基于社会认知的患方医院工作场所暴力行为影响因素及其干预研究

In recent years, the doctor-patient relationship in China continued to deteriorate and the hospital workplace violence from patient took place frequently. That not only seriously interfered with the normal medical order and destroyed the medical staff's working environment, but also had become an important threat to the sustainable development of China's medical and health services and the social stability. Study on the generation and prevention of the hospital workplace violence from patient, which as the concentrated reflection of intensified social contradictions in medical activity, should from the level of whole social system. The cognitive behavior theory believes that the social cognition of patient plays an vital intermediation role in the generation and development of hospital workplace violence from patient. Therefore, based on building the social cognitive model of hospital workplace violence from patient, this study would search the key factors that may influence the social cognitive of patient, which developed as the core variable, on the basis of case analysis and field investigation. And intervention measures on the social cognitive of patient would be designed based on analyzing the influence strength and path of factors on the social cognitive of patient, to prevent the hospital workplace violence from patient. This study would expand solution and research scope of the hospital workplace violence from patient.

近年来，我国医患关系持续恶化，患方医院工作场所暴力事件频发，不仅严重干扰了正常的医疗秩序，破坏了医务人员的从业环境，同时也已成为威胁我国医疗卫生事业可持续发展和社会稳定的重要因素。作为社会矛盾激化在医疗活动中的集中体现，患方医院工作场所暴力行为的产生和防范应当从社会大系统层面加以研究。认知行为理论认为，患方的社会认知在其暴力行为的发生发展过程中起着至关重要的中介作用。因此，本研究在构建患方医院工作场所暴力行为的社会认知模型的基础上，以患方的社会认知为核心变量，基于案例分析和现场调查，寻找影响患方社会认知的关键因素，并分析各种因素的作用强度和路径，据此设计患方社会认知的干预措施集，以防范患方的医院工作场所暴力行为，拓展了患方医院工作场所暴力行为的解决思路和研究视野。

近年来，患方医院工作场所暴力事件频发，严重干扰了正常的医疗秩序，成为威胁我国医疗卫生事业可持续发展和社会稳定的重要因素。作为社会矛盾激化在医疗活动中的集中体现，患方医院工作场所暴力行为的产生和防范应当从社会大系统层面加以研究。认知行为理论认为，患方的社会认知在其暴力行为的发生发展过程中起着至关重要的中介作用。因此，本研究在构建患方医院工作场所暴力行为的社会认知模型的基础上，以患方的社会认知为核心变量，基于案例分析和现场调查，寻找影响患方社会认知的关键因素，并分析各种因素的作用强度和路径，据此设计患方社会认知的干预措施集。研究结果表明，本次调研的患方群体的总体暴力倾向和暴力行为发生率不高，但对于他人的暴力伤医行为仍存在一定程度的理解、同情或宽容；患方的社会认知倾向整体偏向正面，不同社会人口学特征的患方，其社会认知状况具有显著的统计学差异，而亲友对卫生行业的评价、媒体舆论及健康教育等因素也会对患方的社会认知产生明显影响。根据理论和实证研究结果，提出并筛选优化了患方社会认知的干预策略，主要包括加强社会舆情管理、加强公众健康教育及深化体制机制改革等三方面内容，以促使患方的社会认知保持客观理性，防范其暴力伤医行为发生。