1.697至5.860)、儿科工作(OR 3.808,95%CI 1.976至7.338)、具有宜人性人格(OR 2.112,95%CI 1.140至3.911)、之前听说过PVV(OR 1.749,95%CI 1.305至2.346)以及所在医院积极鼓励报告(OR  2.700,95%CI 1.848至3.946),同时保障员工利益(OR 2.072,95%CI 1.010至4.248)并更重视护士(OR 2.109,95%CI 1.123至3.958)。相反,阻碍护士报告PVV的因素包括每月值5至9次夜班(OR 0.481,95%CI 0.282至0.819)以及根据暴力严重程度选择性报告(OR 0.550,95%CI 0.344至0.878)。

结论

护士中PVV的报告率极低。护理管理者应考虑采取综合措施,解决本研究中确定的促进因素和阻碍因素。这种战略方法旨在提高护士中PVV事件的报告率,在医疗机构内营造一个更安全、更具支持性的环境。

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