背景:患者(及其亲戚/朋友)的侵略和暴力行为被广泛认为是一种严重的职业危害,医生特别容易在医院内目睹和经历此类事件。研究表明,这种侵略和暴力的负面后果不仅在个人层面上感受到,而且在团队和组织层面。了解如何预防和管理这种行为的医生在医院是紧迫的,没有充分的研究。虽然有许多潜在的有效干预措施,目前尚不清楚哪些对中国医院是有价值和可行的。因为患者的侵略和暴力在中国医院可能比其他国家更频繁地发生,这表明文化差异起到了一定作用,可能需要有针对性的干预措施.
方法:我们进行了一项德尔菲研究,以就医院干预措施的重要性和可行性达成共识,以预防和管理患者(及其亲属/朋友)对中国医院医生的侵略和暴力行为。中国的17位专家应邀完成了三轮在线问卷调查。
结果:经过三轮,就44项干预措施达成共识,其他五项干预措施被拒绝,在另外两个问题上没有达成共识。这些干预措施分为八类:环境设计,入口和入口,人员配备和工作实践,领导力与文化,培训和教育,支持,在事件操作期间/之后,医院政策。每个类别都被认为在预防和管理患者(及其亲戚/朋友)对中国医院医生的侵略和暴力方面很重要。这项研究还调查了建议干预措施的可行性,发现44项干预措施中有36项被认为不仅相关,而且在中国医院实施也是可行的。
结论:本研究概述了可以在中国医院实施的干预措施,以预防和管理患者(及其亲属/朋友)的侵略和暴力行为。during,在暴力事件发生后。
BACKGROUND: Aggression and violence by patient (and their relatives/friends) is widely acknowledged as a serious occupational hazard, with physicians being particularly susceptible to witnessing and experiencing such incidents within hospitals. Research has shown that the negative consequences of such aggression and violence are not only felt at the individual level, but also at the team and organizational levels. Understanding how to prevent and manage this behavior towards physicians in hospitals is urgent and not fully researched. While there are many potentially effective interventions, it is unclear which ones would be valuable and feasible for Chinese hospitals. Because patient aggression and violence may occur more frequently in Chinese hospitals than in other countries, this suggests that cultural differences play a role and that tailored interventions may be needed.
METHODS: We conducted a Delphi study to reach a consensus on the importance and feasibility of hospital interventions to prevent and manage patient (and their relatives/friends) aggression and violence against physicians in Chinese hospitals. Seventeen experts in China were invited to complete online questionnaires over three rounds.
RESULTS: After three rounds, consensus was achieved concerning 44 interventions, five other interventions were rejected, and no consensus was reached on another two. These interventions were clustered into eight categories: environment design, access and entrance, staffing and working practices, leadership and culture, training and education, support, during/after-the-event actions, and hospital policy. Each category is considered important in preventing and managing patient (and their relatives/friends) aggression and violence towards physicians in Chinese hospitals. This study also investigated the feasibility of the suggested interventions and found that 36 of the 44 interventions were considered not only relevant, but also feasible for implementation in Chinese hospitals.
CONCLUSIONS: This study provides an overview of interventions that can be implemented in Chinese hospitals to prevent and manage patient (and their relatives/friends) aggression and violence before, during, and after a violent incident occurs.