基层医院护士工作场所暴力与其生存质量的相关性研究

目的探讨护理人员工作场所暴力与其生存质量的关系,为预防护理人员遭受工作场所暴力、提高护理人员生存质量提供理论依据。方法采用生存质量量表（WHOQOL-100）对285名护理人员的生存质量进行调查,并由其自行评价过去1年内是否遭受工作场所暴力、工作场所暴力类型及原因。结果180名（63．16％）护士在过去的一年里遭受过工作场所暴力。基层医院护士是否受到工作场所暴力其生存质量的总体状况、心理、环境、精神支柱维度的评分有统计学差异（P〈0．05,P〈0．01）。工作场所暴力与生存质量呈显著负相关（均P〈0．05）。结论遭受工作场所暴力对护理人员的生存质量有影响,应采取措施预防和控制工作场所暴力的发生。     

护士工作场所暴力氛围感知现况调查

目的 了解护士对工作场所暴力氛围感知现状,为有针对性干预提供参考.方法 采用分层随机整群抽样法,以护士工作场所暴力氛围感知量表对荆州地区不同级别医院的997名在岗护士进行调查.结果 护士工作场所暴力氛围感知总分(97.11±23.74)分,组织管理维度得分率(71.30％)高于暴力事件处理(70.49％)、暴力预防(66.61％).不同年龄、工作年限、科室、医院级别、暴力事件经历的护士工作场所暴力氛围感知总分比较,差异有统计学意义(P＜0.05,P＜0.01).结论 护士工作场所暴力氛围感知处于中等水平,需注重暴力防范与处理,为护士创造安全的执业环境.     

护理人员工作场所暴力与工作倦怠调查分析

目的了解工作场所暴力对护理人员工作倦怠的影响。方法抽取上海市宝山区3所二级以上医院护理人员904人,应用护理人员工作场所暴力问卷、Maslach工作倦怠问卷和领悟社会支持量表进行调查。结果 69.91%的护理人员曾遭受暴力,其中遭受躯体暴力8.41%,心理暴力61.50%。遭受心理暴力组护士情绪疲倦感、工作冷漠感及成就感低落程度显著高于未遭受心理暴力组,遭受躯体暴力组护士情绪疲倦感及工作冷漠感程度显著高于未遭受躯体暴力组(P0.05,P0.01);多元线性回归分析显示工作场所暴力是护士情绪疲倦感和工作冷漠感的影响因素,领悟社会支持是护士工作倦怠的影响因素(P0.05,P0.01)。结论护理人员遭受医院场所暴力的发生率高,工作场所暴力加剧工作倦怠感;应采取有效措施防范暴力事件,提高护士的社会支持度等,维护其心身健康。     

不同科室护士遭受工作场所暴力调查分析

目的比较不同科室护士在医院工作场所遭受暴力状况,为预防暴力事件的发生及维护护理人员的身心健康提供依据。方法自编医务人员医院暴力发生状况调查问卷,对171名护士进行有关遭受工作场所暴力情况的问卷调查。结果因肇事者醉酒、药物滥用、精神障碍或意识障碍患者引发的暴力,急诊科发生率显著高于普通病房(P0.05,P0.01);普通病房因患者病情无好转而引发的暴力发生率显著高于急诊科(P0.05);急诊科施暴源来于患者、患者家属或朋友显著高于普通病房(均P0.01);急诊科遭受暴力类型中躯体冲突、威胁性事件或姿势有2种躯体损伤情况显著高于普通病房(均P0.01);急诊科护士无助感和缺乏安全感显著高于普通病房(均P0.01);未受过正规防范工作场所暴力知识培训的急诊科护士显著多于病房护士(P0.01)。结论急诊科护士遭受工作场所暴力的问题较为严重,应加强法律、法规、防范暴力知识的培训及心理疏导,以有效防范医院暴力事件发生,维护护理人员的身心健康。     

应对方式与组织支持对遭受工作场所暴力急诊护士抗逆力的影响

目的 调查遭受工作场所暴力急诊护士抗逆力现状,并分析应对方式和组织支持对其抗逆力的影响。方法 以上海市6所三甲医院急诊护士1 241名为研究对象,采用暴力频度量表筛选出近1个月遭受过工作场所暴力的急诊护士,并采用一般情况调查表、组织支持量表、特质应对方式问卷以及中文版医护人员抗逆力评价量表对其进行调查。结果 749名急诊护士近1个月在工作场所中曾遭受工作场所暴力,其中以语言暴力为主。遭受工作场所暴力急诊护士的抗逆力得分为（69.84±12.68）分。相关性分析显示,积极应对方式、组织支持与抗逆力总分呈正相关,消极应对方式与抗逆力呈负相关（均P＜0.05）;多元逐步回归分析显示,应对方式、组织支持是遭受工作场所暴力急诊护士抗逆力的主要影响因素（均P＜0.05）。结论 遭受工作场所暴力急诊护士的抗逆力水平有待提高,积极应对方式、组织支持对其有正向预测作用,需制订干预方案以提升急诊护士抗逆力水平。     

不同等级医院护士工作场所暴力发生现况研究

目的了解不同等级医院护士工作场所暴力发生情况并分析其差异性,为针对性开展WPV预防提供参考。方法采用整群随机抽样法,分别选取苏州市2所三级医院、4所二级医院护士1 305人和632人进行问卷调查。结果二级医院护士工作场所暴力发生率(69.94%)显著高于三级医院(62.61%),且语言攻击发生率差异有统计学意义(均P0.01);二级医院护士听说过工作场所暴力等4个条目认知率显著低于三级医院护士,对医院鼓励上报、有处理工作场所暴力科室等4个条目选择率低于三级医院护士(P0.05,P0.01)。结论护士遭受工作场所暴力现象较普遍;二级医院护士工作场所暴力发生率高于三级医院护士,但暴力认知(及对所在医院暴力事件处理方式的评价)低于三级医院护士。应加强对二级医院护士工作场所暴力的关注,加强暴力应对培训,提升医院管理部门对暴力事件的重视,从而降低暴力事件的发生。     

遭受工作场所暴力急诊护士情绪调节策略在应对方式与抗逆力之间的调节效应

目的 探讨遭受工作场所暴力急诊护士情绪调节策略在应对方式与抗逆力之间的调节作用，为护理管理者实施针对性管理措施提供依据。方法 选择上海市三甲医院239名遭受工作场所暴力的急诊科护士作为调查对象，采用一般资料问卷、中文版抗逆力简表、情绪调节问卷、特质应对方式问卷进行调查。结果 239名遭受工作场所暴力急诊护士的抗逆力得分为(27.42±7.44)分。认知重评、表达抑制、积极应对与急诊护士抗逆力呈正相关(均P<0.05),消极应对方式与抗逆力呈负相关(P<0.05);积极应对方式可以直接预测抗逆力，认知重评(β=-0.022,P<0.05)和表达抑制(β=-0.031,P<0.05)在积极应对方式与抗逆力间起调节作用。结论 遭受工作场所暴力急诊护士的抗逆力得分处于较低水平，情绪调节策略能够增强护士积极应对方式对抗逆力的影响。提高遭受工作场所暴力急诊护士的积极应对方式，同时帮助他们增强情绪调节策略的使用，能够有助于提高急诊护士的抗逆力，减少工作场所暴力带来的不良影响，维持身心健康。     

不同地区两医院护理人员工作场所暴力的现状分析

目的:对哈尔滨某医院与杭州某医院医院护理人员工作场所暴力发生的情况等方面进行研究,找出两医院的差异性.方法:采用陈祖辉、王声口的《医院工作场所暴力调查问卷》对两医院各约100名护士进行调查.结果:两医院在遭受躯体攻击情况、认为“工作场所暴力”是否值得大惊小怪、是否受益于预防工作场所暴力事件的培训、是否鼓励员工遭受工作场所暴力后上报四个条目上存在差异.结论:两医院之间存在一定差异,需取长补短,预防和减少医院工作场所暴力的发生.     

新执业护士工作场所遭受暴力现状及其相关因素调查

目的了解新执业护士工作场所遭受暴力的基本情况,分析不同暴力类型及特征与新执业护士工作效果的关系。方法在深圳市4所医院中采用便利整群抽样法选取521名新执业护士,调查入职6~12个月遭受暴力事件的类型、频率、特点,并探讨遭受暴力频次与工作满意度、组织承诺、工作倦怠的相关性。结果新执业护士遭受辱骂的发生率最高,达到64.04%。新执业护士在病房遭受暴力的比例均明显高于护士台及医生办公室,施暴者主要是患者家属。新执业护士遭受暴力频次与其工作满意度和组织承诺呈负相关,与工作倦怠呈正相关(均P<0.05)。结论新执业护士遭受工作场所暴力的频次较高,管理者需采取针对性措施降低工作场所暴力,以提高对新执业护士的工作满意度及组织承诺,减轻工作倦怠程度。     

不同科室护士遭受工作场所暴力调查分析

目的比较不同科室护士在医院工作场所遭受暴力状况,为预防暴力事件的发生及维护护理人员的身心健康提供依据。方法自编医务人员医院暴力发生状况调查问卷,对171名护士进行有关遭受工作场所暴力情况的问卷调查。结果因肇事者醉酒、药物滥用、精神障碍或意识障碍患者引发的暴力,急诊科发生率显著高于普通病房（P〈0．05．P〈0．01）;普通病房因患者病情无好转而引发的暴力发生率显著高于急诊科（P〈0．05）;急诊科施暴源来于患者、患者家属或朋友显著高于普通病房（均P〈0．01）;急诊科遭受暴力类型中躯体）中突、威胁性事件或姿势有2种躯体损伤情况显著高于普通病房（均P〈0．01）;急诊科护士无助感和缺乏安全感显著高于普通病房（均P〈0．01）;未受过正规防范工作场所暴力知识培训的急诊科护士显著多于病房护士（P〈0．01）。结论急诊科护士遭受工作场所暴力的问题较为严重,应加强法律、法规、防范暴力知识的培训及心理疏导,以有效防范医院暴力事件发生,维护护理人员的身心健康。     

Dangers on the road: A longitudinal examination of passenger‐initiated violence against bus drivers

This study examined the impact of workplace violence against 109 bus drivers over a 1‐year span. Workplace violence is related to both psychological and work‐related consequences. Our findings showed that bus drivers experienced a wide range of violence at work and the psychological consequences were devastating: Half of the participants met the diagnostic criteria for acute stress disorder within the first month following the index event. Majority of them experienced at least moderate levels of post‐traumatic stress disorder (PTSD) problems over the 1‐year span. About 9.3% of participants showed a delayed onset of PTSD 6 months after. Furthermore, counter‐supportive behaviours and reexposure to violence played important roles in the maintenance of PTSD symptoms over time. Even though PTSD symptoms per se did not relate to bus driver's confidence in coping with aggressive passengers, the immediate post‐traumatic reaction—symptoms of acute stress disorder—showed a significant long‐term negative effect on bus drivers' confidence in dealing with aggressive passengers 12 months after. This study provided empirical evidence of the changing nature of PTSD symptoms over time among bus drivers.     

Intimate Partner Violence Among Women Veterans: Previous Interpersonal Violence as a Risk Factor

Experiences of abuse during childhood or military service may increase women veterans’ risk for intimate partner violence (IPV) victimization. This study examined the relative impact of 3 forms of interpersonal violence exposure (childhood physical abuse [CPA], childhood sexual abuse [CSA], and unwanted sexual experiences during military service) and demographic and military characteristics on past‐year IPV among women veterans. Participants were 160 female veteran patients at Veterans Afffairs hospitals in New England who completed a paper‐and‐pencil mail survey that included validated assessments of past‐year IPV and previous interpersonal violence exposures. Women who reported CSA were 3.06 times, 95% confidence interval (CI) [1.14, 8.23], more likely to report past‐year IPV relative to women who did not experience CSA. Similarly, women who reported unwanted sexual experiences during military service were 2.33 times, 95% CI [1.02, 5.35], more likely to report past‐year IPV compared to women who did not report such experiences. CPA was not associated with IPV risk. Having less education and having served in the Army (vs. other branches) were also associated with greater risk of experiencing IPV in the past year. Findings have implications for assisting at risk women veterans in reducing their risk for IPV through detection and intervention efforts.     

急诊护士工作场所暴力应对策略的SWOT分析

运用SWOT方法对急诊护士应对工作场所暴力的优势、劣势、机会、挑战进行综合分析,提出急诊护士工作场所暴力应对策略,即建立预防工作场所暴力指南和工作机制,建立完善的监测和评估系统;加强对急诊护士培训,提高急诊护士职业素质;优化医院环境和流程,以及以社区医院为依托,急诊专科护士为主导,提高居民院前急救技能和医学基本知识;对降低急诊护士遭受医院工作场所暴力事件发生有重要作用。     

Health‐related quality of life of female sex workers living with HIV in South Africa: a cross‐sectional study

IntroductionHealth‐related quality of life (HRQoL) is an important HIV outcome beyond viral suppression. However, there are limited data characterizing HRQoL of key populations, including female sex workers (FSW) living with HIV.MethodsWe used baseline data (22 June 2018–23 March 2020) of FSW who were diagnosed with HIV and enrolled into a randomized trial in Durban, South Africa. HRQoL information was collected by a generic preference‐accompanied tool with five domains (EQ‐5D), and summarized into a single score (range 0–1), which represents health utility. We employed multivariable beta regression models to identify determinants of HRQoL and to estimate subgroup‐specific HRQoL score. Using external estimates of life expectancy and population size, we estimated the number of quality adjusted life years reduced among FSW living with HIV in South Africa associated with violence and drug use.ResultsOf 1,363 individuals (mean age: 32.4 years; mean HRQoL score: 0.857) in our analysis, 62.6% used drugs, 61.3% experienced physical or sexual violence and 64.6% self‐reported taking antiretroviral treatment (ART). The following were associated with a reduction in the average marginal HRQoL score: older age (per decade: 0.018 [95% confidence interval (CI): 0.008, 0.027]), drug use (0.022 [0.007, 0.036]), experience of violence (0.024 [0.010, 0.038]) and moderate (vs. no) level of internalized stigma (0.023 [0.004, 0.041]). Current ART use was associated with a 0.015‐point (–0.001, 0.031) increase in the HRQoL score. The estimated mean (95% CI) HRQoL scores ranged from 0.838 (0.816, 0.860) for FSW who used drugs, experienced violence and were not on ART; to 0.899 (0.883, 0.916) for FSW who did not use drugs nor experience violence and were on ART. Our results can be translated into a reduction in 37,184 and 39,722 quality adjusted life years related to drug use and experience of violence, respectively, in South Africa.ConclusionsThese results demonstrate the association of ART with higher HRQoL among FSW and the need to further address structural risks, including drug use, violence and stigma. Population‐specific estimates of HRQoL score can be further used to calculate quality‐adjusted life years in economic evaluations of individual and structural interventions addressing the needs of FSW living with HIV.Clinical Trial Registration{"type":"clinical-trial","attrs":{"text":"NCT03500172","term_id":"NCT03500172"}}NCT03500172 (April 17, 2018).     

Quality of Life after Laparoscopic Adjustable Gastric Banding for Severe Obesity: Postoperative and Retrospective Preoperative Evaluations

BACKGROUND: The aim of this study was to examine postoperative as well as retrospective preoperative evaluations of multiple dimensions of quality of life of patients with morbid obesity after laparascopic adjustable gastric banding (LAGB). METHODS: 12 to 38 months after LAGB, 74 consecutive patients (64 female, 10 male, mean age 36.6 years, age range 23-56) filled out the RAND-36 Health Survey questionnaire to evaluate their current postoperative as well as their past preoperative quality of life. RESULTS: Pre- to 1 year postoperative weight reduction (127.5 to 100.7 kg) and change of BMI (45.2 to 35.6 kg/m2) were highly significant (p<0.001). As compared to age reference groups, the preoperative quality of life was evaluated very poor (p<0.002), postoperative psychological and social quality of life were about normal (all p's >0.10), and postoperative physical functioning (p=0.04), vitality (p=0.01) and general health (p=0.03) were below normal. No differences were found between postoperative evaluations of patient groups with varying postoperative follow-up duration, but patients in the second year after surgery evaluated some aspects of their preoperative quality of life as poorer than patients in the third year after surgery. CONCLUSION: Postoperative psychosocial quality is at a level that may be expected to motivate patients to consolidate the surgically established weight reduction, but attention should be paid to the physical condition. Since the relative gain in quality of life as experienced by patients tends to be evaluated less with a longer duration of the postoperative interval, the risk of relapse may increase with passage of time.     

Quality of life before and after liver transplantation: experiences with 7 patients with primary biliary cirrhosis in a 2-year follow-up

Seven patients with end-stage primary biliary cirrhosis were evaluated both before and 1 and 2 years after liver transplantation using a clinical psychiatric interview and the self-rating questionaire SCL-90. Neuro-psychological tests were done before and 1 year after operation. Preoperatively, all patients had a poor general condition and overall quality of life. Flattening of emotions and reactions, regression, disturbances of verbal memory and cognitive function, and dependence on close relatives were observed. One year after transplantation, 6 patients had a much better overall quality of life, and with five patients it improved still further during the 2nd year, but only 2 patients felt that their life situation had fully stabilised. However, nearly all of them experienced phases of moderate or even severe depression or anxiety during those 2 years. On neuropsychological tests patients appeared to be near their normal level. The only patient who died during this follow-up (some months after transplantation) had in her life history a prominent sense of insecurity and mistrust. It seems to take more than a year for the majority of patients to give up the regressive mode of experience and turn to adult interests in life again, as well as psychologically experience the new liver as part of oneself.     

Risk markers of severe psychological violence against women: a WorldSAFE multi-country study

This study was an attempt to determine the prevalence and significant risk factors associated with severe psychological violence in 6 WorldSAFE sites. The respondents were 3975 women aged 15-49 years and residing in selected urban areas in Chile, Egypt, the Philippines and India. Using a standard instrument translated locally, psychological violence was measured using items indicating the following domains: verbal abuse, fear and separation. A woman who had experienced severe psychological violence had admitted that she had experienced any of the above-mentioned behaviors '3 or more times' in her lifetime (lifetime prevalence) or with her current partner during the past 12 months (current prevalence). The results showed a lifetime prevalence of severe psychological violence ranging from 10.5% of women in Egypt to about 50% in Chile and Trivandrum, India. Verbal abuse was most common among the different behavioral indicators. A woman's mental health status and partner alcohol use were found to be the common significant risk factors. Recommendations were made to facilitate efforts to address severe psychological violence in developing countries.