Pastor L H
George Washington University School of Medicine, Washington, D.C., USA.
Am Fam Physician. 1995 Sep 15;52(4):1169-74.
Homicide is now the cause of 12 percent of deaths in the workplace, and workplace violence by disgruntled employees or former employees continues to increase. The family physician may be the first or only professional to examine such persons before an act of violence occurs. The assessment of a potentially violent employee includes evaluating for threats, a history of violence, paramilitary interests, access to weapons, paranoia, substance abuse and a sense of having no future or no alternative to violence. A shame-rage cycle that may include a sense of evernarrowing options often precedes the violent act and may reveal warning signs that represent potential opportunities for intervention before the act is committed. Initial interventions include ensuring the immediate safety of potential victims, initiating measures to reduce acute shame and rage in the person at risk and facilitating an effective referral. Preventive strategies at the organizational level include preemployment screening, explicit nonharassment policies, employee counseling, physical security measures and the establishment of an organizational clearinghouse for reporting and assessing threatening behaviors.
如今，杀人已成为职场中12%死亡事件的死因，心怀不满的在职或离职员工引发的职场暴力事件仍在不断增加。家庭医生可能是暴力行为发生前首个或唯一检查此类人员的专业人员。对有潜在暴力倾向的员工进行评估包括评估其是否有威胁行为、暴力史、准军事兴趣、获取武器的途径、偏执狂、药物滥用情况以及有无前途或除暴力外别无选择的感觉。暴力行为发生前往往会出现一种羞耻-愤怒循环，其中可能包括选择越来越少的感觉，这可能会揭示一些警示信号，这些信号代表着在暴力行为实施前进行干预的潜在机会。初步干预措施包括确保潜在受害者的即时安全、采取措施减轻高危人员的急性羞耻感和愤怒情绪并促成有效的转诊。组织层面的预防策略包括入职前筛查、明确的无骚扰政策、员工咨询、实体安全措施以及设立一个用于报告和评估威胁行为的组织信息中心。
