Background: Workplace violence is a social problem of special interest in both intervention and research. Among the sectors that most perceive this type of violence, health care professionals stand out. The most common type of violence for this professional group is the one perpetrated by the users or patients themselves. It has been reported that one out of every four acts of violence in the workplace occurs in the healthcare setting. Within the health sector, the Mental Health, Emergency and Primary Care services have been widely reported as being among the most vulnerable, with Primary Care being the least addressed of the three. Although the available literature is extensive, there are hardly any studies that explore from a qualitative perspective what are the sources of conflict in this sector from the perspective of the users, the most common being to work with professionals.Objective: The aim of this study is to examine those aspects derived from the organization, the professionals or the users of Primary Care that, from the users' point of view, cause violent situations and how they think these could be avoided.Method: The sample consisted of 80 users of the Primary Care services of the Health Service of Murcia. For data collection, a qualitative study was conducted through 10 focus groups and a subsequent thematic analysis of the data.Results: The results have allowed us to identify that, from an organizational point of view, the uncertainty in waiting times, the need to adapt the telematic or telephone appointment to the different types of users, or the management of emergencies in Primary Care are the aspects that cause most conflicts between users and professionals. In this sense, suggested improvements are aimed at providing information in the mobile application updated on the opening hours or maintaining the telephone appointment for those who need or request it, among many others. As for the professionals, users point out that the medical staff is perceived as distant and sometimes does not provide enough information on the health status of users. Another professional group widely addressed in the focus groups was the administrative staff, being described as lacking in communication skills, assertiveness, or empathy. Users recognize the existence of a demanding/aggressive profile among users, who makes instrumental use of violence to achieve privileges over users in general. We have also identified the profile of the user who makes use of Primary Care as a way of socializing or managing conflicts of a socioemotional nature. As proposals for this thematic block, users suggest group therapies, the use of audiovisual material complementary to the information provided by professionals or community interventions in psychoeducation.Conclusion: This study allows to explore conflicts between users and professionals from the Primary Care patients' perspective. Our results are complementary to the available evidence that has used the professional's approach to study the phenomenon of workplace violence. The identification of sources of conflict and the assessment and contribution of users on possible ways of improvement can serve as a basis for the design of prevention and intervention plans to improve the work environment in Primary Care centers.
Partner aggressors present psychopathological, criminal, and sociodemographic characteristics that have been used for classification in typologies. The goal of the present work was to identify profile of aggressors as a function of the risk of recidivism, and assess whether there correspondence with type of offenders proposed by Holtzworth–Munroe and Stuart. The sample was made up of 90 men condemned for partner violence, of whom 50 were serving a prison sentence, and 40 mandatory community intervention/programs. The risk of recidivism was assessed with the SARA - Spousal Assault Risk Assessment Guide, completed with information obtained from prison records, clinical interviews for the assessment of personality disorders, and self-reports. The results reveal three profile of aggressors according to their risk of recidivism, related to the above-mentioned classification: high-risk aggressors coincide with the Dysphoric/Borderline (DB) type, medium-risk aggressors with the low-level antisocial type (LLA), and the low-risk group with the type of aggressors family only (FO). The implications are discussed in the penitentiary intervention of these results.
A B S T R A C TEtiological models of intimate partner violence (IPV) identify general risk factors in delinquency (sociodemographic, delinquent, and psychopathological) and specific factors in this type of aggression (characteristics of the couple relationship and attitudes favoring IPV). The goal of the present work is to study these factors in individuals convicted for drug trafficking and/or theft, so-called common delinquents (n = 89), comparing them with a group of partner aggressors (n = 50). Assessment was carried out with a mixed method, reviewing case files, clinical interviews for personality disorders, and self-reports. The results show a similar profile in sociodemographic and criminal characteristics and in attitudes favoring IPV. The differences emerge in variables of the couple relationship and psychopathological variables, finding higher prevalence of the antisocial disorder in common delinquents and of the borderline disorder in aggressors. The final model identifies the level of relationship satisfaction, control over the partner, blaming female victims, and incidence of borderline personality disorder as relevant variables. The implications of these results for penitentiary treatment as a preventive measure of IPV, both in IPV aggressors and in the general prison population, are discussed.Los modelos etiológicos de la violencia contra la pareja (VCP) identifican factores de riesgo generales en delincuencia (sociodemográficos, delictivos y psicopatológicos) y factores específicos en este tipo de agresión (características en la relación de pareja y actitudes que facilitan la VCP). El objetivo del presente trabajo es estudiar estos factores en sujetos condenados por tráfico de drogas y/o robo, denominados delincuentes comunes (n = 89), comparándolos con un grupo de agresores contra la pareja (n = 50). La evaluación se ha realizado a través de un método mixto, con supervisión de expedientes penitenciarios y entrevistas clínicas para los trastornos de personalidad y autoinformes. Los resultados muestran un perfil similar en características sociodemográficas, delictivas y en actitudes que favorecen la VCP. Las diferencias se dan en variables de relación de pareja y psicopatológicas, encontrando una mayor prevalencia del trastorno antisocial en los delincuentes comunes y del trastorno límite en los agresores. El modelo final identifica como variables relevantes el nivel de satisfacción en la relación, control sobre la pareja, culpabilización a las mujeres víctimas e incidencia del trastorno límite de personalidad. Se discuten las implicaciones de estos resultados en el tratamiento penitenciario, tanto de los agresores en VCP como de la población reclusa en general, como medidas preventivas de la VCP.
In Spain, there are two types of sentence for partner aggressors: prison sentence and the alternative measure, specifically psychosocial intervention programs. The goal of this study was to determine differences in the delinquent and psychopathological profile of these aggressors as a function of the prison sentence received, for which the models proposed by Dutton (1995) and Holtzworth-Munroe and Stuart (1994) were followed. The sample was made up of 50 incarcerated aggressors and 40 men sentenced to mandatory community orders. The variables were obtained through a mixed method, with supervision of penitentiary case files, clinical interview for personality disorder (SCID-II), and self-reports for the personality profile (NEO-PI-R). Binary logistic regression was used to identify the final model, which best reveals the differences between both groups. The results describe the incarcerated aggressors' profile as having more altered risk factors at the socioeconomic, delinquent, and psychopathological levels. The three variables that increase the probability of belonging to the prison inmate group, according to the final model obtained were: use of weapons, drug consumption, and personality disorder. In contrast to other investigations, the high incidence in the outcomes of the target variables, mainly drug use and personality disorder, makes us wonder whether the diagnostic method used influenced the results in contrast to the exclusive use of self-reports, a goal to be confirmed in future studies.
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