Conflicts with patients and relatives occur frequently in intensive care units (ICUs), driven by factors that are intensified by critical illness and its treatments. A majority of ICU healthcare professionals have experienced verbal and/or physical violence. There is a need to understand how healthcare professionals in ICUs experience and manage this workplace violence. A qualitative descriptive analysis of four hospitals in Sweden was conducted using semi-structured focus-group interviews with ICU healthcare professionals. A total of 34 participants (14 nurses, 6 physicians and 14 other staff) were interviewed across the four hospitals. The overarching theme: “The paradox of violence in healthcare” illustrated a normalisation of violence in ICU care and indicated a complex association between healthcare professionals regarding violence as an integral aspect of caregiving, while simultaneously identifying themselves as victims of this violence. The healthcare professionals described being poorly prepared and lacking appropriate tools to manage violent situations. The management of violence was therefore mostly based on self-taught skills. This study contributes to understanding the normalisation of violence in ICU care and gives a possible explanation for its origins. The paradox involves a multifaceted approach that acknowledges and confronts the structural and cultural dimensions of violence in healthcare. Such an approach will lay the foundations for a more sustainable healthcare system.

中文翻译：

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重症监护室工作场所暴力的悖论：焦点小组研究


在重症监护病房 (ICU) 中，与患者和亲属的冲突经常发生，而危重疾病及其治疗加剧了这些因素。大多数 ICU 医护人员都经历过言语和/或身体暴力。有必要了解重症监护室的医疗保健专业人员如何经历和管理这种工作场所暴力。通过对 ICU 医疗保健专业人员进行半结构化焦点小组访谈，对瑞典四家医院进行了定性描述性分析。四家医院共有 34 名参与者（14 名护士、6 名医生和 14 名其他工作人员）接受了采访。总体主题：“医疗保健中的暴力悖论”说明了 ICU 护理中暴力的常态化，并表明医疗保健专业人员之间存在复杂的关联，他们将暴力视为护理的一个组成部分，同时又将自己视为这种暴力的受害者。医疗保健专业人员表示，他们准备不足，并且缺乏适当的工具来管理暴力局势。因此，暴力管理主要依靠自学技能。这项研究有助于理解 ICU 护理中暴力的常态化，并为其起源提供了可能的解释。这一悖论涉及多方面的方法，承认并面对医疗保健中暴力的结构和文化层面。这种方法将为更可持续的医疗保健系统奠定基础。