Work‐related Aggression and Violence Committed by Patients and Its Psychological Influence on Doctors

Abstract

Work-related Aggression and Violence Committed by Patients and Its PsychologicalInfluence on Doctors: Keigo Saeki, et al. Department of Community Health and Epidemiology, Nara Medical University School of Medicine-Objectives: To determine the incidence rate of work-related aggression and violence (WRAV) against doctors and investigate risk factors and psychological influences of WRAV doctors. Methods: We sent a self-administered questionnaire on WRAV committed by patients and their associates to 1,148 doctors in Nara Prefecture, Japan. We calculated the incidence rate of WRAV using the number of incidents encountered during the previous 12 mo and the doctor's average weekly working hours. Risk factors for the incidence WRAV were analyzed by Poisson regression, and the influence of WRAV on the symptoms of post-traumatic stress disorder (PTSD) was evaluated by multiple logistic regression analysis. Results: A total of 758 (66.0%) doctors returned the questionnaire. The incidence rate of WRAV was 0.20 [95% CI: 0.17-0.24]×10 -3 per practice hour. Adjusted incidence rate ratios of WRAV were significantly increased among doctors 1) with a shorter career (11.0; 95% CI: 5.0-24.2), 2) working in a region with the lowest average taxable income (1.6; 1.1-2.4), and 3) whose specialties were dermatology (3.8; 2.3-6.3), psychiatry (2.7; 1.3-5.6) and ophthalmology (1.9; 1.2-3.2). Of 289 subjects who had encountered WRAV at least once during their career, 26 doctors (8.2%) had symptoms suggestive of PTSD due to the most severe incident. Conclusions: Doctors encountered WRAV at an incidence rate of 0.20×10 -3 per practice hour, and some of them might develop PTSD. Countermeasures are required to maintain sound health and safe workplaces for doctors. (J Occup Health 2011; 53: 356-364)

Violence against doctors in China

“…They threaten and assault hospital personnel, damage facilities and equipment, and prevent the normal activities of the hospital • Although some people approach Yi Nao to deal with medical disputes, Yi Nao also solicit business by wandering around hospitals, looking for potential "malpractice" cases and encouraging individuals to pursue them • Yi Nao disturbances, many of which have been very serious with fatal consequences, have been widely reported in the Chinese press recent studies from other countries. [10][11][12][13][14][15][16][17][18] Comparisons between studies are difficult because they use widely varying definitions of violence-from rudeness, verbal abuse, threats, and stalking, to physical violence with or without injury-with the exact distinctions not always clear. Many of the studies have small sample sizes and low (or unstated) response rates, which could lead to bias.…”

Workplace Violence and Its Effects on Burnout and Secondary Traumatic Stress among Mental Healthcare Nurses in Japan

“…WPV may cause not only physical injuries but also psychological impacts, resulting in higher rates of fear or anxiety, anger, insecurity, depression, emotional exhaustion, suicidal thoughts, post-traumatic stress symptoms, guilt, self-blame, and shame [2,8]. The consequences of WPV include decreased job satisfaction, increased intent to leave the organization, and lowered health-related quality of life [2].WPV and its consequences among nurses in Japan have been described [10,[16][17][18][19][20]. Of respondents to previous surveys, 33-47% of the nurses had experienced WPV during the prior 12 months [16][17][18].…”

Violencia laboral externa tipo amenaza contra médicos en servicios hospitalarios de Lima Metropolitana, Perú 2014

“…Sin embargo, no siempre se establece una relación de colaboración médico-paciente-familia y en este caso el familiar poco involucrado e informado en el proceso de atención tendería a atacar al médico. Por tanto, el médico debería poner en práctica sus habilidades para entrevistar, negociar, solucionar problemas y comunicarse no solo con el paciente sino también con el familiar, haciéndolo parte activa del manejo del paciente (27) .…”

“…Se sugiere, por ejemplo, que las estrategias deben ser preventivas y de soporte. Las preventivas enfocadas a considerar algoritmos estandarizados de clasificación de pacientes, sobre todo en la emergencia, señalizaciones claras en los establecimientos de salud, información y concientización al paciente y sus familiares, mediadores en salas de esperas y unidades de seguridad con personal y recursos adecuados (27) . Paralelamente, las estrategias de soporte también deberían apoyar a la víctima tanto en la rehabilitación emocional -debido al alto impacto que pueden producir (28) -como en relación a las leyes que regulen lo actos de violencia.…”