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中国患者对医生的攻击和暴力行为对团队及组织层面的影响:一项定性研究

Impact of patient aggression and violence against physicians on the team and organisational levels in China: a qualitative study.

作者信息

Wu Yuhan, Ahaus Kees, Zhao Dahai, Buljac-Samardzic Martina

机构信息

Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Rotterdam, The Netherlands

Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Rotterdam, The Netherlands.

出版信息

BMJ Open. 2025 May 28;15(5):e092229. doi: 10.1136/bmjopen-2024-092229.

Abstract

OBJECTIVES

Aggression and violence against physicians in hospitals is acknowledged to be an issue, and patients (and their relatives/friends) have been identified as the most prevalent source. The aim of this study is to investigate the impact of patient aggression and violence against physicians on the team and organisational levels.

DESIGN

This is a qualitative interview study based on semistructured, in-depth individual interviews. Interview transcripts were coded and analysed in Atlas.ti.

SETTING

Interviews were conducted in Chinese hospitals.

PARTICIPANTS

This study involved 29 diverse participants, including physicians, hospital team leaders and hospital board members, working in two secondary hospitals and two tertiary hospitals in China.

RESULTS

This study found that, at the team level, aggression and violence by patients (and their relatives/friends) can affect team climate, team communication, team beliefs and team resources. At the organisational level, such aggression and violence can have negative financial impacts (ie, involving compensation and additional costs) and societal impacts (ie, image and reputational damage, and public distrust). Although peer support and leaders' support were identified as important sources for physicians to deal with violent incidents, these sources were not used to their full potential.

CONCLUSIONS

Recovering a team climate after a violent incident and providing diverse forms of support, especially proactive support from leaders and peers, represent two important approaches to cope with the negative impact of patient (and their relatives/friends) aggression and violence against physicians on both team and organisational levels.

摘要

目的

医院内针对医生的攻击和暴力行为被公认为是一个问题,患者(及其亲属/朋友)被确定为最主要的源头。本研究的目的是调查患者对医生的攻击和暴力行为在团队和组织层面的影响。

设计

这是一项基于半结构化、深入的个人访谈的定性访谈研究。访谈记录在Atlas.ti中进行编码和分析。

地点

在中国医院进行访谈。

参与者

本研究涉及29名不同的参与者,包括在中国两家二级医院和两家三级医院工作的医生、医院团队领导和医院董事会成员。

结果

本研究发现,在团队层面,患者(及其亲属/朋友)的攻击和暴力行为会影响团队氛围、团队沟通、团队信念和团队资源。在组织层面,此类攻击和暴力行为会产生负面的财务影响(即涉及赔偿和额外成本)和社会影响(即形象和声誉受损以及公众信任度下降)。尽管同伴支持和领导支持被认为是医生应对暴力事件的重要来源,但这些来源并未得到充分利用。

结论

在暴力事件后恢复团队氛围并提供多种形式的支持,尤其是来自领导和同伴的积极支持,是应对患者(及其亲属/朋友)对医生的攻击和暴力行为在团队和组织层面产生的负面影响的两种重要方法。

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