河南省三级综合性医院重症监护室护士遭受工作场所暴力的现况分析
Cross-sectional analysis on workplace violence among intensive care unit nurses in tertiary general hospitals in Henan Province
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摘要:
背景 医院工作场所暴力严重影响医务人员的身心健康，而我国重症监护室(ICU)护士工作场所暴力的发生现况尚未可知。
目的 调查河南省三级综合性医院ICU护士遭受医院工作场所暴力的现状并探索其影响因素，为改善护士职业环境提供有效参考。
方法 2019年采用多阶段抽样法从河南省18个地级市中随机选取29家三级综合性医院的ICU护士作为研究对象，以医院工作场所暴力问卷为主要调查工具，采用电子问卷调查ICU护士遭受医院工作场所暴力的现状及特征。采用
χ 2检验进行单因素分析，采用logistic回归对可能引起ICU护士发生医院工作场所暴力的相关因素进行多因素分析。结果 本次研究共回收问卷1 937份，有效问卷1 883份，有效回收率为97.21%。河南省三级综合性医院ICU护士的医院工作场所暴力发生率为44.1%(830/1 883)，其中语言攻击、威胁、躯体攻击、性骚扰发生率分别为43.7%(823/1 883)、27.4%(516/1 883)、20.7%(390/1 883)、4.6%(86/1 883)。ICU护士不同性别、年龄、学历、职称、工龄、婚姻状况、是否独生子女组间医院工作场所暴力发生率差异均无统计学意义(
P >0.05)，遭受过与未遭受过医院工作场所暴力的护士的认知和态度得分差异有统计学意义(6.63±0.92)分vs(6.85±0.95)分(P < 0.001)。logistic回归分析结果显示，ICU护士对医院工作场所暴力的认知及态度可能是暴力事件发生的影响因素(OR =0.786，95%CI ：0.711~0.868，P < 0.001)。结论 近一半ICU护士遭受过医院工作场所暴力事件，以语言暴力为主。ICU护士对医院工作场所暴力的认知及态度可能是遭受暴力事件的保护因素。护理管理部门应加强对ICU护士相关知识的培训，从而减少暴力事件发生。
Abstract:Background Hospital workplace violence has a serious impact on the physical and mental health of medical staff. However there are few studies for intensive care unit (ICU) nurses.
Objective This cross-sectional study investigates the prevalence and influencing factors of hospital workplace violence reported by nurses working in ICU of tertiary general hospitals in Henan Province, and provides suggestions to effectively improve the workplace environment.
Methods A multi-stage sampling method was used to randomly select ICU nurses from 29 tertiary general hospitals in 18 prefecture-level cities in Henan Province in 2019. The prevalence and characteristics of hospital workplace violence suffered by ICU nurses were investigated using an online Hospital Workplace Violence Questionnaire. Univariate analysis was performed by chisquare test, and multiple analysis was performed by logistic regression to analyze the factors that may lead to hospital workplace violence towards ICU nurses.
Results A total of 1 937 questionnaires were received with 1 883 valid questionnaires, and the valid recovery rate was 97.21%. The prevalence rate of hospital workplace violence was 44.1% (830/1 883), and the prevalence rates of verbal abuse, threats, physical assaults, and sexual harassment were 43.7% (823/1 883), 27.4% (516/1 883), 20.7% (390/1 883), and 4.6% (86/1 883), respectively. There were no significant differences in the prevalence rate of hospital workplace violence among ICU nurses of different gender, age, education background, job title, length of service, marital status, or being only child or not groups (
P >0.05), but the scores of perceptions and attitudes towards hospital workplace violence were different between those who had experienced and those who had not(6.63±0.92) vs (6.85±0.95) (P < 0.001). The results of logistic regression analysis showed that the ICU nurses' perceptions and attitudes were the influencing factors of hospital workplace violence occurrence (OR =0.786, 95%CI :0.711~0.868,P < 0.001).Conclusion Almost half of the selected ICU nurses suffer from hospital workplace violence, mainly verbal abuse. Nurses' perceptions and attitudes towards hospital workplace violence are possibly a protective factor against violence events. Therefore, managers should strengthen training on relevant knowledge and skills of ICU nurses to prevent workplace violence.
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