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Vold og Trusler om vold i arbejdet med stofbrugere: Et studie af problemets størrelse og mulige minimering
Nordic Council of Ministers, Nordic School of Public Health NHV.
2005 (Danish)Independent thesis Advanced level (degree of Master (Two Years))Student thesisAlternative title
Work related violence and threats during substance abuse treatment. : A study of the problem and its extent, and how to minimise it. (English)
Abstract [da]

Formål: Bestemme omfangen, typen, udløsende årsager, bagvedliggende faktorer og konsekvenser af vold og trusler om vold mod behandlere i Københavns Amts Behandlingscenter for Stofbrugere samt at udvikle kliniske retningslinier for håndtering og minimering af vold og trusler om vold.

Metode: Omfanget af voldsepisoder blev vurderet ved to metoder: 1) Retrospektiv anonym tværsnitsspørgeskemaundersøgelse af samtlige 84 fastansatte medarbejder 2) Kohorte undersøgelse med prospektiv registrering af alle psykiske og fysiske voldsepisoder i en tre måneders periode i 2001-2002. Årsager, faktorer og konsekvenser blev undersøgt i semi-strukturerede interviews med den voldsramte medarbejder og den voldelige klient. Håndteringen af voldsepisoderne blev vurderet i en audit procedure og kliniske retningslinier i relation til håndtering af arbejdsrelateret vold og trusler om vold blev udviklet .

Resultat: I tværsnitsundersøgelsen svarede 73 (87%), 45% (n=33) af medarbejderne havde været udsat for vold af psykisk eller fysisk karakter indenfor det sidste år, 48% (n=35) indenfor de sidste fem år. Hyppigheden var uafhængig af medarbejderens alder, køn og arbejdserfaring. Kohorteundersøgelsen afslørede, med en svar procent på 57%, 16 tilfælde af ren psykisk vold medførende en incidens på 0.77 pr. arbejdsår pr. medarbejder eller 0.24 psykisk voldsepisode pr. dag, 11 tilfælde af kombineret psykisk/fysisk vold medførende en incidens 0.53 pr. arbejdsår pr. medarbejder eller 0.17 psykisk/fysisk voldsepisode pr. dag (ca. een ugentligt). Politi blev tilkaldt 5(19%) gange. Bagvedliggende faktorer inkluderede dybe frustrationer mod behandlersystemet, lavt selvværd og dårlig kommunikationsevne hos klienterne. Hovedparten af medarbejderne oplevede efterfølgende angstreaktioner. Sygemelding og psykologisk krisehjælp forekom kun i få tilfælde. På basis af audit-panelets rekommandationer blev der udviklet kliniske retningslinier for håndtering af vold og trusler om vold.

Konklusion: Prævalenses og incidensen af vold og trusler om vold i arbejdet med stofbrugere er højere end i andre fagområder både i og uden for sundhedsvæsenet med væsentlige konsekvenser for både medarbejderen og specielt for den voldelige klient. Resultaterne i dette studie kvantificerer arbejdsrelateret vold som ikke fremgår af officielle registre (”mørketal”)

Abstract [en]

Purpose: To determine the extent, type, precipitating factors, causality and consequences of work related threats and violence at the Copenhagen County Substance Abuse Treatment Centre and to develop clinical guidelines in order to minimise threats and violence.

Methods: The extent of violent episodes was estimated using two methods: 1) Retrospective anonymous questionnaire issued to all (n=84) full-time employed staff-members. 2) In a tree months period 2001-2002 prospective registration of all physical and psychological violent episodes at the Copenhagen County Substance Abuse Treatment Centre was performed. Precipitating factors, causality and consequences were investigated in semi-structured interviews including all abused staff-members and violent clients. The management of violent episodes was audited in an audit panel and clinical guidelines regarding work related threats and violence were developed.

Results: 73 (87%) staff-members completed the questionnaire. 33(45%) staff-members had experienced work related violence in the last year, 35(48%) in the last 5 years. There were no sub-group differences. The prospective registration identified 16 episodes of psychological violence, constituting an incidence of 0.77 pr. work-year pr. staff-member or 0.24 psychological violent episodes pr. day at the centre. 11 combined physical and psychological violent episodes were identified ending up with an incidence of 0.53 violent episode pr. work-year pr. staff-member or 0.17 violent episodes at the centre pr. day. Police was called in 5(19%) of the cases. The clients were characterized by harboring deep frustrations towards the system, low self-esteem and poor communication skills. The majority of the abused staff-members experienced anxiety reactions. Only a few required sick-leave and psychological crises counseling. On the basis of the audit-panel’s recommendations clinical guidelines regarding threats and violence were developed.

Conclusions: The prevalence and incidence of work related threats and violence is higher among staff-members treating substance users than in other fields both in- and outside the Health Service. There are consequences of significance for both the abused staff-member and the violent client. The results of this study quantify the extent of violence not registered in official registers.

Place, publisher, year, edition, pages
2005. , 58 p.
Series
Master of Public Health, MPH, ISSN 1104-5701 ; MPH 2005:22
Keyword [en]
Drug Addiction, Epidemiology, Prevention, Structured Interview, Clinical Guidelines
Keyword [da]
stofmisbrug, epidemiologi, forebyggelse, struktureret interview, kliniske retningslinie
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:norden:org:diva-3299OAI: oai:DiVA.org:norden-3299DiVA: diva2:733243
Presentation
2005-06-01, Nordic School of Public Health NHV, Box 12133, 402 42 Göteborg, Sweden, 13:00 (Danish)
Supervisors
Note

ISBN 91-7997-109-1

Available from: 2014-07-08 Created: 2014-07-08 Last updated: 2015-01-28Bibliographically approved

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