Safety climate and workplace violence prevention in state-run residential addiction treatment centers.
Safety climate and workplace violence prevention in state-run residential addiction treatment centers.
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DOI：
10.3233/wor-2012-1330
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发表时间：
2012
期刊：
影响因子：
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通讯作者：
J. Lipscomb;M. London;Y. M. Chen;K. Flannery;M. Watt;J. Geiger-Brown;J. Johnson;K. McPhaul
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文献类型：
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作者：
J. Lipscomb;M. London;Y. M. Chen;K. Flannery;M. Watt;J. Geiger-Brown;J. Johnson;K. McPhaul
目的探讨预防暴力措施、安全氛围措施与自报的对戒毒所工作人员的暴力行为之间的关系。方法2006年年中，来自美国东部一个监管13个住宅成瘾治疗中心(ATCs)系统的州机构的409名工作人员完成了一项自我管理的调查，作为全面风险评估的一部分。这项调查是为了确定和衡量设施层面的暴力风险因素，包括工作人员对美国职业安全和健康管理局(OSHA)现有计划要素质量的看法，并最终指导暴力预防规划。关键的线人访谈和工作人员焦点小组为研究人员提供了定性数据，以了解这些工作环境中的安全气氛和预防暴力的努力。结果工作人员报告经历过暴力行为的频率从37%的“客户以威胁的方式对你大声喊叫”到1%的“客户推搡、殴打、踢打或殴打”不等。工作人员调查的结果包括以下显著预测暴力的因素：“客户积极抵制计划”(OR=2.34，95%CI=1.35，4.05)、“与不知道暴力史的客户合作”(OR=1.91，95%CI=1.18，3.09)和“管理层对预防暴力的承诺”，报告为“从不/几乎从不”和“很少或有时”(OR=4.30和OR=2.31)，同时控制其他协变量。结论我们采用定性和定量相结合的研究方法，开始描述在这种情况下预防暴力的风险和潜力。该机构治疗设施内工作人员身体暴力的发生率低于预期。可能的解释包括治疗计划的自愿性质；对居民行为的强有力的政策和后果，以及持续的质量改进努力。量化数据表明，管理层对预防暴力的承诺较低，这是工作人员报告的暴力行为的重要预测因素。
OBJECTIVE To examine the association between violence prevention safety climate measures and self reported violence toward staff in state-run residential addiction treatment centers. METHODS In mid-2006, 409 staff from an Eastern United States state agency that oversees a system of thirteen residential addiction treatment centers (ATCs) completed a self-administered survey as part of a comprehensive risk assessment. The survey was undertaken to identify and measure facility-level risk factors for violence, including staff perceptions of the quality of existing US Occupational Safety and Health Administration (OSHA) program elements, and ultimately to guide violence prevention programming. Key informant interviews and staff focus groups provided researchers with qualitative data with which to understand safety climate and violence prevention efforts within these work settings. RESULTS The frequency with which staff reported experiencing violent behavior ranged from 37% for "clients raised their voices in a threatening way to you" to 1% for "clients pushed, hit, kicked, or struck you". Findings from the staff survey included the following significant predictors of violence: "client actively resisting program" (OR=2.34, 95% CI=1.35, 4.05), "working with clients for whom the history of violence is unknown" (OR=1.91, 95% CI=1.18, 3.09) and "management commitment to violence prevention" reported as "never/hardly ever" and "seldom or sometimes" (OR=4.30 and OR=2.31 respectively), while controlling for other covariates. CONCLUSIONS We utilized a combination of qualitative and quantitative research methods to begin to describe the risk and potential for violence prevention in this setting. The prevalence of staff physical violence within the agency's treatment facilities was lower than would be predicted. Possible explanations include the voluntary nature of treatment programs; strong policies and consequences for resident behavior and ongoing quality improvement efforts. Quantitative data identified low management commitment to violence prevention as a significant predictor of staff reported violence.