Study On Violence Against Health Workers In Zhejiang Province

Objective:To describe the situation of physical violence,threats and Yi Nao against health workers in hospital,to analyses the influencing factors about workplace violence in hospital,to specify the impact of hospitals encourage to keep silence on the occurrence,copying styles of workplace violence and processing method,to know the results of physical violence.From the perspective of the health workers,to discuss the reasons of violence against health workers.Method:Using a stratified cluster random sampling method,4862 health workers in 45 hospitals in Zhejiang Province were investigated to investigate health workers in the hospital.The survey includes:the demographic characteristics of hospitals and health workers,the situation about workplace violence,the different styles of workplace violence,the reasons of violence against health workers by open-ended questions,the copying styles of physical violence and the results of handling the violent incident,and the consequences of physical violence and threats.The statistical analyses were conducted with IBM SPSS Statistics 20.00 Statistical methods used descriptive analysis,Student’s t test,Chi-square test,logistic regression,p<0.05 was considered statistically significant.Results:1.The situation of workplace violence in hospital setting6089 health workers were involved in this investigation.5154 questionnaires were received with a replying rate 84.5%.After screening following the defined principle,4862 questionnaires were left eventually as valid forms and the valid replying rate was 94.5%.In the past year,4.6%of the health workers suffered physical violence,17.4%suffered threats of violence and 40.2%experienced Yi Nao.Among health workers suffered physical violence,the main way is to attack victims was push(48.6%),beating up(14.5%),other damaging-behaviors using implements(12.7%).Major perpetrators were family members or friends(71.4%).Coping styles includes:“attempted to tell each other’s theory,wishing them to calm down”(49.5%),“tried to defend myself physically”(28.6%),“running away”(23.5%),“told the person to stop”(20.4%),“fight back”(8.6%),“shout for help”(14.5%),“took no action”(7.80%),“swearing”(3.2%);only 29.0%chose the alarm,74.3%said there is no investigation or they did not know if there is an investigation.71.4%said the perpetrators did not receive any punishment.47.9%were dissatisfied with the result of handling violence,and 55%did not report to superiors because they thought it was useless.2.The influenced factors on workplace violence in hospital settingCompared with female health workers,male health workers have high risk in physical violence(OR=0.51,95%CI 0.35-0.74,p<0.001),physical violence and threats(OR=0.69,95%CI 0.57-0.84,p<0.001),Yi Nao(OR=0.76,95%CI 0.64-0.89,p<0.001).Compared with health workers who worked in township health centers,health workers in county hospitals have high risk in physical violence(OR=4.33,95%CI 2.34-8.00,p<0.001),physical violence and threats(OR=1.93,95%CI 1.46-2.56,p<0.001),Yi Nao(OR=2.89,95%CI 2.26-3.68,p<0.001).Compared with health workers in general medicine,health workers in emergency/ambulance have high risk in physical violence(OR=3.31,95%CI 1.77-6.21,p<0.001),physical violence and threats(OR=2.67,95%CI 1.80-3.98,p<0.001),Yi Nao(OR=4.06,95%CI2.72-6.05,p<0.001).CoMpared with hospitals encouraging health workers to report violence,hospitals encouraging health workers not to report have high risk in physical violence(OR=2.21,95%CI 1.48-3.30,p<0.001),physical violence and threats(OR=1.70,95%CI 1.33-2.16,p<0.001),Yi Nao(OR=1.51,95%CI 1.20-1.90,p<0.01).Compared with hospitals encouraging health workers not to keep silence,hospitals encouraging health workers to keep silence have high risk in physical violence(OR=2.93,95%CI 1.99-4.30,p<0.001),physical violence and threats(OR=3.78,95%CI3.06-4.67,p<0.001),YiNao(OR=2.52,95%CI 2.06-3.08,p<0.001).3.Reasons and consequences of violence against health workersOf the 4862 health workers suffered physical violence,3045 answered the question about reasons of violence.1532(50.3%)health workers think that the reason for the high rate of workplace violence is the low cost of violence against health workers and even the benefit of violence.1263(41.5%)health workers think the reason is poor health system.617(20.3%)health workers think the reason is over,bias,and fake media reports.582(19.1%)health workers think the reason is too high expectation.475(15.6%)health workers think the reason is poor doctor-patient relationship.222(7.3%)health workers think the reason is poor social capital.Of the 1072 health workers suffered physical violence and threats,95.7%chose ’Deal with patients(or practice medicine)more cautiously’,93.8%chose ’Being super-alert or watchful and on guard’,82.0%chose ’Need to first consider how to protect yourself while seeing patients’,58.0%chose ’Wanting to quit direct patient care’.4.Hospitals encouraging health workers to keep silence towards the impact of occurrence of violence,response and coping stylesThe possibility of hospitals encouraging not to report workplace violence is 0.3 times hospitals encouraging to report(95%CI 0.11-0.79,p<0.05).Hospitals encouraging to keep silence reduces the likelihood of action which was taken to investigate the incident(ORF=0.24,95%CI 0.08-0.76,p<0.05).The possibility of the perpetrator who was sentenced silence is lower in hospitals encouraging to keep silence than in hospitals encouraging not to keep silence(OR=0.05,95%CI 0.01-0.21,p<0.001).Conclusion:Health workers in Zhejiang Province have a high proportion of threat.Health workers have a high proportion of Yi Nao,and 40.2%health workers experienced Yi Nao.The risk factors of physical violence are men,county hospitals,provincial/city level hospital,emergency rooms,hospitals encouraging not to report and hospitals encouraging to keep silence.The risk factors of physical violence and threats are men,county hospitals,emergency rooms,hospitals encouraging not to report and hospitals encouraging to keep silence,higher professional title has higher risk.The risk factors of Yi Nao are men,county hospitals,provincial/city level hospital,general surgery,emergency rooms,doctors,hospitals encouraging not to report and hospitals encouraging to keep silence.Health workers thinks the reasons for the high rate of workplace violence are the low cost of violence against health workers and even the benefit of violence,poor health system,over bias and fake media reports,too high expectation,poor doctor-patient relationship,and poor social capital.More than 90%thought they would deal with patients(or practice medicine)more cautiously and they would be super-alert or watchful and on guard.Over a half health workers experienced physical violence and threats,they would want to quit direct patient care.In view of this,the public hospitals should enhance hospital social support for health workers,and hospital supporting of health workers to report the workplace violence will increase the confidence of health workers.Provide training and counseling for health workers on how to improve their self-protection skills,especially counseling after violent incidents to improve the environmental safety of health workers and reduce the impact of workplace violence on health workers.