PDF(Pubmed)
Abstract：
BACKGROUND: Conflicts with patients and relatives occur frequently in intensive care units (ICUs), driven by factors that are intensified by critical illness and its treatments. A majority of ICU healthcare professionals have experienced verbal and/or physical violence. There is a need to understand how healthcare professionals in ICUs experience and manage this workplace violence.
METHODS: A qualitative descriptive analysis of four hospitals in Sweden was conducted using semi-structured focus-group interviews with ICU healthcare professionals.
RESULTS: A total of 34 participants (14 nurses, 6 physicians and 14 other staff) were interviewed across the four hospitals. The overarching theme: \"The paradox of violence in healthcare\" illustrated a normalisation of violence in ICU care and indicated a complex association between healthcare professionals regarding violence as an integral aspect of caregiving, while simultaneously identifying themselves as victims of this violence. The healthcare professionals described being poorly prepared and lacking appropriate tools to manage violent situations. The management of violence was therefore mostly based on self-taught skills.
CONCLUSIONS: This study contributes to understanding the normalisation of violence in ICU care and gives a possible explanation for its origins. The paradox involves a multifaceted approach that acknowledges and confronts the structural and cultural dimensions of violence in healthcare. Such an approach will lay the foundations for a more sustainable healthcare system.
METHODS: A qualitative descriptive analysis of four hospitals in Sweden was conducted using semi-structured focus-group interviews with ICU healthcare professionals.
RESULTS: A total of 34 participants (14 nurses, 6 physicians and 14 other staff) were interviewed across the four hospitals. The overarching theme: \"The paradox of violence in healthcare\" illustrated a normalisation of violence in ICU care and indicated a complex association between healthcare professionals regarding violence as an integral aspect of caregiving, while simultaneously identifying themselves as victims of this violence. The healthcare professionals described being poorly prepared and lacking appropriate tools to manage violent situations. The management of violence was therefore mostly based on self-taught skills.
CONCLUSIONS: This study contributes to understanding the normalisation of violence in ICU care and gives a possible explanation for its origins. The paradox involves a multifaceted approach that acknowledges and confronts the structural and cultural dimensions of violence in healthcare. Such an approach will lay the foundations for a more sustainable healthcare system.
摘要：
背景：重症监护病房（ICU）经常发生与患者和亲属的冲突，由危重病及其治疗加剧的因素驱动。大多数ICU医疗保健专业人员都经历过口头和/或身体暴力。有必要了解ICU中的医疗保健专业人员如何体验和管理这种工作场所暴力。
方法：使用与ICU医疗保健专业人员的半结构化焦点小组访谈，对瑞典的四家医院进行了定性描述性分析。
结果：共有34名参与者（14名护士，对四家医院的6名医生和14名其他工作人员)进行了采访。总体主题：“医疗保健中的暴力悖论”说明了ICU护理中暴力的正常化，并表明了医疗保健专业人员之间的复杂关联，将暴力视为护理的一个组成部分。同时认定自己是这种暴力的受害者。医疗保健专业人员描述了准备不足，缺乏管理暴力局势的适当工具。因此，暴力管理主要基于自学成才的技能。
结论：这项研究有助于理解ICU护理中暴力的正常化，并为其起源提供了可能的解释。悖论涉及多方面的方法，承认并面对医疗保健中暴力的结构和文化层面。这种方法将为更可持续的医疗保健系统奠定基础。
方法：使用与ICU医疗保健专业人员的半结构化焦点小组访谈，对瑞典的四家医院进行了定性描述性分析。
结果：共有34名参与者（14名护士，对四家医院的6名医生和14名其他工作人员)进行了采访。总体主题：“医疗保健中的暴力悖论”说明了ICU护理中暴力的正常化，并表明了医疗保健专业人员之间的复杂关联，将暴力视为护理的一个组成部分。同时认定自己是这种暴力的受害者。医疗保健专业人员描述了准备不足，缺乏管理暴力局势的适当工具。因此，暴力管理主要基于自学成才的技能。
结论：这项研究有助于理解ICU护理中暴力的正常化，并为其起源提供了可能的解释。悖论涉及多方面的方法，承认并面对医疗保健中暴力的结构和文化层面。这种方法将为更可持续的医疗保健系统奠定基础。
