Hobbs F D
Department of General Practice, University of Birmingham.
Br J Gen Pract. 1994 Sep;44(386):390-4.
Relatively few data exist on the scale of aggression from patients or patients' relatives suffered by doctors at work. Such aggression might be expected to pose considerable risks of continued morbidity among abused practitioners.
This study set out to survey the continued levels of intimidation experienced by general practitioners who had suffered a previous episode of aggression.
A retrospective survey was carried out of all general practitioners in the West Midlands Health Authority region, using a piloted postal questionnaire. Of the 2694 surveyed 1093 (41%) responded. Among responding doctors, 687 (63%) had suffered some degree of aggression in the previous 12 months, and these respondents reported on the degree of intimidation experienced during specified clinical duties.
Nearly three quarters of previously abused doctors did, at times, express ongoing fears for their safety at work. Indeed, 71% of doctors who qualified in India and Pakistan and 57% of doctors who qualified in the United Kingdom experienced some degree of intimidation within their surgery (90% and 73%, respectively, on night visits). Fear was most commonly reported during visits made out of hours with mild fear being occasionally experienced between 19.00 and 23.00 hours by 316 (56%) of the responding abused doctors and after 23.00 hours by 286 (51%). Eleven respondents (2%) were frequently severely fearful on evening visits and 15 (3%) were always fearful. On night visits frequent severe fear was reported by eight respondents (1%), while 31 were always fearful (6%). The differences between men and women doctors were relatively small within the surgery, but during out-of-hours calls women were significantly more likely to report intimidation than men practitioners and to report significantly higher levels of severity of fear.
These findings support further consideration of the contractual commitment for general practitioners to provide out-of-hours visiting, of investment in safer surgeries and of greater provision of in-service training in handling aggression and its attendant stress.
关于医生在工作中遭受患者或患者亲属攻击的规模,相关数据相对较少。这种攻击可能会给受虐从业者带来持续发病的相当大风险。
本研究旨在调查曾遭受过攻击事件的全科医生所持续经历的恐吓程度。
对西米德兰兹郡卫生局辖区内的所有全科医生进行了一项回顾性调查,使用了经过试点的邮寄问卷。在2694名被调查者中,1093人(41%)做出了回应。在做出回应的医生中,687人(63%)在过去12个月里遭受了某种程度的攻击,这些受访者报告了在特定临床工作期间所经历的恐吓程度。
近四分之三曾受虐的医生有时确实会表达对其工作安全的持续担忧。事实上,在印度和巴基斯坦获得资格的医生中有71%,在英国获得资格的医生中有57%在其诊疗室经历了某种程度的恐吓(夜间出诊时分别为90%和73%)。恐惧最常出现在非工作时间出诊时,316名(56%)做出回应的受虐医生偶尔在19:00至23:00之间会感到轻微恐惧,286名(51%)在23:00之后会感到轻微恐惧。11名受访者(2%)在夜间出诊时经常极度恐惧,15名(3%)总是感到恐惧。在夜间出诊时,8名受访者(1%)报告经常极度恐惧,31名(6%)总是感到恐惧。在诊疗室内,男女医生之间的差异相对较小,但在非工作时间出诊时,女性比男性从业者更有可能报告受到恐吓,并且报告的恐惧严重程度明显更高。
这些发现支持进一步考虑全科医生提供非工作时间出诊的合同承诺、对更安全诊疗室的投资以及增加处理攻击行为及其伴随压力的在职培训。