中文摘要

目的 对某传染病医院工作场所暴力事件进行调查，分析其影响因素，探究我国传染病专科医疗机构暴力事件发生的深层原因以及寻求个性化的工作场所暴力的预防控制措施。

方法 本研究采用定量研究和定性研究相结合的混合方法研究（Mixed Methods Research，MMR），通过问卷调查和现场访谈的方式对传染病医院工作场所暴力进行调查。采用中文版《医疗部门工作场所暴力国家案例研究工具——调查问卷》。采用电话或面对面的形式对重点人群进行半结构化个人深入访谈，收集该院医务工作者对工作场所暴力事件发生原因及应对措施的看法。

结果 在本次调查的720名医务工作者中，女性医务工作者533名，男性187名；年龄范围为19.0～70.0（35.0±9.4）岁。本次调查中共有248名医务工作者遭受不同形式的工作场所暴力，该医院在过去12个月内工作场所暴力的发生率为34.4%（248/720，34.44%）。其中，有24名医务工作者遭受身体暴力，身体暴力发生率为3.3%（24/720，3.33%）；有244名医务工作者遭受心理暴力，心理暴力发生率为33.89%（244/720，33.89%）。按照心理暴力分类，不同类型心理暴力的发生率从高到低依次为语言侮辱（235/720，32.64%）、欺负/团伙欺负（61/720，8.47%）、性骚扰（16/720，2.22%）、民族歧视（9/720，1.25%），差异有统计学意义（趋势性χ²=470.13，P＜0.01）。本次调查充分考虑年龄、性别、职位等因素后，共访谈到该院医务工作者28名（28/720，占3.9%）。受访者认为工作场所暴力发生的原因主要存在于以下方面：施暴者的个人因素，如醉酒、吸毒等神志不清、性格急躁、文化程度低、法律意识淡薄等（18/28）；患者及家属认为治疗花费高但治疗效果不满意（12/28）；医患之间缺乏有效的沟通（7/28）。

结论 医院工作场所暴力是一个系统性问题，须从工作场所暴力定义的角度完善身体暴力和心理暴力的防控，并纳入医院职业健康安全管理体系。

Abstract

Objective Workplace violence was investigated in this hospital, analyzed its influencing factors, and explored the underlying causes of violence in the infectious diseases hospital in China as well as sought individualized preventive and control measures for workplace violence.

Method Mixed Methods Research (MMR) of quantitative research and qualitative research was used in this study. The Chinese version of “Workplace Violence in the Health Sector Country Case Studies Research Instruments -Survey Questionnaire ”was adopted for a Cross-sectional study. Semi-structured in-depth interviews with key groups were conducted on the phone or face-to-face to collect the opinions of the health workers on the causes and response measures of workplace violence.

Results Among the 720 health workers in this survey, 533 (74.0%) were female health workers and 187 (26.0%) were male; and the age range was 19.0 to 70.0 years (35.0 ± 9.4).A total of 248 health workers suffered from different forms of workplace violence in this survey, and the self-reported incidence of workplace violence in the past year was 34.4% (248/720). Of these, 24 health workers suffered from physical violence, with an self-reported incidence was 3.3% (24/720).244 health workers suffered from psychological violence in the past year. The incidence of psychological violence in the workplace of health workers was 33.9% (244/720).According to the classification of psychological violence, the incidence of different types of psychological violence from high to low was verbal abuse (235/720, 32.6%), bullying/gang bullying (61/720, 8.5%), sexual harassment (16/720, 2.2%), racial discrimination (9/720, 1.3%), respectively. The difference was statistically significant (χ2=470.13, P < 0.01).A total of 28 health workers were interviewed in this survey after taking full consideration of age, gender, position and other factors. Participants believed that the causes of workplace violence mainly existed in the following aspects: personal factors of the perpetrators, such as drunkness and drug addiction, impatient character, low education level, and weak legal awareness (18/28); Patients and their families thought that the treatment cost was high but the treatment effect was not satisfactory (12/28); Lack of effective communication between doctors and patients (7/28).

Conclusion Workplace violence in hospital is a systemic issue. The prevention and control of physical violence and psychological violence should be improved from the perspective of the definition of workplace violence and incorporated in the hospital’s occupational health and safety work system.