TY - JOUR

T1 - Facteurs liés aux épisodes violents dans les soins

T2 - résultats de l'enquête européenne Presst-Next

AU - Estryn-Behar, Madeleine

AU - Duville, Nathalie

AU - Menini, Marie-Laurène

AU - Camerino, Donatella

AU - Le Foll, Serge

AU - le Nézet, Olivier

AU - Bocher, Rachel

AU - Van Der Heijden, Beatrice

AU - Conway, Paul Maurice

AU - Hasselhorn, Hans-Martin

AU - Next-Study group

PY - 2007/1/1

Y1 - 2007/1/1

N2 - INTRODUCTION: The respective roles of medical specialties and work organization on violent events against healthcare workers (HCW) in different countries was examined.METHODS: Using the results of the Presst-Next study, we analyzed data from 27134 HCW in 7 European countries. Multivariate logistic analyses were conducted with SPSS 12 software.RESULTS: After adjustment for age, gender and other occupational risk factors, the factors indicating insufficient team work were highly associated with an increased risk of violent events. Dissatisfaction with shift change (OR=1.35; 95%CI 1.23-1.47), uncertainty about treatment (OR=1.57; 95%CI 1 .44-1.71), and frequent interruptions (OR=2.04; 95%CI 1.81-2.31) were linked to violent events, up to twice the number among HCW reporting better team work. Contradictory orders, dissatisfaction with psychological support, and harassment by superiors were all significantly associated with increased reporting of frequent violent events. We observed a positive gradient between violent events and job demand (time pressure) (OR=1.25 for an intermediate score and OR=1.55 for a high score, compared with a low score). Loneliness at work, certain work schedules, and physical load increased the risk. Nurses' aides were exposed to violent events more often (OR=1.57; 95%CI 1.38-1.79) than head nurses. Older HCW and those with more experience were less exposed. The highest risks were associated with working in psychiatric (OR=4.89; 95%CI 3.82-6.25) and emergency (OR=2.68; 95%CI 2.10-3.44) departments, compared with home care and day care. The excess risk was an additional 30% in geriatrics and long-stay departments. Significantly less risk was observed in pediatrics, obstetrics and gynecology departments (OR=0.70; 95%CI 0.56-0.88).CONCLUSION: Team building requires time, and shift change is a key period. This time is far from nonproductive. Rather, its effective use reduces treatment errors, enhances quality of care, and reduces the frequency of violent events. It is crucial in every department.

AB - INTRODUCTION: The respective roles of medical specialties and work organization on violent events against healthcare workers (HCW) in different countries was examined.METHODS: Using the results of the Presst-Next study, we analyzed data from 27134 HCW in 7 European countries. Multivariate logistic analyses were conducted with SPSS 12 software.RESULTS: After adjustment for age, gender and other occupational risk factors, the factors indicating insufficient team work were highly associated with an increased risk of violent events. Dissatisfaction with shift change (OR=1.35; 95%CI 1.23-1.47), uncertainty about treatment (OR=1.57; 95%CI 1 .44-1.71), and frequent interruptions (OR=2.04; 95%CI 1.81-2.31) were linked to violent events, up to twice the number among HCW reporting better team work. Contradictory orders, dissatisfaction with psychological support, and harassment by superiors were all significantly associated with increased reporting of frequent violent events. We observed a positive gradient between violent events and job demand (time pressure) (OR=1.25 for an intermediate score and OR=1.55 for a high score, compared with a low score). Loneliness at work, certain work schedules, and physical load increased the risk. Nurses' aides were exposed to violent events more often (OR=1.57; 95%CI 1.38-1.79) than head nurses. Older HCW and those with more experience were less exposed. The highest risks were associated with working in psychiatric (OR=4.89; 95%CI 3.82-6.25) and emergency (OR=2.68; 95%CI 2.10-3.44) departments, compared with home care and day care. The excess risk was an additional 30% in geriatrics and long-stay departments. Significantly less risk was observed in pediatrics, obstetrics and gynecology departments (OR=0.70; 95%CI 0.56-0.88).CONCLUSION: Team building requires time, and shift change is a key period. This time is far from nonproductive. Rather, its effective use reduces treatment errors, enhances quality of care, and reduces the frequency of violent events. It is crucial in every department.

KW - Adult

KW - Europe

KW - Female

KW - Health Personnel

KW - Humans

KW - Interprofessional Relations

KW - Job Satisfaction

KW - Male

KW - Middle Aged

KW - Patient Care Team

KW - Personnel Staffing and Scheduling

KW - Surveys and Questionnaires

KW - Violence

KW - Workload

KW - English Abstract

KW - Journal Article

U2 - 10.1016/j.lpm.2006.07.007

DO - 10.1016/j.lpm.2006.07.007

M3 - Tidsskriftartikel

C2 - 17261445

VL - 36

SP - 21

EP - 35

JO - Presse Medicale

JF - Presse Medicale

SN - 0755-4982

IS - 1 Pt 1

ER -