急診職場暴力之成因探討：多元利害關係人之不同觀點

Abstract

研究背景與目的 醫院是發生職場暴力的高風險環境，急診室尤其如此。醫護人員若遭受急診暴力，除了身心受傷外，亦可能影響其醫療照護品質、或導致離職。衛福部將急診暴力列為目前台灣急診室的困境之一，社會大眾近年也對醫院職場暴力事件更加關注，為了瞭解事件、解決問題，本研究擬探討急診職場暴力事件的成因，以期防範並且制止。 研究方法 本研究搜尋新聞中的醫院職場暴力事件進行分析，並訪談暴力事件中的各個利害關係人，據此瞭解暴力發生的因子；另外觀察台灣醫院職場暴力之頻率及數量以瞭解嚴重程度；再從不同身份的受訪者中歸納其態度及行為，嘗試針對不同的類別角色提出適當的改善措施。 結果與結論 新聞中提到急診暴力的次數，自2007年開始巨幅上升，可能與當年所發生的暴力事件有關。此後一般民眾對急診暴力的認識大為提升，急診暴力這個詞彙也被新聞媒體廣為使用。 分析新聞及受訪者所描述的暴力事件共計74件，從中歸納高風險因子，發現男性、酒後或有酒癮、病人等均是施暴者方相當明顯的高風險因子，而大夜班及診療、急救、留觀等位置亦是環境方面的高風險因子；此外酒後或有酒癮的施暴者，在74件暴力事件中就佔了32件（43%），是造成台灣急診暴力事件的最重要成因。 利害關係人中，即使是相同的職業角色，面對急診暴力時可能有完全相反的態度與行為，瞭解人員的類型並依其不同角色類型給予協助，應能有助於人員面對暴力，不致讓暴力事件進一步影響人員的服務品質與留任。

Background and Purpose Hospital is a high-risk workplace where the workplace violence occurs, especially in emergency room. Violence makes the staff physical and mental injuries, affects the quality of their medical care, and causes them to leave. Ministry of Health and Welfare pointed Emergency violence as one of Taiwan's current plight to the emergency room. In recent years, the public concerned the hospital workplace violence more. In order to solve the problem, this study is to investigate the factors of workplace violence in emergency room. Study Methods In order to understand the factors of workplace violence in emergency room, this study searched the hospital workplace violence news and interviewed multiple stakeholders in violence events. In order to understand the severity in Taiwan, the study observed the frequency and quantity of Taiwan hospital workplace violence. In order to make appropriate recommendations for improvements, this study summarized the attitude and behavior of respondents from different categories of staff. Results and Conclusions Since 2007, the number in news mentioned emergency violence rose obviously, and might be related to the violence that occurred in the relevant year. Public awareness on emergency violence rises greatly, and emergency violence, this vocabulary is also widely used by the news. The violence events from news and the respondents totaled 74. The high risk factors includes: men, drink or alcohol addiction, and the emergency room patient. The high risk factors about the environment includes: at 0-8 A.M. and in the process of diagnosis, first aid, and stay in hospital for observation. In this study, drink or alcohol addiction perpetrators caused 32 violence events (43%). The factor, drink or alcohol addiction, is the most important cause of emergency violence in Taiwan. The same professional roles, stakeholders may have completely opposite attitude and behavior when they faced emergency violence. Understanding the type of staff and giving different assistance according to the types could help people face the violence and not affected about their quality of service and retention.