Understanding workplace violence against medical staff in China: a retrospective review of publicly available reports

The effect of sense of security on job performance of medical staff: the mediating effect of psychological capital

Objective

To investigate the current situation of sense of security, psychological capital and job performance of medical staff in Guangdong Province, and to explore the mediating role of psychological capital on the relationship between sense of security and job performance of medical staff.

Methods

In this study, 969 health care workers were selected from February 2023 to April 2023 from 37 hospitals in Guangdong Province, China, using purposive sampling method. The Sense of Security Scale for Medical Staff (SSS-MS), psychological capital scale (PCS) in Chinese version and the Chinese version of job performance scale (JPS) were used in this study. We use SPSS 26.0 for statistical analysis and Amos 24.0 for structural equation modeling (SEM). The control variables entering SEM were selected by regression analysis. SEM analysis confirmed psychological capital scale's mediating function in the link between work performance scale and Sense of Security.

Results

The overall SSS-MS, PCS, and JPS scores were 67.42 ± 16.136, 87.06 ± 15.04, and 77.87 ± 10.50, respectively. The results of Pearson's correlation analysis showed that there was a positive relationship between PCS and JPS (r = 0.722, P < 0.01), SSS-MS and JPS (r = 0.312, P < 0.01), and SSS-MS and PCS (r = 0.424, P < 0.01). PCS demonstrated a fully mediating influence on the link between medical workers' SSS-MS and JPS, according to structural equation modeling.

Conclusion

The JPS of medical personnel in Guangdong Province is at a medium level, with much room for improvement. PCS is positively impacted by a sense of security. There is a supportive correlation between PCS, JPS, and SSS-MS. Furthermore, PCS fully mediates the relationship between medical staff members' JPS and their SSS-MS. The Job Diamond-Resource model and Conservation of Resource theory are further validated and supplemented by the findings of this study, which also gives managers a theoretical foundation for enhancing medical staff performance.

Triage practices for emergency care delivery: a qualitative study among febrile patients and healthcare workers in a tertiary care hospital in Nepal

BACKGROUND

Improving screening and triage practices is essential for early severity assessments at the first point of contact and ensuring timely attention by healthcare workers (HCWs). The main objective of this study was to explore the triage process among febrile patients and HCWs in the emergency department (ED) of a tertiary care hospital in a resource-constrained setting.

METHODS

This qualitative study was conducted from March to May 2023 at the ED of Tribhuvan University Teaching Hospital (TUTH), Nepal. The study included in-depth interviews with febrile patients (n = 15) and HCWs (n = 15). Additionally, direct observation notes (n = 20) were collected to document the triage process and patients' experiences in the ED. Data underwent thematic analysis using the Interpretative Phenomenological Analysis (IPA) approach.

RESULTS

The ED of TUTH offered comprehensive triage services with clear delineation for the severity of febrile patients in line with the World Health Organization (WHO) guidelines. Nonetheless, challenges and constraints were identified. In the ED, evenings were generally the busiest period, and the triage process was not thorough during night shifts. Perception of triage was limited among patients and variable among HCWs. Digitalizing recordings of patient information including payment was deemed necessary for effective management of patients' waiting times at the triage station. High patient throughput added pressure on HCWs and had a potential influence on the delivery of services. Availability of medical equipment and space were also identified as challenges, with patients sometimes compelled to share beds. There were constraints related to waste disposal, hygiene, cleanliness, and the availability and maintenance of washrooms. Febrile patients experienced delays in receiving timely consultations and laboratory investigation reports, which affected their rapid diagnosis and discharge; nonetheless, patients were satisfied with the overall healthcare services received in the ED.

CONCLUSIONS

Improving current triage management requires resource organization, including optimizing the waiting time of patients through a digitalized system. Urgent priorities involve upgrading visitor facilities, patient consultations, laboratory investigations, hygiene, and sanitation. HCWs' recommendations to resource the ED with more equipment, space, and beds and a dedicated triage officer to ensure 24-hour service, together with training and incentives, warrant further attention.

Workplace violence inflicted by patients or their family members/visitors and its relationship with suicidal ideation among undergraduate medical students during clinical training in China

BACKGROUND

Workplace violence in healthcare settings is a significant public concern that profoundly impacts healthcare workers. However, there is a dearth of knowledge regarding the prevalence of workplace violence and its correlation with suicidal ideation among undergraduate medical students in China during their clinical training. The objective of this study was to evaluate the prevalence of workplace violence inflicted by patients or their family members/visitors and to assess its association with suicidal ideation among undergraduate medical students.

METHOD

The snowballing sampling technique was used to recruit Chinese medical students. A question designed by the research team was used to ask medical students about their encounters with workplace violence. Students' basic demographic information and mental distresses (learning burnout, depression symptoms, anxiety symptoms, alcohol abuse/dependence, excessive daytime sleepiness and history of mental disorders) were also assessed. As appropriate, the data were analysed using descriptive statistics, chi-square tests, independent-sample t-tests and multiple logistic regression.

RESULTS

Out of the 1402 undergraduate medical students who participated, 493 (35.2%) reported having experienced workplace violence inflicted by patients or their family members/visitors, of which 394 (28.1%) were verbal abuse, 14 (1.0%) were physical aggression, and 85 (6.1%) were suffered from both verbal abuse and physical aggression. Furthermore, students exposed to workplace violence were more likely to report suicidal ideation and had a higher prevalence of learning burnout, depression symptoms, anxiety symptoms, alcohol abuse/dependence and excessive daytime sleepiness. Depression symptoms, history of mental disorders, learning burnout and having a partner were significantly associated with suicidal ideation in this population.

CONCLUSION

The prevalence of workplace violence inflicted by patients or their family members/visitors was high among undergraduate medical students in China. This may be associated with their mental distress and suicidal ideation. Consequently, it is crucial to strengthen workplace safety measures and promptly implement interventions to mitigate the potentially serious consequences.