Abstract：
Workplace violence (WPV) is a commonly reported occupational hazard in healthcare and its prevalence is increasing. WPV occurs in all types of practice settings, but little is known about WPV in primary care settings in the United States (US). Because primary care practice settings differ from the inpatient settings, further examination of WPV in primary care is warranted. Our objective was to summarize the available literature highlight important gaps. We conducted a search using Pubmed and OVID for US studies of WPV in US-based adult primary care practices. Studies including only pediatric populations were excluded. Due to the lack of available literature conducted in US primary care settings, we expanded our search to include international studies. We identified 70 studies of which 5 were US based. Due to the lack of significant numbers of US-based studies, we opted to conduct a narrative review of all available studies. The evidence shows that WPV is a common occurrence in primary care settings in many countries and that the majority of primary care clinicians have experienced at least some form of non-physical violence in their careers. Most of the studies conducted were cross-sectional in design and reported on both non-physical and physical forms of WPV. There was not a consistent trend between genders in experiencing the major forms of WPV, but women were consistently more likely to be subjected to sexual harassment. Potential root causes for WPV could generally be categorized as patient-level, clinician-level, clinical encounter specific, and operational root causes. While most WPV was found to be non-physical, it still had significant emotional and job-related impacts on clinicians. These troubling results highlight the need for further studies to be conducted in the US.
摘要：
工作场所暴力（WPV）是医疗保健中常见的职业危害，其患病率正在增加。WPV发生在所有类型的练习设置中，但对美国(US)初级保健机构中的WPV知之甚少。由于初级护理实践设置与住院设置不同，有必要在初级保健中进一步检查WPV.我们的目标是总结现有文献，突出重要的差距。我们使用Pubmed和OVID对美国成人初级保健实践中WPV的美国研究进行了搜索。仅包括儿科人群的研究被排除。由于缺乏在美国初级保健机构中进行的可用文献，我们扩大了搜索范围，包括国际研究。我们确定了70项研究，其中5项是基于美国的。由于缺乏大量基于美国的研究，我们选择对所有现有研究进行叙述性回顾.证据表明，WPV在许多国家的初级保健机构中很常见，大多数初级保健临床医生在其职业生涯中至少经历过某种形式的非身体暴力。进行的大多数研究都是横截面设计，并报告了WPV的非物理和物理形式。在经历WPV的主要形式时，性别之间没有一致的趋势，但是女性更容易受到性骚扰。WPV的潜在根本原因通常可以归类为患者级别，临床医生级别，临床接触特异性，和运营根本原因。虽然大多数WPV被发现是非物理的，它仍然对临床医生有显著的情绪和工作相关影响.这些令人不安的结果凸显了在美国进行进一步研究的必要性。
