Vivencias y percepción de los profesionales sanitarios de las urgencias extrahospitalarias ante las agresiones

ObjetivoConocer las opiniones de los profesionales sanitarios que trabajan en el Punto de Atención Continuada de Ourense (PAC) con relación a las agresiones laborales.DiseñoEstudio cualitativo con enfoque fenomenológico realizado entre enero y mayo del 2019.EmplazamientoPAC.ParticipantesVeinte profesionales de distintas categorías.MédodoMuestreo estructural. Se emplearon entrevistas abiertas grabadas en audio, previo consentimiento de los participantes.ResultadosLos profesionales entrevistados manifiestas haber sido víctimas de agresiones, sobre todo verbales. Estas agresiones según los participantes son tan habituales que las han normalizado dentro de su jornada laboral. Ninguno ha denunciado nunca este tipo de conductas, en gran medida porque consideran que la burocracia y los trámites administrativos son tediosos, y otros por desconocimiento del procedimiento. Este tipo de situaciones, a nivel laboral, les causa sentimientos de tristeza, rabia e impotencia y son la causa, según ellos, del aumento de la medicina defensiva. Los profesionales consideran que la causa del aumento de las agresiones entre el colectivo es la mala educación y la gestión inadecuada del empoderamiento del paciente.ConclusionesLos profesionales sanitarios sufren continuamente agresiones, sobre todo de tipo verbal, siendo algo habitual en su día a día. Estas agresiones no son denunciadas, pero les causan múltiples sentimientos negativos y disruptivos, llegando a modificar su manera de trabajar.Palabras clave: Violencia laboral, Personal de salud, Agresión, Violencia     

Implementing Non-violent Resistance,a Method to Cope with Aggression in Child and Adolescent Residential Care: Exploration of Staff Members Experiences

Staff members in residential care for youth are frequently confronted with aggressive behaviour, which has adverse effects on their stress levels and work satisfaction. This paper describes a qualitative evaluation to find out how staff members benefit from Non-violent Resistance (NVR), a method to create an aggression mitigating residential climate. Staff members were positive about NVR and reported feeling more relaxed. Most valued aspects of this method were the focus on being a team, delayed response and giving up the illusion of control. However, training and the intention to use NVR isn't enough, high quality implementation and maintenance are crucial.     

Criminal victimisation and health: Examining the relation in nine countries of the former Soviet Union

Previous research suggests that criminal victimisation can impact negatively on both physical and psychological health. However, as yet, little is known about crime and its effects on population health in the former Soviet Union (fSU) – despite a sharp growth in crime rates in the countries in this region after the collapse of the communist system. Given this gap in current knowledge, this study examined two forms of crime, theft and violent victimisation, in nine fSU countries – Armenia, Azerbaijan, Belarus, Georgia, Kazakhstan, Kyrgyzstan, Moldova, Russia and Ukraine. Using nationally representative data from the Health in Times of Transition (HITT) study collected from 18,000 respondents in 2010/11, the study had two main objectives: (1) to identify which demographic and socioeconomic factors are associated with being a victim of crime; (2) to examine the relation between criminal victimisation and two health outcomes – self-rated health and psychological distress. We found that similar factors were associated with experiencing both forms of crime among respondents. Those who were younger, not married and who consumed alcohol more frequently were at increased risk of victimisation, while greater social capital was associated with lower odds for victimisation. Low education increased the risk of experiencing violence by 1.5 times. Victimisation was strongly associated with poorer health: victims of violence were 2.5 and 2.9 times more likely to report poor self-rated health and psychological distress, respectively, while the corresponding figures for theft victimisation were 1.9 and 1.8. The strong association we observed between criminal victimisation and poorer individual health suggests that, in addition to policies that reduce rates of crime, more research is now urgently needed on victimisation. Specifically, researchers should ascertain whether the association with poor health is causal, determine its potential mechanisms, and evaluate interventions that might mitigate its impact on health that are contextually appropriate in the fSU.     

South Africa: Challenges and successes of the COVID-19 lockdown

At the beginning of March 2020, South Africa (59 million inhabitants) was hit by the pandemic of COVID-19 and soon became the most affected country in Africa by the SARS-CoV-2 virus. From one single case on March 5th, the number of cases increased rapidly, forcing the South-African Government to swiftly react and place the country under strict lockdown for six weeks. The strategy of the South African Government bore fruits with a contained spread of the virus. If the number of positive cases at the end of the lockdown reached 5647, the number of fatal casualties was limited to 103 deaths. The lockdown was overall well respected, even if serious problems of food supply soon occurred in informal settlements, leading to riots and confrontation with security forces. Indeed, populations were obedient, but not being able to practice sport or outdoors activities appeared heavy. The constant fear of the poorest not to have enough money to pay rent and buy food (even if the Government organised food parcels’ distributions), and to find less and less work was echoed by the fear of losing jobs among those more privileged. Despite the risk of an economic crisis, the South African Government has continued on the reasonable path of containing the pandemic with ending the lockdown at a slow pace, in five phases.     

Longitudinal pathway from violence exposure to firearm carriage among adolescents: The role of future expectation

IntroductionExposure to violence is a risk factor for firearm carriage. Youth exposed to violence also have difficulty envisioning positive future outcomes (e.g., educational outcomes), which can increase the likelihood of firearm carriage over time. Researchers, however, have not yet examined whether changes in exposure to violence over time can influence the developmental trajectories of firearm carriage. To address this gap, we (1) examined the longitudinal association between exposure to violence and firearm carriage (grades 9 to 12) and then (2) examined whether changes in future expectations mediated this longitudinal association.MethodThe longitudinal association between exposure to violence and firearm carriage through future expectations was examined among 850 adolescents from the Flint Adolescent Study. Participants were recruited from four high schools in a midwestern city in the United States. Parallel latent growth models and latent growth mediation models were estimated.ResultsA positive association was observed between the rate of change in exposure to violence and firearm carriage. Exposure to violence also indirectly increased the risk for firearm carriage over time by decreasing future expectation in the 9th grade.ConclusionsOur results support the idea that helping youth develop positive attitude about educational success may help reduce firearm carriage. Increasing positive expectations about future may help prevent firearm carriage within the context of violence exposure.     

住院精神病患者暴力行为原因分析及护理对策

目的研究住院精神病患者暴力行为发生的原因,采取相应的护理对策,尽量降低暴力行为发生率。方法对65例发生暴力行为的住院精神病患者临床资料进行回顾分析,找到暴力行为发生的主要原因,并提出相应的护理对策;然后再统计对策实施后的精神病患者暴力行为发生情况,以检验实施效果。结果发生暴力行为疾病多见于精神分裂症和双相情感障碍。在采取针对性防范措施后,暴力攻击行为发生率由2.6%下降到1.0%,差异有统计学意义(P0.05)。两组暴力攻击率、精神分裂、双向情感等,拳击、脚踢等比较差异有统计学意义(P0.05),抓伤无统计学意义(P0.05)。结论多数暴力攻击行为由精神症状所致,尽早对精神病患者的症状进行控制,并采取对新入院患者予暴力风险评估、加强医护沟通、加强对患者的宣教、提升护士的防暴能力培训和建立良好的护患关系等措施,可有效降低暴力行为发生率。