İntörn Hekimlerin İletişim Becerilerinin Şiddete Maruz Kalma Durumları ile İlişkisi

Öz

Amaç: Bu çalışmada XXXX Tıp Fakültesi’nde görev yapan intörn hekimlerin iletişim becerilerinin, şiddete maruz kalma durumları ile ilişkisinin incelenmesi amaçlanmıştır. Yöntemler: Kesitsel tipte planlanan çalışmanın evrenini XXXX Tıp Fakültesi’nde 2018-2019 eğitim-öğretim yılında intörn hekim olarak görev yapan 287 öğrenci oluşturdu. Çalışma, araştırmaya katılmayı kabul eden 234 kişi ile yürütüldü. Veriler yüz yüze görüşme metodu ile uygulanan anket formu aracılığıyla toplandı. Toplam 33 sorudan oluşan anket formunda, sosyodemografik özellikler ve şiddetle ilgili soruların yanı sıra İletişim Becerilerini Değerlendirme Ölçeği (İBDÖ) kullanıldı. İstatistiksel anlamlılık düzeyi p<0.05 olarak kabul edildi. Bulgular: İntörn hekimlerin 86’sı (%36.8) son bir sene içerisinde şiddete maruz kaldıklarını ifade etmiş olup, bu kişiler içinden 84’ü (%97.7) sözel şiddete, 5’i (%5.8) fiziksel şiddete maruz kaldıklarını belirtti. En az bir şiddet türüne veya sözlü şiddete maruz kalma açısından katılımcılar arasında İBDÖ puan ortalaması yönünden anlamlı fark bulunmazken, ölçek puanı fiziksel şiddete uğrayanlarda anlamlı düzeyde daha düşük bulundu (p=0.032). Sonuç: Sözlü şiddete sebep olan esas sebepler arasında intörn hekimlerin iletişim konusundaki yetersizliğinin yer almadığı belirlenmiş, fiziksel şiddete uğrayan intörn hekimlerin iletişim becerileri daha düşük bulunmuş olsa da toplum genelinde değerlendirme yapmak için daha geniş gruplar üzerinde çalışılmasının gerekli olduğu kanısına varılmıştır.

Anahtar Kelimeler

• İletişim
• İntörn
• Sağlık çalışanları
• Şiddet

The relationship between the communication skills of intern physicians and their exposure to violence

Abstract

Background/Aim: Violence against healthcare workers has become a major problem worldwide. This study aimed to examine the relationship between the communication skills of interns and their exposure to violence. Methods: This cross-sectional study comprised 287 students working as intern physicians at the Ondokuz Mayis University Faculty of Medicine within the academic year of 2018-2019. It was conducted with 234 volunteering individuals. The data were collected through a questionnaire, consisting of 33 questions in total, applied with a face-to-face interview. The Communication Skills Scale was used, as well as questions about sociodemographic characteristics and violence. The level of statistical significance was set at P<0.05. Results: Eighty-six (36.8%) intern physicians stated that they had been subjected to violence in the last year. Eighty-four (97.7%) of these participants stated that they were subjected to verbal violence and 5 (5.8%) to physical violence. While there was no significant difference between the participants in terms of being exposed to at least one type of violence or verbal violence, the mean scale score was significantly lower in those who were exposed to physical violence (P=0.032). Conclusion: The inadequacy of interns in communication was not included among the main reasons for verbal violence. Although the communication skills of interns who were exposed to physical violence were lower, it is necessary to work on larger groups to make a community-wide assessment.

Keywords

• Communication
• Intern
• Medical staff
• Violence

Kaynakça

1. 1. Saines JC. Violence and aggression in A & E: recommendations for action. Accid Emerg Nurs. 1999 Jan;7(1):8-12. doi: 10.1016/s0965-2302(99)80094-0. PMID: 10232107.
2. 2. World Health Organization. Violence and injury prevention. https://www.who.int/violence_injury_prevention/violence/workplace/en/. Accessed 28 Dec 2020.
3. 3. Li YL, Li RQ, Qiu D, Xiao SY. Prevalence of Workplace Physical Violence against Health Care Professionals by Patients and Visitors: A Systematic Review and Meta-Analysis. Int J Environ Res Public Health. 2020 Jan 1;17(1):299. doi: 10.3390/ijerph17010299. PMID: 31906306; PMCID: PMC6982349.
4. 4. Polat Ö, Çırak M. Evaluation of Violence in the Health with White Code Data. Bakirkoy Tip Dergisi 2019 12;15(4):393-8. DOI:10.4274/BTDMJB.galenos.20190918115436
5. 5. Turkish Medical Association. Turkey's health - 2019 report. https://www.raporlar.org/turkiyenin-sagligi-2019-raporu-ttb/. Accessed 9 Jan 2021.
6. 6. Ministry of Health. Legal aid and white code implementation. Circular 2016/3. https://dosyasb.saglik.gov.tr/Eklenti/439,hybupdf.pdf?0. Accessed 29 Dec 2020.
7. 7. Eğici MT, Öztürk GZ. Violence against healthcare workers in the light of White Code data Ank. Med. J. 2018;18(2):224-31. doi:10.17098/amj.436537
8. 8. İnanıcı SY, Yardımcı G, Yüksel RG, Binatamir Y. 5th and 6th year medical students’ experience of violence towards doctors and its relationship with education, patient expectations and coping strategies. Tıp Eğitimi Dünyası. 2020;19(58):73-88. Doi: 10.25282/ted.535217

9. 9. Terzi Ö, Pekşen Y. Assessing the risks that interns meet in the working environment. JHSM. 2016;5(1):65-71.
10. 10. Ceylan Ş. Evaluation of effective communication skills in health care workers [dissertation]. University of Health Sciences Tepecik Training and Research Hospital; 2019.
11. 11. Liu J, Gan Y, Jiang H, Li L, Dwyer R, Lu K, et al. Prevalence of workplace violence against healthcare workers: a systematic review and meta-analysis. Occup Environ Med. 2019 Dec;76(12):927-37. doi: 10.1136/oemed-2019-105849. Epub 2019 Oct 13. PMID: 31611310.
12. 12. Korkut F. İletişim becerileri değerlendirme ölçeğinin geliştirilmesi: güvenirlik ve geçerlik çalışmaları. TPCGJ. 1996;2(7):18-23.
13. 13. İlhan MN, Özkan S, Kurtcebe ZÖ, Aksakal FN. Exposure to violence and related factors among research asistans and intern doctors in Gazi University Hospital. Socıal Society Bullettin. 2009;28(3):15-23.
14. 14. Cihan FG, Kutlu R, Karademirci MM. Occupational future concerns and stress management conditions of intern doctors. JAREM. 2017;7(3):122.
15. 15. Afkhamzadeh A, Bolbanabad AM, Moloudi B, Safari H, Piroozi B. Workplace violence against physicians and medical students in west part of Iran. International Journal of Human Rights in Healthcare. 2019;12(2):116-23.
16. 16. Nikathil S, Olaussen A, Gocentas RA, Symons E, Mitra B. Review article: Workplace violence in the emergency department: A systematic review and meta analysis. Emerg Med Australas. 2017 Jun;29(3):265-75. doi: 10.1111/1742-6723.12761. Epub 2017 Apr 12. PMID: 28406572.
17. 17. Mento C, Silvestri MC, Bruno A, Muscatello MRA, Cedro C, Pandolfo G, et al. Workplace violence against healthcare professionals: a systematic review. Aggress Violent Behav. 2020;51:101381.
18. 18. Ferri P, Silvestri M, Artoni C, Di Lorenzo R. Workplace violence in different settings and among various health professionals in an Italian general hospital: a cross-sectional study. Psychol Res Behav Manag. 2016 Sep 23;9:263-75. doi: 10.2147/PRBM.S114870. PMID: 27729818; PMCID: PMC5042196.
19. 19. Aydemir İ, Rabia Ü, Aydoğan A. According to the emergency room staff the reasons for violence. J Ist Faculty Med. 2020;83(1):60-8.
20. 20. İnce A, Torun P, Jadoo SAA. Workplace violence against medical students-A Turkish perspective. JIDHealth. 2019;2(1):70-4.
21. 21. Wallace S, Finley E. Standardized emergency codes may minimize “Code Confusion.” PA Patient Saf Advis. 2015;12(1):1-7.
22. 22. Arnetz JE, Hamblin L, Ager J, Luborsky M, Upfal MJ, Russell J, Essenmacher L. Underreporting of Workplace Violence: Comparison of Self-Report and Actual Documentation of Hospital Incidents. Workplace Health Saf. 2015 May;63(5):200-10. doi: 10.1177/2165079915574684. Epub 2015 May 22. PMID: 26002854; PMCID: PMC5006066.
23. 23. D'Ettorre G, Pellicani V, Mazzotta M, Vullo A. Preventing and managing workplace violence against healthcare workers in Emergency Departments. Acta Biomed. 2018 Feb 21;89(4-S):28-36. doi: 10.23750/abm.v89i4-S.7113. PMID: 29644987; PMCID: PMC6357631.
24. 24. Anand T, Grover S, Kumar R, Kumar M, Ingle GK. Workplace violence against resident doctors in a tertiary care hospital in Delhi. Natl Med J India. 2016 Nov-Dec;29(6):344-348. PMID: 28327484.
25. 25. Turla A, Aydın B, Ünlü B. The experiences and views of medical interns on violence and aggression against physicians. The Bulletin of Legal Medicine. 2012;17(1):5-11.
26. 26. Sood R, Singh G, Arora P. To study medical students' perspective on rising violence against doctors. Do they consider obstetrics and gynecology a risky branch. Int J Reprod Contracept Obstet Gynecol. 2017;6(8):3314-8.
27. 27. Ergitürk Ö. Status of violence exposure of hospital health employees, communication and problem solving skills and affecting factors [dissertation]: Marmara University Institute of Health Sciences; 2019.
28. 28. Baby M, Gale C, Swain N. Communication skills training in the management of patient aggression and violence in healthcare. Aggress Violent Behav. 2018;39:67-82.
29. 29. Mercy JA, Hillis SD, Butchart A, Bellis MA, Ward CL, Fang X, et al. Interpersonal violence: global impact and paths to prevention. In: Mock CN, Nugent R, Kobusingye O, Smith KR, eds. Injury Prevention and Environmental Health. Disease Control Priorities (third edition), Volume 7. Washington: World Bank; 2017. pp. 81.
30. 30. Fazel S, Smith EN, Chang Z, Geddes JR. Risk factors for interpersonal violence: an umbrella review of meta-analyses. Br J Psychiatry. 2018 Oct;213(4):609-14. doi: 10.1192/bjp.2018.145. Epub 2018 Jul 30. PMID: 30058516; PMCID: PMC6157722.