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中国急诊科医护人员工作场所暴力流行现状及空间分布分析

Prevalence and spatial distribution of workplace violence against emergency medical staff in China: a cross-sectional study

  • 摘要:
    目的  分析我国急诊科工作场所暴力流行现状及空间分布规律,明确全国急诊科工作场所暴力流行趋势和高发区域,为政府制定和实施相关的干预措施提供科学依据。
    方法  采用多阶段随机抽样,于2019年7 — 9月对全国31个省级行政区共34 819名急诊科医护人员进行工作场所暴力调查。采用Stata 17.0和GeoDa 1.18软件分析数据,基于地理信息系统技术和空间分析方法探究工作场所暴力发生的空间分布。
    结果  我国急诊科工作场所暴力的平均发生率为84.16%,其中情感虐待发生率最高(80.43%),其次是威胁恐吓(59.96%)、躯体暴力(42.11%)、言语性骚扰(30.54%)、躯体性骚扰(15.27%)。空间自相关分析表明,工作场所暴力中的躯体暴力(Moran′s I = 0.246)、威胁恐吓(Moran′s I = 0.092)和躯体性骚扰(Moran′s I = 0.478)存在明显的空间聚类关系(均P < 0.05)。局部空间自相关分析结果显示,我国急诊科工作场所暴力高发区域主要在西北地区和东北地区,其中内蒙古自治区的工作场所暴力情况尤为严重,而我国东南沿海地区的发生率则普遍较低。
    结论  我国急诊科医护人员工作场所暴力发生情况较为严重,尤其在西北地区和东北地区,存在着明显空间分布差异,亟须受到相关部门的重视。

     

    Abstract:
    Objective This study aimed to analyze the prevalence and spatial distribution of workplace violence (WPV) in emergency departments (EDs) in China, to identify national trends and high-incidence areas, and to provide scientific evidence for the government to formulate and implement relevant intervention measures.
    Methods A multi-stage random sampling method was used to conduct a survey of 34 819 ED medical staff in 31 provincial administrative regions in China from July to September 2019. The spatial distribution of WPV was explored based on geographic information system technology and spatial analysis methods. Data were analyzed using Stata 17.0 and GeoDa 1.18 software.
    Results The average incidence of WPV in EDs in China was 84.16%, with the highest incidence of emotional abuse (80.43%), followed by threats and intimidation (59.96%), physical violence (42.11%), verbal harassment (30.54%), and physical harassment (15.27%). Spatial autocorrelation analysis showed that physical violence (Moran′s I = 0.246), threats and intimidation (Moran′s I = 0.092), and physical harassment (Moran′s I = 0.478) in WPV had significant spatial clustering relationships (all P < 0.05). The results of local spatial autocorrelation analysis showed that the high-incidence areas of WPV in EDs in China were mainly in the northwest and northeast regions, with the most serious situation in Inner Mongolia Autonomous Region, while the incidence rate in the southeast coastal areas of China was generally low.
    Conclusions WPV among ED medical staff in China is serious, especially in the northwest and northeast regions, with significant spatial distribution differences, which urgently needs the attention of relevant departments.

     

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