Abstract
BackgroundIncidents of aggression and violence from patients and visitors occur in emergency primary care. Most previous studies have focused on risk factors such as characteristics of patient, health personnel or situation. This study aimed to explore professional-patient interaction in aggressive situations.MethodsA focus group study with eight focus groups was performed, including a total of 37 nurses and physicians aged 25–69 years. The participants were invited to talk about their experiences of violence in emergency primary care. Analysis was conducted by systematic text condensation. Results were then illuminated by Honneth’s theory The Struggle for Recognition.ResultsWe identified three main themes regarding the interaction between health personnel and patients or visitors in aggressive situations: (1) unmet needs, (2) involuntary assessment, and (3) unsolicited touch. In all interactions the aggressive behaviour could be understood as a struggle for recognition.ConclusionsAggression is more likely to arise in situations where the patients’ needs or personal borders are invalidated. The struggle for personal recognition during the interaction between patient and health professionals should be addressed in health professionals’ education. This knowledge might increase their awareness and help them to react in a more expedient manner.
Highlights
Incidents of aggression and violence from patients and visitors occur in emergency primary care
This study was based on a re-reading of a data material, collected in a focus group study, which explored emergency primary care staffs’ experiences with workplace violence [12]
Unmet needs Several participants told stories about patients who attended the emergency primary care centre with needs that the health personnel did not comply with in the way they perceived that the patient, or relative, expected
Summary
Incidents of aggression and violence from patients and visitors occur in emergency primary care. Most previous studies have focused on risk factors such as characteristics of patient, health personnel or situation. This study aimed to explore professional-patient interaction in aggressive situations. Working in emergency primary care is associated with high risk of experiencing aggression and violence from patients and visitors [1,2,3]. In Norway, municipalities are obliged by law to provide emergency primary care around the clock. This service is organised in special clinics or as part of a general medical practice, many of them small and isolated and far from the hospital, and not in hospital emergency departments as in many other countries. When nurses or other health personnel are present, they perform triage in the patient’s initial contact with the centre, give advice when appropriate and assist the physician when needed
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