Construction Of A Training Indicator System Against Workplace Violence For Nurses Based On Behavioral Objectives Theory

ObjectiveTo construct a set of training indicator system against workplace violence for nurses,provide the basis and standards for the training of clinical nurses’ ability to prevent violence in the workplace and further improve the content of occupational protection in the continuing education and training program for nurses.Methods1.With “workplace violence”,“nurse*”,“train*” and “education” as the search terms,the research team conducted literature search in domestic and foreign databases.With reference to the literature and clinical practice,the theoretical framework and items of the training indicator system against workplace violence for nurses were determined preliminarily.2.Nurses from tertiary grade A polyclinic in 3 municipal districts of Qingdao were selected as the research objects.Through the investigation of the revised questionnaire on workplace violence in hospitals,the current situation of workplace violence among nurses in tertiary grade A polyclinic was described for enriching the item pool for nurses to prevent workplace violence.3.The semi-structured interview method was used to conduct face-to-face in-depth interviews with 19 interviewees,including clinical nurses,patients and their families,and hospital administrators.The interview data were analyzed and sorted by Colaizzi method to determine the training needs of nurses for workplace violence prevention.Based on the results of literature review,current situation investigation and semi-structured interview,the training system for preventing workplace violence against nurses was initially formed.4.The Delphi method was applied to carry out two rounds of expert consultation,and the training system on prevention of workplace violence for nurses was finally constructed.5.Based on the importance of each indicator graded by the experts,it’s weight was calculated by AHP.Results1.The item pool of the nurses’ training indicator system against workplace violence was initially formed by literature review.2.The results of the questionnaire:(1)31.31% of the nurses in in tertiary grade A polyclinic had experienced workplace violence.From high to low,the incidence was verbal abuse,threats,sexual harassment and physical assault.(2)Most violent incidents occurred on day shift(67.63%),in the presence of other colleagues(76.98%),nurse office(39.57%)and emergency rooms(61.06%).The main reasons were low quality(71.22%),unreasonable demands(60.43%)and long waiting time(46.76%).The main coping strategies of nurses were patient explanation(79.14%),tolerance and avoidance(53.96%),asking for help from security personnel(30.94%).After workplace violence,nurses were prone to grievance(80.58%),anger(77.70%)and decreased work enthusiasm(52.52%),and there wrere often lasting effects(62.59%).(3)Nurses generally had a low level of awareness of workplace violence.66.67% of nurses had heard of workplace violence,76.13% believed that workplace violence was inevitable in nursing,6.76% did not believe that workplace violence was not a cause for alarm,and more than 95% of nurses had a positive attitude towards training on prevention of workplace violence.(4)49.77% of nurses had received training related to the prevention of workplace violence in their hospitals.3.A total of 7 training needs themes including violence identification,coping strategies,self-protection,teamwork,communication skills,psychological support and legislations were extracted from the interview.Based on the results of literature review,current situation investigation and semi-structured interview,the training aims consisted of 6 first-level indicators and 26 second-level indicators,and the training contents consisted of 3 first-level indicators,8 second-level indicators and 28 third-level indicators in the training system for preventing workplace violence against nurses initially formed.4.There were 20 experts who participated in two-round experts’ consultation.The experts’ positive coefficient were 95.24%,95.00% respectively in two rounds of Delphi technique.About training aims,authority coefficient was 0.828,and the coefficient of concordance was 0.333(P<0.001)in the second round.About training contents,authority coefficient was 0.803,and the coefficient of concordance was 0.263(P<0.001)in the second round.In the final indicator system,training aims consisted of 6 first-level indicators and 25 second-level indicators.The first-level indicators included developing awareness against workplace violence,equipping with the ability to recognize workplace violence,learning how to deal with workplace violence,mastering self-protection skills,maintaining mental health and acquainting with relevant laws and regulations.Training contents consisted of 3 first-level indicators,8 second-level indicators and 29 third-level indicators.The first-level indicators included the overview of nurses’ workplace violence,the characteristics of nurses’ workplace violence and the guidelines for dealing with nurses’ workplace violence.Training methods included classroom teaching,case studies,scenario simulation,workshops and etc.5.By AHP,in the training aims of a nurses’ training indicator system against workplace violence,“developing awareness against workplace violence” and “mastering self-protection skills”(0.262)accounted for the biggest,“equipping with the ability to recognize workplace violence”,“learning how to deal with workplace violence” and “maintaining mental health”(0.146)were next,“acquainting with relevant laws and regulations”(0.038)was third.In the training contents of a nurses’ training indicator system against workplace violence,“the guidelines for dealing with nurses’ workplace violence”(0.547)accounted for the biggest,“the characteristics of nurses’ workplace violence”(0.345)was next,“the overview of nurses’ workplace violence”(0.109)was third.ConclusionNurses in tertiary grade A polyclinic are in high demand for training to prevent workplace violence.The nurses’ training indicator system against workplace violence based on behavioral objectives theory was scientific and reliable,which can provide valuable references for training program against workplace violence for clinical nurses.