护士遭受暴力现状及相关因素研究
摘要
目的:
1研究福建省护士遭受医院工作场所暴力的现状,分析其流行病学特征及影响因素。
2研究护士和病人两种不同人群对医院工作场所暴力相关因素的认知情况,比较分析双方观点的异同之处。
3探讨如何预防和减少护士遭受医院工作场所暴力的措施。
方法:
1根据WHO有关医院工作场所暴力的定义、并结合相关文献,设计护士遭受医院工作场所暴力情况问卷。采用多阶段分层随机抽样方法在福建全省抽取12家医院,并各医院临床科室中共抽取1630位临床护士,进行护士遭受医院工作场所暴力现状问卷调查,回收有效问卷1369份,采用描述性统计、χ2检验、多因素Logistic逐步回归分析和Spearman等级相关分析等统计方法研究护士遭受医院工作场所暴力的现状及影响因素。
2参考Donabedian照护质量靶心模式,设计护士遭受医院工作场所暴力相关因素调查问卷,并进行信度、效度检测。
3对上述医院的1630位护士和1400位病人进行护士遭受医院工作场所暴力相关因素问卷的调查,分别回收有效问卷1369份和1008份,采用t检验、排序、单因素方差分析及多元线性回归分析等统计方法比较护患双方对护士遭受医院工作场所暴力相关因素的认知及影响因素。
结果:
1 1369名护士1年中有821名遭受过医院工作场所暴力,暴力事件发生率为59.97%,其中心理暴力为52.45%,身体暴力为8.98%。
2χ2检验和多因素Logistic逐步回归分析显示不同医院等级、科室、学历、工作年限与护士遭受医院工作场所暴力发生率有关。
3 Spearman等级相关显示年龄、婚姻、职称、职务、工作年限及聘用方式与护士对医院工作场所暴力知晓程度有关;医院等级、学历和聘用方式与护士对成立应对医院工作场所暴力专门机构的赞同程度有关。
4 t检验及排序结果显示护患双方在护士遭受医院工作场所暴力相关因素认知上存在较大差异。
5单因素方差分析和多元线性回归结果显示护士婚姻状况、所在医院等级、职务、职称、工作年限、聘用方式、工作科室对暴力相关因素认知有一定影响。病人的性别、就诊医院等级、常住地、付费方式、职业和就诊科室对暴力相关因素认知有一定影响。
结论:
1福建省护士遭受医院工作场所暴力的情况较为严重,其主要影响因素是护士的学历、工作年限、所在医院的等级和科室。
2护患双方在护士遭受医院工作场所暴力相关因素的认知上存在较大差异。
3有关部门应采取有针对性的防范措施,加强护士应对医院工作场所暴力的培训,提高护士综合素质,改善医院管理,同时呼吁政府部门的关注及社会舆论的正确导向。
OBJECTIVE
1 To investigate the status quo of workplace violence in hospital on the nurses of the integrative hospitals above two in Fujian province, and analyse the epidemiological charactenistics.
2 To analyse and compare the viewpoint between the nurses and the patients in these hospital about the reason of workplace violence in hospital on the nurses.
3 To inquire into effective countermeasure on preventing and reducing the workplace violence in hospital on the nurses.
METHODS
1 To design a questionnaire about workplace violence in hospital on the nurses according to the WHO definition of workplace violence. A convenient sample of 1630 nurses in two-stage stratified cluster sample of 12 hospitals of Fujian province provided data. 1369 questionnaires were fully completed by the nurses and were used to analyse the status quo and correlative factor of workplace violence in hospital on the nurses. The statistics method, such as descriptive statistics, chi square test, logistic regression and spearma correlation analysis, were used.
2 A questionnaire about the reason of workplace violence in hospital on the nurses was designed according to Donabedian’s Bulls eye of target about the quality of care and the reliability and validity explored.
3 A convenient sample of 1630 nurses and 1400 patients in the hospitals which above-mentioned provided data. 1369 questionnaires were fully completed by the nurses and 1008 questionnaires were fully completed by the patients. The statistics method, such as t-test, rank test ,one way ANOVA and linear stepwise were used to compare the cognizance of the nurses and patients about the reason of workplace violence in hospital on the nurses, and analyse influencing factor of the cognizance. RESULT
1 Among totally 1369 nursing staffs were investigated, 821 of them had experienced workplace violence in hospital in the last 12 months preceding the survey. With a total rate of 59.97% which was accounted for of 52.45% psychological and of 8.98% physical violence respectively.
2 The chi square test and logistic regression analysis of the different interventions on the questionnaires showed a statistiaclly significant relationship between suffered violence and hospital grade, department, educational background, the service years of work of nurses.
3 Spearman correlation analysis on the questionnaires showed a statistiaclly significant relationship between the mastery of hospital violence knowledge and age, marriage, the type of professional post, post, educational background, type of recruitment of nurses, and a statistiaclly significant relationship between the attitude about violence management and hospital grade, educational background, type of recruitment of nurses.
4 There are many differences on the viewpoints of the reason of workplace violence in hospital on the nurses between nurses and patients.
5 One way ANOVA and linear stepwise regression analysis of the different interventions on the questionnaires showed marriage, hospital grade, post, the type of professional post, the service years of work, type of recruitment and department of nurses could influence their viewpoint of the reason of workplace violence in hospital on the nurses, and sex, hospital grade, type of payment, occupation, department of patients could influence their viewpoint of the reason of workplace violence in hospital on the nurses.
CONCLUSION
1 The workplace violence in hospital on the nurses of Fujian integrative hospital was very serious. The educational background, the service years of work and hospital grade, department of nurses were the dominating influencing factor.
2 There are many differences between nurses and patients in the viewpoints of the reason of workplace violence in hospital on the nurses.
3 The related department should take pertinent countermeasure on the workplace violence in hospital on the nurses, such as education on how to reply workplace violence in hospital, improvement of nurses’general quality, amelioration of hospital management, appeal of the attention of the government and correct direction of public consensus.
1研究福建省护士遭受医院工作场所暴力的现状,分析其流行病学特征及影响因素。
2研究护士和病人两种不同人群对医院工作场所暴力相关因素的认知情况,比较分析双方观点的异同之处。
3探讨如何预防和减少护士遭受医院工作场所暴力的措施。
方法:
1根据WHO有关医院工作场所暴力的定义、并结合相关文献,设计护士遭受医院工作场所暴力情况问卷。采用多阶段分层随机抽样方法在福建全省抽取12家医院,并各医院临床科室中共抽取1630位临床护士,进行护士遭受医院工作场所暴力现状问卷调查,回收有效问卷1369份,采用描述性统计、χ2检验、多因素Logistic逐步回归分析和Spearman等级相关分析等统计方法研究护士遭受医院工作场所暴力的现状及影响因素。
2参考Donabedian照护质量靶心模式,设计护士遭受医院工作场所暴力相关因素调查问卷,并进行信度、效度检测。
3对上述医院的1630位护士和1400位病人进行护士遭受医院工作场所暴力相关因素问卷的调查,分别回收有效问卷1369份和1008份,采用t检验、排序、单因素方差分析及多元线性回归分析等统计方法比较护患双方对护士遭受医院工作场所暴力相关因素的认知及影响因素。
结果:
1 1369名护士1年中有821名遭受过医院工作场所暴力,暴力事件发生率为59.97%,其中心理暴力为52.45%,身体暴力为8.98%。
2χ2检验和多因素Logistic逐步回归分析显示不同医院等级、科室、学历、工作年限与护士遭受医院工作场所暴力发生率有关。
3 Spearman等级相关显示年龄、婚姻、职称、职务、工作年限及聘用方式与护士对医院工作场所暴力知晓程度有关;医院等级、学历和聘用方式与护士对成立应对医院工作场所暴力专门机构的赞同程度有关。
4 t检验及排序结果显示护患双方在护士遭受医院工作场所暴力相关因素认知上存在较大差异。
5单因素方差分析和多元线性回归结果显示护士婚姻状况、所在医院等级、职务、职称、工作年限、聘用方式、工作科室对暴力相关因素认知有一定影响。病人的性别、就诊医院等级、常住地、付费方式、职业和就诊科室对暴力相关因素认知有一定影响。
结论:
1福建省护士遭受医院工作场所暴力的情况较为严重,其主要影响因素是护士的学历、工作年限、所在医院的等级和科室。
2护患双方在护士遭受医院工作场所暴力相关因素的认知上存在较大差异。
3有关部门应采取有针对性的防范措施,加强护士应对医院工作场所暴力的培训,提高护士综合素质,改善医院管理,同时呼吁政府部门的关注及社会舆论的正确导向。
OBJECTIVE
1 To investigate the status quo of workplace violence in hospital on the nurses of the integrative hospitals above two in Fujian province, and analyse the epidemiological charactenistics.
2 To analyse and compare the viewpoint between the nurses and the patients in these hospital about the reason of workplace violence in hospital on the nurses.
3 To inquire into effective countermeasure on preventing and reducing the workplace violence in hospital on the nurses.
METHODS
1 To design a questionnaire about workplace violence in hospital on the nurses according to the WHO definition of workplace violence. A convenient sample of 1630 nurses in two-stage stratified cluster sample of 12 hospitals of Fujian province provided data. 1369 questionnaires were fully completed by the nurses and were used to analyse the status quo and correlative factor of workplace violence in hospital on the nurses. The statistics method, such as descriptive statistics, chi square test, logistic regression and spearma correlation analysis, were used.
2 A questionnaire about the reason of workplace violence in hospital on the nurses was designed according to Donabedian’s Bulls eye of target about the quality of care and the reliability and validity explored.
3 A convenient sample of 1630 nurses and 1400 patients in the hospitals which above-mentioned provided data. 1369 questionnaires were fully completed by the nurses and 1008 questionnaires were fully completed by the patients. The statistics method, such as t-test, rank test ,one way ANOVA and linear stepwise were used to compare the cognizance of the nurses and patients about the reason of workplace violence in hospital on the nurses, and analyse influencing factor of the cognizance. RESULT
1 Among totally 1369 nursing staffs were investigated, 821 of them had experienced workplace violence in hospital in the last 12 months preceding the survey. With a total rate of 59.97% which was accounted for of 52.45% psychological and of 8.98% physical violence respectively.
2 The chi square test and logistic regression analysis of the different interventions on the questionnaires showed a statistiaclly significant relationship between suffered violence and hospital grade, department, educational background, the service years of work of nurses.
3 Spearman correlation analysis on the questionnaires showed a statistiaclly significant relationship between the mastery of hospital violence knowledge and age, marriage, the type of professional post, post, educational background, type of recruitment of nurses, and a statistiaclly significant relationship between the attitude about violence management and hospital grade, educational background, type of recruitment of nurses.
4 There are many differences on the viewpoints of the reason of workplace violence in hospital on the nurses between nurses and patients.
5 One way ANOVA and linear stepwise regression analysis of the different interventions on the questionnaires showed marriage, hospital grade, post, the type of professional post, the service years of work, type of recruitment and department of nurses could influence their viewpoint of the reason of workplace violence in hospital on the nurses, and sex, hospital grade, type of payment, occupation, department of patients could influence their viewpoint of the reason of workplace violence in hospital on the nurses.
CONCLUSION
1 The workplace violence in hospital on the nurses of Fujian integrative hospital was very serious. The educational background, the service years of work and hospital grade, department of nurses were the dominating influencing factor.
2 There are many differences between nurses and patients in the viewpoints of the reason of workplace violence in hospital on the nurses.
3 The related department should take pertinent countermeasure on the workplace violence in hospital on the nurses, such as education on how to reply workplace violence in hospital, improvement of nurses’general quality, amelioration of hospital management, appeal of the attention of the government and correct direction of public consensus.
引文
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1 WHO. Violence: a public health priority. Geneva: World Health Organization, 1995.
2 Wykes T, Whittington R. Prevalence and predictors of early traumatic stress reactions in assaulted psychiatric nurses[J]. J Forensic Psychiatry, 1998, 9(8): 643- 658.
3 Folger R, Baron RA. Violence and hostility at work: a model of reactions to perceived injustice. In G. R. VandenBos & E. Q. Bulatao (eds.): Violence on the Job, Washington, DC: American Psychological Association. 1996.
4 陈祖辉,王声湧，卢业成，等．医院工作场所暴力的流行病学特征及蜲找蛩?分析[J].中华流行病学杂志,2004,25(1):3-5.
5 陈祖辉,王声湧，?合迹阒菔辛剿皆汗ぷ鞒∷┝ο窒蟮鞑閇J].中华预防医学杂志,2003,37(5):358-360.
6 荆春霞,王声湧，谭冠昶，等．医院场所暴力发生的流行特征及原因分析[J].中国公共卫生杂志,2003,19(7):863-864.
7 Elliott P. Violence in health care: what nurse managers need to know[J]. Nursing Management, 1997, 28(12):38-41.
8 Saarela KL, Isotalus N. Workplace Violence in Finland: High-risk groups and preventive strategies[J]. American Journal of Industrial Medicine Supplement, 1999, 1: 80-81.
9 Arnetz JE, Arnetz BB, Petterson IL. Violence in the nursing profession: occupational and lifestyle risk factors in Swedish nurses[J]. Work & Stress, 1996, 10: 119-127.
10 Sibbald B. Physician protect thyself[J]. Canadian Medical Association Journal, 1998, 159 (8):987-989.
11 张斌.对医院医院暴力事件的思考[J].中国医院管理,2006,26(3):21-25.
12 Hewitt JP, Levin P. Violence in the Workplace[J]. Annual Review of Nursing Research, 1997, 15: 81-99.
13 Carol A. Protecting yourself from violence in the workplace[J]. Nursing, 2002, 32(6):58-63.
14 Smith-Pittman MH, McKoy YD. Workplace violence in healthcare environments[J]. Nursing Forum, 1999, 34(3):5-13.
15 王璠,杨小明,江启成.医疗暴力的危害、原因及对策[J].医学与哲学,2005,26(11):16-18.
16 Bensley L, Nelson N, Kaufman J, et al. Patient and staff views of factors influencing assaults on psychiatric hospital employees[J]. Issues in Mental Health and Nursing, 1995, 16(5):433-446.
17 马伟光,李继平.医院场所暴力原因分析及对策[J].护理管理杂志,2005,5(5):23-25.
18 Levin PF, Hewitt JB, Misner ST. Insights of nurses about assault in hospital-based emergency departments[J]. Image: Journal of Nursing Scholarship, 1998, 30: 249- 254.
19 Neuman JH, Baron RA. Workplace violence and workplace aggression: Evidence concerning specific forms, potential causes, and preferred targets[J]. Journal of Management, 1998, 24:391-419.
20 Lawrence C, Leather P. The social psychology of violence and aggression. In P. Leather et al.: Work-Related Violence: Assessment and Intervention. London: Routledge. 1999.
21 叶文琴,杜萍,徐筱萍.上海市护理人力资源配置现状研究[J].中华护理杂志,2006,41(10):874-876.
22 乔晓斐,房彤.安徽省临床护理人力资源配置现状的调查研究[J].中华护理杂志,2007,42(7):595-598.
23 施雁,高秋韵,毛雅芬.护理人力资源配置调查及对策[J]. 中华护理杂志. 2005,40(5):373-375.
24 Jr Hurrell JJ, Worthington KA, Driscoll RJ. Job stress, gender and workplace violence: Analysis of assault experiences of state employees, in Violence on the Job, by G.R. VandenBos and E.Q. Bulatao, American Psychological Association, Washington DC, 1997, 163-170.
25 Boyd N. Violence in the workplace in British Columbia: A preliminary investigation [J]. Canadian Journal of Criminology, 1995, 10:451-519.
26 刘明溱,孙光研.加强防范措施,减少医疗纠纷[J].中国医院管理,2000,20(5):40.
27 McClure LF. Origins and incidence of workplace violence in North America. In T.P. Gullotta and S.J. McElhaney (eds.) Violence in homes and communities: Prevention, intervention, and treatment. Thousand Oaks, CA: Sage Publications. 1999, 71-99.
28 Aiken LH, Sochalski J, Lake ET. Studying outcomes of organizational change in health service[J]. Medical Care, 1997, 35(11):6-18.
29 Parker SK, Chamiel N, Wall TD. Work characteristics and employee well-being within a context of downsizing [J]. Journal of Occupational Health Psychology, 1997, 2(4):289-303.
30 马伟光,李继平.医院场所暴力原因分析及对策[J].护理管理杂志,2005,5 (5):23～24.
31 李霜.暴力——医院中的职业危害[J]. 国外医学卫生学分册,2003,30(3):163.
32 Budd T. Violence at Work: Findings from the British Crime Survey. London: Home Office. 1999.
33 Flannery RB, Hanson MA, Penk WE. Patients’ threats: Expanded definition of assault[J]. General Hospital Psychiatry, 1995, 17(6):451-453.
34 Quine L. Workplace bullying in NHS community trust: staff questionnaire survey[J]. British Medical Journal, 1999, 318:228-232.
35 Wykes T, Whittington R. Prevalence and predictors of early traumatic stress reactions in assaulted psychiatric nurses[J] . J Forensic Psychiatry, 1998, 9(8): 643-658.
36 Judith AO. 2001年国际护士会主题:联合反对暴力[J].中华护理学会会刊,2001,15(4):10-32.
37 Distasio C. Violence against home care providers: Stop It before It starts[J] . Caring, 2000, 10:14-18.
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