国际全科医生工作场所患者源暴力的研究进展：流行现状、影响因素与干预策略

全科医生是综合程度较高的医学人才,是居民健康的“守门人”。涉医暴力事件不仅严重危害全科医生的生理、心理健康,而且影响基本医疗的服务质量和水平,加重了全科医学人才流失与医疗卫生系统的经济负担。研究显示,超过一半的全科医生遭受过工作场所暴力,其中最常见的暴力类型为言语暴力、威胁,其次为身体暴力和性骚扰、性侵犯;患者及其家属是主要施暴者。医疗服务质量不能满足患者需求、肇事者酗酒、药物滥用、精神失常、医患沟通不畅等是导致工作场所暴力的重要因素。建议完善医疗工作者工作场所暴力相关政策法规和处理规范,建立健全暴力的上报及处罚机制;提高医疗卫生工作者和医疗机构提供医疗服务和防治工作场所暴力的能力;正确发挥媒体作用,推进“暴力零容忍”制度的建立。

Research Progress of Workplace Violence among General Practitioners at Home and Abroad: Prevalence,Influencing Factors,and Intervention Strategies

General practitioners are medical personnel with high integrated degree, and are the "gatekeepers" of residents' health. Violent incidents affecting health care not only seriously harm the the physical and psychological health of general practitioners, also affect the quality and level of basic medical services, which increases the turnover of general practitioners and the economic burden on the health care system. Previous studies have shown that more than half of general practitioners had experienced workplace violence, with the most common types including verbal violence and threats, followed by physical violence, sexual harassment and assault, patients and their family members were the main perpetrators. The failure of the medical services quality to meet the demands of patients, alcohol abuse, drug abuse and mental disorders of perpetrators, poor physician-patient communication were important factors associated with workplace violence. It is suggested to improve policies and regulations, norms of conduct related to workplace violence of healthcare workers, establish and improve the reporting and punishment mechanisms, enhance the capacity of healthcare workers and health care institutions to provide medical services and prevent workplace violence, give proper play to the role of the public media, promote the establishment of "zero-tolerance" system for violence.