Impacts of users' antisocial behaviors in an ophthalmologic emergency department - a qualitative study

Constance d'Aubarede (1, 2) , Philippe Sarnin (3) , Pierre-Loïc Cornut (4) , Sandrine Touzet (5) , Antoine Duclos (5) , Carole Burillon (4) , Jean-Baptiste Fassier (1, 2)

1 UMRESTTE UMR T9405 - Unité Mixte de Recherche Epidémiologique et de Surveillance Transport Travail Environnement
2 HCL - Hospices Civils de Lyon
3 GRePS - Groupe de Recherche en Psychologie Sociale
4 Hôpital Edouard Herriot [CHU - HCL]
5 CHLS - Centre Hospitalier Lyon Sud [CHU - HCL]

Health-care workers in emergency departments are frequently exposed to risk of antisocial behavior and violence (ABV) by users. Underreporting of ABV by health-care professionals has been identified. In order to understand this phenomenon, we explored the experience of ABV in 30 health workers in an ophthalmology emergency department in the Rhône-Alpes administrative region of France. Methods: A grounded theory qualitative approach was followed. Data were collected from field observations, 30 semistructured individual interviews, violence report forms, and 364 patient satisfaction questionnaires. Qualitative thematic content analysis of the interviews was performed with qualitative data analysis software. Results: Third-party antisocial behaviors and violence were an everyday occurrence, with varying levels of seriousness: impoliteness, vulgarity, nonrecognition, insults, verbal threats, and aggressive gestures. Health-care workers adopted various strategies to adapt to such violence: proactive and reactive attitudes and the political and economic context, hospital work organization, and health workers’ behavior were identified as potentially contributing to ABV. Excessive waiting times, lack of user information, and understaffing emerged as factors contributing to users’ ABV. Conclusions: Antisocial behaviors by hospital users are underreported by professionals and under-recognized. They appear to be like continuous occupational exposure leading to delayed adverse consequences either on workers’ health or motivation. However, violence in hospitals is not the result of only the action of users, and it may be related to work organization and workers’ own behaviors. Only a grounded analysis of the causes of violence in the local work context can uncover relevant solutions.

Mots clés: Qualitative research; Hospitals; Occupational hazards; Antisocial behavior; France; Grounded theory; Health-care workers; Workplace violence

Domaines: Psychologie

Constance d'Aubarede, Philippe Sarnin, Pierre-Loïc Cornut, Sandrine Touzet, Antoine Duclos, et al.. Impacts of users' antisocial behaviors in an ophthalmologic emergency department - a qualitative study. Journal of Occupational Health, 2015, 58, pp.96 - 106. ⟨10.1539/joh.15-0184-FS⟩. ⟨halshs-01559188⟩