急診護理人員職場暴力經驗及相關因素研究

Violence in the Workplace: Experiences of Emergency Department Nurses

目的：本研究的目的在探討中部地區急救責任醫院急診室護理人員職場暴力經驗，並進一步分析職場暴力預防的可能措施。方法：採橫斷式調查法，以結構式問卷為研究工具，採便利取樣，研究對象為中部地區急救責任醫院239位急診護理人員。結果：護理人員曾遭受暴力事件傷害以心理層面暴力最高，語辱罵者（76.4％），身體層面暴力（36.7％）。暴力來源以病人（60.6％）或家屬（33.4％）居多，暴力發生地點大多發生在機構或工作場所中（89.7％）。遭受暴力事件後的行為反應「會告訴告訴施暴者停止施暴」之外，其次是「告訴朋友或家人」、「告訴同事」，而「通報主管」及「填寫事件報告單」的比例偏低。未通報的原因，認為「沒有用」最高（42.2％）。遭受暴力傷害事件後，雇主或主管所提供的協助以「給予談論／報告的機會」（47.3％）與「諮商輔導」（31.2％）居多。護理人員的性別、年齡、工作年資、教育程度和職場暴力經驗具有差異性；但醫院屬性、婚姻、是否輪班與職場暴力並無顯著差異，受訪者認為造成職場暴力原因是環境因素和病人的態度問題。結論：為了防止暴力產生和提供安全的工作環境，建議檢視職場預防暴力的措施，貫徹執行零容忍政策和成立危機處理的專責人員，舉辦教育訓練、加強溝通和關鍵問題立即處理機制。

Purposes: The aims of this study were to investigate the experiences of emergency department nurses with violence in the work place and to determine precautionary measures. Methods: A total of 239 nurses from hospitals in central Taiwan completed a questionnaire. Only hospitals with the capability of handling severe and moderate level emergencies were included. Results: Emotional abuse was experienced by most of the participants; 76.4% experienced verbal abuse and 36.7% reported physical violence. Patients (60.6%) and their families (33.4%) were the main perpetrators. The most common responses of nurses who experienced work place violence were to “tell the aggressors to stop their violent behaviors”, “complain about them to their families or friends”, and “pour out their bitterness to coworkers.” They seldom reported the incidents to their supervisors or recorded them on the “Report Form.”According to the results of the questionnaire ,the main reason that they did not report these incidents was because they thought they would not get any help (42.2%). Employers and executives offered opportunities for the victims to discuss or report violent events (47.3%) and victims could also consult with their supervisors and receive counseling (31.2%). Conclusions: In order to prevent violence and promote workplace safety training to improve communication skills and rapid management of critical issues should be improved. Policies aimed at violence prevention should be established and consistently enforced and staff should maintain positive working relationships with security officers.