Violencia de usuarios hacia los profesionales de salud mental

Abstract

This Doctoral Thesis explore the users violence perceived by Mental Health staff in the Región de Murcia. The risk of workplace violence is especially relevant in the health sector, being one of the most affected ones, as reflected in various studies (Llor Esteban, Sánchez Muñoz, Ruiz Hernández & Jiménez Barbero, 2016; Magnavita & Heponiemi, 2012; Piquero, Piquero, Craig & Clipper, 2013), so we found it interesting to go deeper into the subject. The objectives of this study are: to determine the exposure to hostile user demonstrations of the Mental Health staff of the Servicio Murciano de Salud (SMS; in English, Murcian Health Service), considering socio-demographic and work variables; also appraising the exposure to hostile behaviors according to socio-demographic and work variables, and including the presence of possible psychological consequences; to adapt y validate the Healthcare-Workers'Aggresive Behaviour Scale-Users (HABS-U), developed in hospitals for mental health population, and to test its psychometric properties; to compare perceived violence in both contexts, and finally, to determine which professional group is most exposed, as well as knowing the service with higher levels of violence in Mental Health Services. For this purpose, a self-applied, anonymous questionnaire was administered to 4 hospital services: Mental Health, Emergency Units, Medical Hospitalization and Maternal-and-Child Units. A sample of 518 participants included two professional categories (nurses and auxiliary nursing staff) and was obtained from 4 public hospitals of the Region of Murcia. In a second fhase, was carry out to adaptation of HABS-U to the Mental Health population. Using qualitative and quantitative methodology, the instrument was applied to a sample of 359 Mental Health professionals from SMS. The results obtained showed a 10-item instrument (Healthcare-Workers'Aggresive Behaviour Scale-Users Version Mental Health [HABS-U-MH]) distributed in two factors (non-physical violence and physical violence), which was validated by means of confirmatory factor analysis. Both the resulting questionnaire and the factors identified present high internal consistency and adequate external validity, analysed by means of statistically significant correlations between the Hospital Aggressive Behaviour Scale and job satisfaction, burnout components, and psychological well-being. There were significant differences in the scales of Physical and Non-physical violence as a function of the sociodemographic and work variables (sex, age, marital status, seniority in the profession and type of profession and service), being the nursing and the non-medical staff, the most exposed groups to user violence. Regarding to type of service, a first comparison it was found significant differences in the frequency and type of violence among the hospital services studied: higher rates of physical violence were found in Mental Health Services, and of non-physical violence in Emergency Units, compared to the other units. A second comparison between Mental Health Services, showed that the most exposed workplaces were the Brief Psychiatric Hospitalization and Half Stay Hospitalization Services. On the basis of these results, we can conclude that the distribution of the risk of exposure to violence is not homogenous within the Health personnel, being especially high in Mental Health staff, and for this reason, it is important to detect the professional groups and services with greater exposure in order to establish and prioritize preventive measures. The obtained scale is useful to assess user violence in MHS, both physical and non-physical.