【作者】 张瑞；

【导师】 石超明；

【作者基本信息】 武汉大学 ， 社会医学与卫生事业管理， 2017， 硕士

【摘要】 暴力伤医,是指由医疗活动引起,发生在医院这种特殊场所内的暴力伤害行为,是医患冲突的极端表现形式。近年来,我国暴力伤医事件呈现出数量增加,影响恶劣的特征。这不仅直接侵犯医务人员的生命财产安全,破坏医院正常的医疗秩序,而且间接地阻碍医疗卫生服务的提供,影响我国医疗卫生事业的健康发展。本文选取了 22个典型的暴力伤医事件,通过对暴力伤医行为产生、发展全过程,以及多个参与主体的细致观察,归纳总结出我国暴力伤医在主体、过程、起因以及结果方面的一些共性特征。导致暴力伤医产生的原因是多元的,主要涉及个人经历、人际关系、医院环境和社会环境方面的因素,这些因素会大大增加患者成为施暴者的可能性。针对愈演愈烈的暴力伤医问题,我国政府制定了诸多治理政策。尽管这些政策已初见成效,但是仍存在以下问题:治理主体单一,政府职能越位;治理手段单一,行政干预过多;治理过程不协同,社会力量参与不足;治理方式不民主,多方利益维护不充分。依据暴力伤医产生的原因和政府治理过程中存在的问题,本研究以社会治理理念为指导,对暴力伤医问题的治理提出以下建议:政府层面,深化医疗卫生体制改革,完善医疗卫生法律法规,加强医疗卫生监督管理;医院层面,加强医疗投诉管理,建立危机防范机制,加强内部环境建设;社会层面,发挥媒体舆论引导功能,加强医疗纠纷人民调解委员会建设,培育发展弱势群体救助组织;公众层面,加强健康教育,增进疾病了解,加强法律宣传,增强法治意识,加强心理疏导,缓解仇视情绪。更多还原

【Abstract】 Hospital violence,refers to the violence that is likely to bring harmful injury and caused by medical activities in hospitals,is an extreme form of conflict between doctors and patients.The number of hospital violence events is increasing and have brought about abominable influence.This is not only a direct violation to the safety of medical staff,undermining hospitals’ normal medical orders,but also impede the provision of health services indirectly,affecting the development of China’s health undertakings.In this paper,22 typical cases of workplace violence against physicians and nurses were used.Through the detailed study on the whole process of the development of violence,and the detailed observation of the participants,the author summed up some common features on the main body,the process,the cause and the result of those violenceevents.There aremltiple reasons lead to violence against physicians,including personal experience,interpersonal relationships,hospital environment and social environment,Which would greatly increase the likelihood of patients becoming a perpetrator.In response to the growing violence towards health care workers,the Chinese government has formulated a number of governance policies.Although these policies have achieved initial results,the following issues remain:The main body of governance is single and the government functions offside;the means of governance is unitary and the administrative intervention is excessive;Governance process is not synergy,lacking of participation in social forces;governance is undemocratic and multi-interest maintenance is not sufficient.Based on the causes of violence and the problems in the process of government governance,this study puts forward the following suggestions on the governance of hospital violence under the guidance of the concept of social governance.Government should deepen the health system reform,improve the health laws and regulations,and strengthen supervision and management on medical care.Hospital should strengthen the management of medical complaints,establish crisis prevention mechanisms and strengthen the construction of internal environment.Social should lead the media to play an important role in guiding public opinion,strengthen the medical dispute people’s mediation committee construction and foster the development of third-party organizations for helping vulnerable groups.Public should strengthen health education to promote disease understanding;strengthen legal publicity to enhance the sense of the rule of law;strengthen psychological counseling to ease the feelings of hatred.更多还原