Causes of Hospital Violence, Characteristics of Perpetrators, and Prevention and Control Measures: A Case Analysis of 341 Serious Hospital Violence Incidents in China

Abstract

Objective: Hospital violence remains a global public health problem. This study aims to analyze serious hospital violence causes in China and the characteristics of perpetrators. It likewise seeks to understand frontline personnel's needs and put forward targeted suggestions.Methods: Serious hospital violence cases from 2011 to 2020 in the China Judgment Online System (CJOS) were selected for descriptive statistical analysis. A total of 72 doctors, nurses, hospital managers, and security personnel from 20 secondary and tertiary hospitals in China were selected for semi-structured interviews.Results: Of the incidents, 62.17% were caused by patients' deaths and dissatisfaction with their treatment results. Moreover, it was found that out-of-hospital disputes (11.14%) were also one of the main reasons for serious hospital violence. The perpetrators were mainly males (80.3%), and had attained junior high school education or lower (86.5%). Furthermore, most of them were family members of the patients (76.1%). Healthcare workers urgently hope that relevant parties will take new measures in terms of legislation, security, and dispute handling capacity.Conclusion: In the past 10 years, serious hospital violence's frequency in China has remained high. Furthermore, their harmful consequences are more serious. The causes of hospital violence are diverse, and the characteristics of perpetrators are obvious. Frontline healthcare workers urgently need relevant parties to take effective measures in terms of legislation, security, and dispute handling capacity, to prevent the occurrence of violence and protect medical personnel's safety.

Prevalence, characteristics, and consequences of verbal and physical violence against healthcare staff in Chinese hospitals during 2010–2020

“…Similar studies in China have shown comparable findings, with the highest prevalence seen in Guangdong, Jiangsu, and Zhejiang. 6 , 10 The National Bureau of Statistics of China ( http://data.stats.gov.cn/search.htm ) reported that the above provinces had high gross domestic products (GDPs) and large populations. Thus, besides the likely selection bias, we speculate that economically developed provinces attract millions of migrant workers every year—and thus adding to the already overloaded burden of the healthcare staff by residents—has led to a higher frequency of medical WPV.…”

“…WPV rate increased dramatically in 2014 and then dropped after 2016, which might be due to the adoption in China of a series of laws on the punishment of unlawful crimes involving medical services to preserve the regular order of health settings since 2014. 6 For instance, the “Views on Punishing Medical‐related Illegal Crimes and Maintaining Normal Medical Order” jointly promulgated by the Supreme People's Court, the Supreme People's Procuratorate, the Ministry of Public Security, the Ministry of Justice, and the National Health and Family Planning Commission in 2014 states that criminals who had intentionally injured healthcare staff or destroyed public or private property without causing serious consequences should be punished under the “Law on Administrative Punishments for Public Security of the People's Republic of China”. However, those who had intentionally severely injured or killed healthcare staff and other serious consequences should be convicted and punished under the relevant provisions of the “Criminal Law of the People's Republic of China”.…”

“…Previous research has also shown that the most serious cases of WPV may be triggered by larger problems, such as those related to diagnosis and treatment, rather than by minor problems. 6 …”

SUSTAINABLE DEVELOPMENT GOALS & VIOLENCE PREVENTION IN HOSPITALS: CONTRIBUTIONS FROM PSYCHOLOGY STUDENTS

“…In Portugal, where (a) enjoying decent work and a healthy and safe working environment is a fundamental right according to the Constitution, (b) the notifications' trend of situations of violence against health care professionals has been increasing, and (c) violence is considered a crime in the Penal Code, a Action Plan to Prevent Violence in the Health Sector was developed (Direção-Geral da Saúde DGS, 2020). Unfortunately, violence against health care workers is not limited to Portugal: it is a worldwide phenomenon (DGS, 2020;Ma et al, 2022;Vento, Cainelli, & Vallone, 2020).…”

“…While strong evidence of the efficacy of preventive interventions is still lacking, several measures have been advocated, including quality courses for healthcare professionals (covering communication, identification of early signs that someone may become violent, dangerous situations' management, and self-protection), well-being promotion and psycho social risks (including stress and burnout) prevention, and education of the general population (DGS, 2020; Ma et al, 2022;Vento et al, 2020).…”