A Study On Emotional Deviation Of Medical Staff

Medical services include not only technical services,but also non-technical services,such as health care service attitude and treatment environment."Regulations of the People's Republic of China Practicing Physician Law","People's Republic of China Practicing Nurses Law" and other relevant occupational management practices,regulations have put forward "should respect and care for patients." In recent years,the health sector also attaches great importance to the improvement of medical services,and the National Health and Family Planning Committee repeatedly introduced "patient-centered to improve the quality of medical services" as the theme of the hospital management program,requiring medical institutions to focus on the quality of medical services,to improve patient's medical experience and increase the patient's access to medical care.Although the "improve the quality of medical services" has been one of the core content of the new medical reform,but China's public hospitals still have the problem of high quality of service.Particularly in recent years,with the relationship between doctors and patients,such as walking thin ice,conflict of violence between doctors and patients was "blowout" outbreak,with evil wounded medical events intensified.In this context,the medical anomie is particularly worthy of attention.Medical misconduct on the patients or health care workers themselves will have a serious impact on the vital interests of patients,while harming the image of health care workers,undermining the relationship between doctors and patients,and even endangering social stability.At present,the misconduct of the medical industry mainly includes medical treatment and treatment of anomie,abnormal charges,serial drug,free referral and other anomie behavior.Psychologists combined with the sociology of the anomie behavior related research,for the first time put forward the " Emotional Deviation" concept.In this study,"Emotional Deviation of Medical Staff " was defined as: medical staff in the provision of medical and health services for patients,in terms of emotional performance contrary to the requirements of the organization,result to patients did not feel respected and cared.In this study,Emotional Deviation of Medical Staff will affect the patient's medical experience,reduce patient satisfaction,reduce the quality of medical services,worsen the relationship between doctors and patients,causing the public to the medical profession of misunderstanding and dissatisfaction,so that the difficulty of solving medical disputes greatly increased.The consequences often seriously disrupt the normal medical order and even social order.However,at this stage,the research on the emotional deviation of the medical staff as the research object has not been reported,even there is no evaluation tool which can quantify the evaluation.Therefore,it is in urgent need to construct a socialist harmonious society in order to carry out research on the behavior of medical staff misconduct and meet the needs of the current era development and social change to reconstruct the medical field norm.ObjectiveThe purpose of this study is to develop a quantitative assessment tool for emotional deviation behavior of medical staff,based on the previous theoretical research,to discuss the structural dimension of emotional deviation behavior of medical staff.The author analyzes the necessity of the behavior of the medical staff,and puts forward some suggestions for the hospital to improve the quality of medical services,improve the relationship between doctors and patients,to reduce the conflict and even the hospital workplace violence,the relevant departments to develop health care workers work norms to provide reference value.MethodThis study used 4 methods to analyze questions step by step.1.Literature analysis.This paper searches the domestic and foreign medical industry in recent years on the misconduct,workplace deviation,emotional misconduct,emotional deviation,workplace violence,doctor-patient relationship and other literature,organize and summarize the recent research trends,research perspective,method innovation and so on.2.Interview.On the basis of the analysis of the literature,according to the interview outline,interview with the hospital managers,doctors,nurses,patients,etc.,to collect their understanding of the emotional deviation of medical staff,experience and perception of the status quo as the basic data.3.Key event law.From the perspective of patients to collect key events,combined with literature analysis,interviews,open questionnaire,through the core group discussion to screen the patient perceived key behavior as a scale entry pool.4.Questionnaire survey.Divided into pre-survey and formal investigation of two stages:(1)pre-survey stage: 300 medical stafves were pre-survey,according to statistical analysis results to form a formal scale.(2)The formal investigation stage: 1020 medical stafves in Sichuan province were sampled,and the " Emotional Deviation of Medical Staff Scale","Doctor-patient Relationship Scale" and "Workplace Violence Table " to carry out the investigation.5.Mathematical statistical analysis method.The reliability,validity test,exploratory factor analysis,confirmatory factor analysis,T-test of independent samples and one-way ANOVA(F-test),Pearson correlation analysis and Regression analysis were used to analyze the data by SPSS21.0 and AMOS21.0,.Explan scientificly the results and ultimately draw conclusions,make recommendations.Result 1.Emotional Deviation of Medical Staff Scale and the structure of the model study shows that:The final Emotional Deviation of Medical Staff Scale involved 4 dimensions,which were emotional indifference(5 items),delayed response(5 items),impatient behavior(5 items),and implicit attack(5 items).Scale and the dimensions of Cronbach's? coefficient are in the range of 0.851 ~ 0.939,the internal consistency is good.Exploratory factor analysis The adaptive test results show that the KMO value is 0.961 and the Bartlett spherical test reaches a significant level(= 8075.005,P = 0.000),indicating that the sample data are suitable for factor analysis.In the condition that the eigenvalue is more than 1,the principal component analysis is carried out and rotated by the maximum variance method.The explanatory rate of the cumulative variance is 65.241%.The load of all the entries is higher than 0.6,and there is no common factor load.Using AMOS for confirmatory factor analysis,the model is well fitted and the fitting index is c2 /df =2.448,RMSEA = 0.053,GFI = 0.92,AGFI=0.905,NFI=0.928,CFI=0.956,CN = 265.2.Status Research of Emotional Deviation of Medical Staff shows that:On the whole,the level of Emotional Deviation of Medical Staff is in the middle level,the scores are lower than the theoretical median,the dimension scores from high to low,followed by emotional indifference,delayed response,impatient behavior,and implicit attack.In the comparison of demographic variables:(1)There was no significant difference between the doctors and the nurses in the total score of Emotional Deviation and the dimensions of the medical staff(P> 0.01);(2)In the sex comparison,male medical staff in the total score of Emotional Deviation and the dimensions were significantly higher than female medical staff(P <0.05);(3)In the hospital grade comparison,the medical staff of the tertiary hospital were significantly higher than the secondary hospital in the emotional indifference dimension(P <0.05);(4)In the age comparison,30-39 year old medical staff in the emotional indifference dimension was significantly higher than the 20-29 year old medical staff(P <0.05);(5)In the comparison of academic qualifications,there were no significant differences in the total score and the dimensions of the medical staff from the secondary school,college,undergraduate and postgraduate students(P> 0.05);(6)In the comparison of the working years,medical staff with a working age of 4 to 20 years are significantly higher than those who have worked for more than 3 years and over 20 years.Implicit attack dimension and Emotional Deviation were significantly higher than those of 10 to 20 years,with a significantly higher than 20 years of medical staff(P <0.05);(7)In the comparison of title,the medical staff of the intermediate grade were in the hidden position of the medical staff in the middle grade,and the medical staff of the intermediate grade were significantly higher than those of the medical staff(P<0.05);(8)In the comparison of employment forms,the formalities of the insider's dimension and Emotional Deviation were significantly higher than those of primary and senior(including positive and negative)and undecided medical staff(P <0.01);(9)There was no significant difference in the total score and the dimensions of the generalists in the normal day shift and the shift workers(P > 0.05);(10)In the departmental comparison,the outpatient department of the medical staff in the emotional indifference dimension was significantly higher than the emergency department and inpatient department of the medical staff(P <0.05).3.The reaserch of impact of Emotional Deviation on the relationship between doctors and patients,the impact of workplace violence shows that:The relationship between the doctors and patients shows a middle level.Each dimension score from high to low is subjective experience of doctors,symptoms of patient behavior and physician subjective response and the quasi-objective problem of patient behavior(R=-0.501 ~-0.702,P <0.05).And there was a significant negative correlation between the dimensions of Emotional Deviation of Medical Staff and the relationship between doctors and patients.After controlling the influence of demographic variables,the Emotional Deviation of Medical Staff ‘s three dimensions had a significant negative predictive effect on the dimensions of the doctor-patient relationship,which could explain the doctor-patient relationship 7%,9.4%,7.4% variation.The incidence of violence in the workplace is 58.4%,which is moderate to high.The incidence of violence is high and low: emotional abuse,threatening,physical attack,sexual harassment of speech,sexual harassment of the body.According to the frequency of violence in the workplace grading,zero frequency(no violence)were 424 people,accounting for 41.6%;low frequency of 516 people,accounting for 50.6%;intermediate frequency of 65 people,6.4% 15 people,accounting for 1.5%.The level of Emotional Deviation of Medical Staff was significantly higher in the group who had suffered from the violent group than the level of emotional anomie of the disabled group(P <0.001).The high incidence of Emotional Deviation of Medical Staff was significantly higher in the workplace violence than in the low group(P <0.05).There is a significant positive correlation between the dimensions of Emotional Deviation of Medical Staff and the workplace violence(r = 0.539 ~ 0.582,P <0.05).After controlling the influence of demographic variables,the OR values of emotional indifference,delayed response and impatient behavior were 1.301,1.333,1.368(P?0.05),and the OR value of implicit attack was not significant.The results show that the emotional indifference,the delayed response and the impatient behavior,these three dimensions of the medical staff had positive predictive effect on the violence in the workplace.The Emotional Deviation of Medical Staff is a risk factor in the workplace violence.Conclusions and RecommendationsThe results show that the Emotional Deviation of Medical Staff is composed of four dimensions: emotional indifference,delayed response,impatient behavior and implicit attack.The analysis of the status quo shows that the Emotional Deviation of Medical Staff are generally in the middle level,but there are still differences in the level of emotional misconduct among health care workers on gender,hospital grade and working age.This suggests that the hospital should pay attention to identify and change the Emotional Deviation of Medical Staff,and according to the different characteristics of the specific situation of medical staff,put forward targeted improvement measures.The Emotional Deviation of Medical Staff has a negative predictive effect on the relationship between doctors and patients,and has a positive predictive effect on violence in the workplace.It is a risk factor in the workplace violence.It is suggested that the health administrative departments,hospitals and medical staff should pay attention to The Emotional Deviation of Medical Staff and its impact,gradually improve the occupational management regulations and related systems of medical staff,improve the hospital management methods,strengthen the binding of emotional performance norms and medical staff should strengthen self-restraint and improve mental health services.