| BackgroundHospital workplace violence(HWPV)was defined by the World Health Organization(WHO)as “the abuse,threat or attack health workers in their workplace,resulting in explicit or implicit challenges to their safety,well-being and health.HWPV is a serious epidemic problem happened in both developed and developing countries,which result in many bad consequences,such as disturbing hospital diagnosis and treatment order,making the quality of services down,affecting the work willingness of the medical staff.HWPV.According to the cognitive behavior theory,the social cognition of the patients and/or relatives play an important mediating role in the occurrence and development of the violent behavior.Therefore,based on the construction of the social cognitive model of hospital workplace violent behavior of patients in this study,to carry out a field investigation for exploring the key factors influencing the social recognition of patients.Then it can provide advices for intervening HWPV.Meanwhile,it is useful to broaden solving mind and research view for researching the HWPV.ObjectiveThe aim of this study is to explore the prevalence and influencing factors of the HWPV,then to construct the social recognition model of workplace violence of patients and analyze the intensity and path of influencing factors on social cognition of patients.Based on this,it can provide the reference for preventing violent behavior in the hospital workplace.MethodsAccording to the method of literature research,such information like “social recognition,hospital workplace violence,doctor-patient relationship” can be as the keywords to search systematically database,so as to the related literature and read profoundly and analyze,especially paying more attention to emphases the reasons and preventive strategies referring to hospital workplace violence.According to the spatial location and economic development level,Guizhou,Henan and Shandon were selected as sample provinces,which stood for Chinese western,central and eastern regions.There were two prefecture-level cities being selected in each province,then randomly selecting 2tertiary hospitals,2 county-level hospitals and 2 town-level hospitals in each prefecture-level city,and 50 outpatient and emergency patients or their relatives were randomly selected from each hospital(30 from each first-level hospital).A pre-designed questionnaire was used to carry out on-site investigation on July,2018.A total of 2,065 valid questionnaires were collected,with an effective recovery rate of 88.2%.The data collected were analyzed by Excel,SPSS 24.0 and AMOS 22.0.Results1.Analysis on the difference of distribution of violence tendency and behavior of patients with different basic characteristicsAccording to the Chi-square test,there were statistically significant differences in the incidence of medical dissatisfaction for these patients with different age,marital status,level of education,job types and family economic situation(P<0.05).There were statistically significant differences in the prevalence of violent behavior against health care workers for these patients with different sex,job types,and health situation(P<0.05).Through the non-parametric test,these patients with different sex,age,job types and family economic situation had statistically significant differences in the cognition of violent behavior toward health care workers(P<0.05).2.The violent tendency and behavior of patientsThe results showed that there were 63(3.1%)patients having verbal behavior against health care workers,among which 17(0.8%)patients had minor physical violent behavior against health care workers and 10(0.5%)of the patients had serious physical violent behavior against health care workers.And it also got a more significant finding that all these patients having violent behaviour toward health care workers had experienced dissatisfaction with medical treatment in the past year.46.7% of the respondents indicated that they had been dissatisfied with medical treatment in the past year.Also,the top three reasons for patients’ dissatisfaction experiences were poor service attitude,cumbersome medical procedures and high medical costs.3.Verification of the model of social cognition and violent behavior of patientsOur study indicated that social relations had an indirect effect(through patients’ cognition on the health care workers and patients’ cognition on hospital and industry)on violent tendencies and behavior,and the total effective value was-0.204.Health education and media reports not only can directly affect(the effective value=0.280)the tendency and behavior of violence,but had an indirect effect(the effective value=0.067)on violent tendencies and behavior,so the total effective value was 0.347.ConclusionOur results have found that the incidence of violence was generally low,while those patients with medical dissatisfaction experiences accounted for a considerable proportion.There was a significant finding that all patients who had violent behaviors against health care workers were found to have medical dissatisfaction experiences.Social relationships and health education and media reports,as antecedent variables,mainly through which affected patients’ social recognition(including patients’ cognition on health care workers and patients’ cognition on hospitals and industry),can have an indirect effect on the violent tendency and behavior of patients.We also got the finding that patients’ cognition on hospitals and industry can influenced their cognition on health care workers. |
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