A Typical Investigation Study Of Participatory Training And Workplace Violence In A Secondary Hospital In Wuhan,China In The Context Of COVID-19 Pandemic

Background and objective The occupational health of health workers has attracted widespread attention in the context of COVID-19,and it becomes increasingly important to improve the working conditions of health workers in various ways and to support health institutions in building their occupational health systems.The objectives of this study are as follows:1.To summarise and evaluate the effectiveness of the ninth Improving Work in Health Services Training of Trainers(HealthWISE TOT),to identify the priority occupational health demands of the secondary hospital in Wuhan(the sample hospital)and to explore the main directions for the subsequent occupational building.2.To explore the epidemiological characteristics,risk factors and responses measures of workplace violence in the sample hospital,and to explore the correlation between experiences of workplace violence,burnout and job competence,and to provide individual suggestion in workplace violence prevention and control measures.Methods Part one:The ninth Health WISE TOT was conducted in the sample hospital to train health workers from Wuhan’s hospitals who were seriously infected in 2020,using the Participatory Action Oriented Training(PAOT)method.The effect of the HealthWISE training class was evaluated by the mixed methods research combining quantitative research and qualitative research.Part two:Based on the research findings of the first part,the study focused on workplace violence in the sample hospital.A mixed methods research was used,combining quantitative and qualitative research.The quantitative part is a crosssectional research using the Chinese version of Workplace Violence in the Health Sector Country Case studies Research Instruments Survey Questionnaire to investigate the epidemiological characteristics and the risk factors of workplace violence in the sample hospital.A linear regression model was constructed to further explore the correlation between experiences of workplace violence,burnout and job competence of health workers Qualitative face-to-face interviews were conducted on key populations by semi-structured in-depth interviews to gather the views of health workers on the causes,response measures and improvement suggestions for workplace violence.Results Part one:The 9th HealthWISE TOT in June 2021 trained 49 health workers from 13 health facilities.The average HealthWISE implementation score increased from 111.76±1.61 pre-training to 124.79±1.66 post-training with a statistically significant difference(χ2=54.49.P<0.01).There were improvements in workplace safety.musculoskeletal disorders,biological hazards and workplace violence.This training achieved effective improvements in beliefs,attitudes and awareness of health workers.The training had a significant impact on improving working conditions in the hospitals.Further research is needed on workplace violence and mental health issues in the sample hospitals in the context of COVID-19.Part two:A total of 571 health workers in the sample hospital participated in the workplace violence survey.In the 12 months prior to June 2022,the total incidence of workplace violence was 31.52%,the incidence of physical violence was 3.33%,and the incidence of psychological violence was 31.35%.Across the different types of violence,the most perpetrators were patients and patients’ families.Multivariate logistic regression results showed that male(OR=4.80.P=0.010),coming from another city(OR=4.40,P=0.013)were risk factors for physical violence;coming from another city(OR=1.60,P=0.026),shift work(OR=2.83.P=0.001)and direct contact/interaction with patients(OR=7.29,P<0.001)were risk factors for psychological violence,A total of 37 health care workers participated in the qualitative interviews.The experience of psychological violence of the respondents was related to the increase of emotional exhaustion(t=-4.02,P<0.001)and depersonalization(t=-5.145,P<0.001).The work ability score of respondents is moderate(34.70± 6.08),and the work ability score of medical workers who have experienced psychological violence is significantly lower than those who have not(t=4.77,P<0.001).In the 12 months prior to June 2022.5 health workers(5/37)had experienced workplace violence and 24(24/37)had witnessed or heard about workplace violence.The impact of violent incidents on health workers can be summarized as having no impact and having an impact(psychological impact,cognitive impact,and work motivation impact).The respondents identified four main reasons for the occurrence of workplace violence:individual level(potential perpetrators and potential victims),organisational level(workplace and work organisation),work environment(physical environment and work design)and social level(local community and social factors).The qualitative study indicated that the sample hospitals still need to strengthen workplace violence prevention and control measures in terms of proactive prevention beforehand,mitigation of conflict escalation to minimise possible harm during the process,and post compensatory measures afterwards.Conclusion The occupational health of health workers in the context of COVID-19 requires more attention,and training methods such as Health WISE can be used to effectively assess and identify priority occupational health needs and priorities for the development of occupational health systems.Workplace violence in hospitals in the context of COVID-19 is a systemic issue that deserves attention.Prevention and control measures for physical and psychological violence need to be improved from the perspective of workplace definition.It is recommended that the sample hospitals focus on the occurrence of psychological violence,such as verbal abuse,and prioritise the prevention of workplace violence among health workers such as males,coming from another city,those who need to work shifts and direct contact/interaction with patient.Actively optimise the COVID-19 prevention and control policy to give health workers best support at individual and organisational levels to prevent workplace violence and incorporate it into the hospital’s occupational health and safety management system.