Whose fault is it? Attribution of causes of patient violence among exposed and unexposed community-based family physicians

Exploring staff experiences and perceptions of patient-perpetrated violence in hospital settings: A qualitative study

AIMS

To explore hospital staff experiences and perceptions of patient-perpetrated violence.

DESIGN

Descriptive qualitative study.

METHODS

Twelve semi-structured interviews (June-August 2022) were held with a diverse sample of hospital nurses, doctors, allied health professionals, security and a non-clinical manager. The framework approach was used to organise and analyse data, using Attribution Theory as a theoretical lens.

RESULTS

Three themes were identified: violence as (un)predictable, violence as (un)preventable and the cumulative toll of violence. In making sense of why patients become violent, participants described different 'types' of aggressive patients and variably attributed behaviours to situation, disposition or a combination of both. Regardless of perceived causal factors, staff overwhelmingly appeared to view violence as predictable. Participants also reflected on the wider structural problems underpinning violence, frequently alluding to their sense of relative powerlessness to initiate change. The cumulative toll of violence was a common thread, with staff describing their acquisition of 'resilience' and reflecting on its role in their responses to escalating situations.

CONCLUSIONS

Many hospital staff are resigned to the inevitability of violence. The concept of staff 'resilience' following violence is not unproblematic, having the potential to serve as a guise for acceptance and as an additional variable for which staff are held accountable. When designing strategies, organisations should ensure that accountability for violence reduction is distributed across multiple levels. This study makes a novel contribution by exploring the perspectives of multiple staff groups working across diverse hospital settings, and adds to a sparse literature on this subject in the UK.

IMPLICATIONS FOR THE PROFESSION

Efforts to address violence against healthcare staff need to be power-conscious, ensuring that accountability is distributed across multiple levels.

REPORTING METHOD

This study is reported in line with the Consolidated Criteria for Reporting Qualitative Studies (COREQ).

PATIENT OR PUBLIC CONTRIBUTION

No patient or public contribution.

More exposure to medical injury news, better doctor-patient communication, but less doctors' professional identity: A moderated chain mediation model

Objectives

In recent years, news of medical malignant injury events has become common in China. However, it is unclear how exposure to this news affects medical staff.

Methods

The present study collected data from a sample of 311 medical staff in China. It explored the effect of exposure to such news on medical staff's communication and willingness to let their children be doctors, which was an attitude that reflects their professional identity well. In addition, this study also examined the mediating roles of outgroup attribution and anxiety, and the moderating role of social support.

Results

The results showed that exposure to news of medical injury could positively and directly predict the quality of doctor-patient communication, but negatively and indirectly predict medical staff's willingness to let their children become doctors. These effects existed through the mediating role of anxiety and the chain mediating role of both outgroup attribution and anxiety. In addition, social support could mitigate the negative correlation between news exposure and outgroup attribution.

Conclusions

These results suggest that news of medical malignant injury events may incentivize medical staff to improve the quality of communication in the short term, but it is not conducive to medical staff's long-term mental health. That is, exposure to news of medical injury is likely to lead to a negative influence on their professional identity, although social support can alleviate this negative influence.

Understanding health outcomes following workplace aggression: A social exchange perspective

This study explored health outcomes following workplace aggression among social workers in Israel. Grounded in the social exchange theory, a relationship-based perspective was used to explain the mechanism through which exposure to workplace aggression results in employee outcomes. Reports of employees and managers were analysed with respect to the impact of varied forms of aggressive behaviours perpetrated by clients and co-workers on posttraumatic stress and somatic symptoms. The intervening effects on symptoms of two forms of perceived organisational support, organisational procedural support and interpersonal co-worker support operationalised as team trust were examined. Overall, 548 employees and 89 managers in 31 social services departments completed self-report questionnaires. Results revealed positive associations between exposure to both co-worker and client aggression, and posttraumatic stress and somatic symptoms. Importantly, while perceived organisational support is often equated with social support, this study found that two elements, organisational procedural support and team trust, had differing impacts on somatic and posttraumatic stress symptoms following WPA. Specifically, team trust was negatively associated with symptoms, while organisational procedural support showed no effect. This study has important implications for timely prevention measures to deal with workplace aggressions and valuable directions for future studies.

Prevalence and associated factors for workplace violence among general practitioners in China: a national cross-sectional study

BACKGROUND

General practitioners (GPs) were at risk of violence in their everyday working lives. Workplace violence (WPV) among GPs is a global public health concern. This study aimed to investigate the prevalence and factors associated with WPV among GPs in China.

METHODS

A cross-sectional study was conducted among 4376 GPs in eastern, central, and western China between March and May 2021 using a structured self-administered questionnaire. The multivariable stepwise logistic regression model was used to examine the factors associated with WPV among GPs in China.

RESULTS

Among these respondents, 14.26% of them reported exposure to WPV in the past 12 months. GPs who were female, practised in a rural area, made home visits occasionally, worked in a fair or good practice environment or work environment, and had a fair or good relationship with patients were less likely to encounter any type of WPV. In addition, GPs who served patients over 20 per day and worked overtime occasionally or frequently were more likely to be exposed to WPV. The determinants of WPV varied in different types of WPV and sexes.

CONCLUSIONS

The prevalence of WPV among GPs is low in China. Our findings could inform the measures to reduce the WPV among GPs.

Does Internet Use Aggravate Public Distrust of Doctors? Evidence from China

The internet has exacerbated the spillover of medical information, and changes in the quantity, quality, and scope of information supply also affect public trust in doctors, which is of great significance to the construction of a harmonious physician–patient relationship. The objective of this study is to explore the relationship between internet use and residents’ trust in doctors using data from the China Family Panel Studies for 2018. The empirical investigation utilizes an endogenous switching regression model (ESR) to overcome the endogeneity bias. Our results indicate that internet use is negatively associated with residents’ trust in doctors (β = 0.07, p < 0.05). Specifically, the patient trust of internet users is nearly 7 percent less than that of non-internet users. Nevertheless, residents with higher dependence on traditional media such as television, newspapers, magazines and radio as an information channel show stronger patient trust. Finally, the results of the subsample analysis indicate a need to focus on older and less-educated residents, who are more vulnerable and more likely to be affected.