Journal
BMJ OPEN
Volume 11, Issue 2, Pages -Publisher
BMJ PUBLISHING GROUP
DOI: 10.1136/bmjopen-2020-042362
Keywords
accident emergency medicine; organisation of health services; qualitative research
Categories
Funding
- programme de recherche sur la performance du systeme des soins (PREPS 2016) of the French Ministry of Health (Ministere charge de la Sante, Direction de l'Hospitalisation et de l'Organisation des Soins)
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The strategies implemented by emergency care professionals when facing tension and interpersonal violence from patients and their friends and family are individualized for the most part, and may not be adapted to all situations. Some cases may be entrusted to professionals specialized in resolving conflict.
Objectives Identify the strategies implemented by emergency care professionals when facing tension and interpersonal violence from patients and their friends and family. Design Descriptive qualitative study based on 38 semidirective interviews. Participants Doctors, nurses, nursing assistants and administrative staff. Setting Four emergency departments (EDs) from three French university hospitals. Results According to the medical professionals interviewed, the difficulties that they encounter with patients or their accompanying family members can be explained by a lack of understanding of the functioning of EDs, by a general increase in individualistic behaviours leading to a lack of civility or by deviant behaviours (related to toxic substance abuse or mental illness). While managing deviant behaviours may sometimes require a collective intervention, ED staff also implement what are essentially individual communication strategies (with the use of rational explanation, seduction and empathy), confrontation or flight to deal with interpersonal difficulties. Conclusions Strategies used by staff members tend to be individualised for the most part, and some, such as confrontational or escape strategies, may not be adapted to all situations. In the face of difficulties between staff and patients, mediators, specialised in resolving conflict, could entrust some cases to professionals.
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