Wu Yuhan, Ahaus Kees, Shi Jiaming, Zhao Dahai, Buljac-Samardzic Martina
Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Rotterdam, The Netherlands.
School of Public Administration, Southwestern University of Finance and Economics, Chengdu, Sichuan, China.
Hum Resour Health. 2025 Jan 20;23(1):5. doi: 10.1186/s12960-025-00976-7.
The prevalence of patient (and their relatives/friends) aggression and violence against healthcare professionals in general, and physicians in particular, is a recognized problem worldwide. While numerous risk factors for such aggression and violence from patients (and their relatives/friends) have been identified, little is known about which risk factors are perceived as relatively most important in a specific context and among a particular group, and about the potentially differing views on the relative importance. This lack of insight prohibits preventive measures being tailored to address the main risk factors.
We conducted a Q-methodology study to investigate physicians' perspectives on risk factors for aggression and violence from patients (and their relatives/friends) against physicians in Chinese hospitals. A total of 33 physicians from public Chinese hospitals participated in this study and were asked to rank 30 risk factors according to their importance in triggering violent incidents. In addition, respondents were asked to explain their ranking of most and least important risk factors.
By employing a by-person factor analysis, four distinct perspectives on the importance of risk factors were identified: (1) unmet expectations of treatment and lack of resources; (2) perpetrator's educational background and personal characteristics; (3) distrust and limited protection measures; and (4) perpetrator's emotional well-being and poor interaction. There was a consensus across perspectives that failure to meet perpetrator's expectations is one of the most important risk factors and that physician's gender is one of the least important risk factors in the occurrence of patient (and their relatives/friends) aggression and violence against physicians in Chinese hospitals.
This study has identified four distinct perspectives held among physicians on the risk factors for patient aggression and violence against physicians in Chinese hospitals. These insights enable the development and prioritization of targeted measures to address specific risk factors according to the dominant views among physicians.
患者（及其亲属/朋友）对医护人员，尤其是医生实施攻击和暴力行为的现象在全球范围内都是一个公认的问题。虽然已经确定了许多导致患者（及其亲属/朋友）出现此类攻击和暴力行为的风险因素，但对于在特定背景下和特定群体中，哪些风险因素被认为相对最为重要，以及对于相对重要性可能存在的不同观点，人们知之甚少。这种认识上的不足阻碍了针对主要风险因素制定预防措施。
我们进行了一项Q方法研究，以调查中国医院中医生对患者（及其亲属/朋友）对医生实施攻击和暴力行为的风险因素的看法。共有33名来自中国公立医院的医生参与了本研究，并被要求根据30个风险因素在引发暴力事件中的重要性进行排序。此外，受访者还被要求解释他们对最重要和最不重要风险因素的排序。
通过进行个人因素分析，确定了关于风险因素重要性的四种不同观点：（1）治疗期望未得到满足和资源匮乏；（2）肇事者的教育背景和个人特征；（3）不信任和保护措施有限；（4）肇事者的情绪健康状况和互动不良。各观点一致认为，在中国医院中，未能满足肇事者的期望是最重要的风险因素之一，而医生的性别是患者（及其亲属/朋友）对医生实施攻击和暴力行为发生时最不重要的风险因素之一。
本研究确定了中国医院医生对患者对医生实施攻击和暴力行为的风险因素持有的四种不同观点。这些见解有助于根据医生中的主流观点制定针对性措施并确定其优先顺序，以应对特定风险因素。
