Fatai Aekkachai, Talerd Wannachart, Siriprathum Sittipong, Karaket Anusorn
J Emerg Nurs. 2025 Sep;51(5):961-971. doi: 10.1016/j.jen.2025.04.007. Epub 2025 May 22.
Workplace violence in health care settings, especially in emergency departments, is a significant concern worldwide. Both physical and psychological violence affect emergency nurses as frontliners. This integrative review aimed to synthesize the literature on the factors contributing to workplace violence in Thai emergency departments.
This study was conducted using Whittemore and Knafl's framework. A search strategy used 7 databases, including PubMed, CINAHL, ERIC, PsycINFO, MEDLINE, Google Scholar, and ThaiJo, covering articles from 2014 to 2024. Eleven studies were included in the final review. Data were extracted into individual, patient, environmental, organizational, and Thai cultural factors.
The results suggested that nurses with less than 10 years of experience had a high risk of workplace violence. Patient-related factors, such as substance abuse and mental health conditions such as schizophrenia, bipolar disorder, and severe depression, were significant contributors to violence. Environmental factors such as overcrowding, understaffing, and a lack of security measures exacerbated the risk. Organizational issues, such as insufficient procedures and reporting systems, increased the violence, given that the lack of reporting mechanisms allowed violence to go unaddressed, worsening workplace safety. Cultural factors in Thailand, such as a lack of understanding of patient screening severity, contribute to the complexity of workplace violence.
Addressing workplace violence in Thai emergency departments requires a multifaceted approach, including policy reforms, staff training, improved security, and cultural sensitivity. Effective interventions can lead to safer working environments for nurses and improved patient care.
医疗保健场所的工作场所暴力，尤其是在急诊科，是全球范围内的一个重大问题。身体暴力和心理暴力都会影响作为一线人员的急诊护士。本整合性综述旨在综合有关泰国急诊科工作场所暴力促成因素的文献。
本研究采用惠特莫尔和克纳夫的框架进行。检索策略使用了7个数据库，包括PubMed、CINAHL、ERIC、PsycINFO、MEDLINE、谷歌学术和泰国期刊数据库，涵盖2014年至2024年的文章。最终综述纳入了11项研究。数据被提取为个人、患者、环境、组织和泰国文化因素。
结果表明，经验不足10年的护士遭受工作场所暴力的风险较高。与患者相关的因素，如药物滥用以及精神健康状况（如精神分裂症、双相情感障碍和重度抑郁症）是暴力的重要促成因素。过度拥挤、人员不足和缺乏安全措施等环境因素加剧了风险。组织问题，如程序和报告系统不足，增加了暴力事件的发生，因为缺乏报告机制使得暴力行为得不到处理，从而恶化了工作场所安全状况。泰国的文化因素，如对患者筛查严重性缺乏理解，也导致了工作场所暴力的复杂性。
解决泰国急诊科的工作场所暴力问题需要采取多方面的方法，包括政策改革、员工培训、加强安全保障和文化敏感性。有效的干预措施可以为护士创造更安全的工作环境，并改善患者护理。
