Change in perception and behavior of patients/attendant and healthcare workers after ?ntroduction of low-cost violence prevention interventions at emergency department of a tertiary care hospital in Karachi

Abstract

Background: Objective of the study was to assess the effect of the intervention on patients/attendant’s awareness of their rights and responsibilities, Healthcare Workers (HCWs) experiences on patients/attendant’s behavior, and their ability to be responsive to them. Methods: This Quasi-Experimental Pre-Post-study was conducted in September 2019 to February 2020 at the Emergency department [ED] of a public sector hospital for 6 months. Pamphlets and Posters on the rights and responsibilities of patients/attendants and HCWs and awareness videos were introduced. HCWs were trained on de-escalation skills, communication, information sharing, and improving responsiveness towards patients and attendants. The assessments were done before and after the interventions with a gap of two month. The qualitative aspect was assessed through 12 Focus Group Discussions (FGDs) and thematic analysis was conducted. The effect of intervention on HCWs responsiveness was done using quantitative tools. All HCWs in emergency department (ED) and a total of 200 patients and attendants were interviewed before and after the intervention. Data analysis was done by applying paired T-test (for HCWs) and independent T-test (for patients and attendants. Results: There was a significant positive difference (<0.001) in the overall score of responsiveness of HCWs as reported by the patients and attendants. Conclusion: The qualitative assessment revealed that interventional training assisted HCWs in better understanding the patient's expectation; however, the patient and attendant educational component was less effective in changing their behavior. Conclusion: Violence in emergency healthcare settings is inevitable; however, its impact and intensity can be reduced significantly by building the capacity of HCW’s in prevention and de-escalation skills. Training on the component of responsiveness related to autonomy, confidentiality, respect, and reduce waiting showed improvement at the end.