The effects of patients initiated aggression on Chinese medical students\u2019 career planning

Zhonghui Xie,Kaijun Cui,Jing Li,Yuhua Chen

doi:10.1186/s12913-017-2810-2

Abstract

BackgroundPatient initiated aggression is common among Chinese health-care workers, reaching over 10,000 incidents annually (Jinyang web. http://6d.dxy.cn/article/55497. 2013), and the tense doctor-patient relationship generates stress among medical students. Because of the paucity of data (few surveys pay attention to the effects of violence perpetrated by patients on medical students), this study aimed to characterize patient initiated aggression against medical students.MethodsIn this cross-sectional survey conducted at a medical school in West China in 2015, 157 medical students completed a self-administered questionnaire and the Short Form-36, which assesses quality of life. The associations between patient initiated aggression exposure and medical students’ career planning or quality of life were assessed using a chi-square test.ResultsOf the 157 medical students, 48 (30.6%) reported having suffered patient initiated aggression at least once during the previous year in the form of mental abuse (20.4%), offensive threat (14.6%), physical violence (8.3%), sexual harassment (verbal: 8.3% or physical: 1.6%), and extreme violence (physical violence leading to surgical treatment or hospitalization) (0.6%). Insufficient communication was the primary reason cited (27.2%). Emotional attack (mental abuse and offensive threat) occurrence differed among age groups (χ2 = 9.786, P = 0.020) and was ubiquitous among those aged >30 years old. Women were more likely than men to suffer physical violence (χ2 = 6.796, P = 0.009). Patient initiated aggression was not significantly associated with medical students’ career planning or quality of life.ConclusionsIn this study, patient initiated aggression, albeit common, as in the rest of China, did not appear to be associated with medical students’ career planning or quality of life. However, the characteristics described can inform policymaking and the design of programs to minimize patient initiated aggression occurrence.

Highlights

Patient initiated aggression is common among Chinese health-care workers, reaching over 10,000 incidents annually (Jinyang web. http://6d.dxy.cn/article/55497. 2013), and the tense doctor-patient relationship generates stress among medical students
Medical students suffer from stress caused by tense doctor–patient relationships, studies are scarce which characterize the effects of patient initiated aggression on medical students’ quality of life and career planning, which is the subject of this survey-based study in a West China medical school
Characteristics of violence during the previous 12 months included extreme violence, physical violence, mental abuse, offensive threats, verbal sexual harassment, and physical sexual harassment

Summary

Introduction

Patient initiated aggression is common among Chinese health-care workers, reaching over 10,000 incidents annually (Jinyang web. http://6d.dxy.cn/article/55497. 2013), and the tense doctor-patient relationship generates stress among medical students. The Chinese Ministry of Health and the Ministry of Public Security put forth a policy of adding security guards in hospitals This policy failed to address the fundamental issue of protection of health-care professionals while perhaps even further intensifying doctor–patient conflicts [4]. Patient initiated aggression likely interferes with diagnosis and treatment [15,16,17,18,19], is hazardous to the physical and mental health of medical staff [13, 20,21,22], and adversely affects medical student recruitment [1]. Medical students suffer from stress caused by tense doctor–patient relationships, studies are scarce which characterize the effects of patient initiated aggression on medical students’ quality of life and career planning, which is the subject of this survey-based study in a West China medical school

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