Salud laboral de profesionales de Atención Primariaestudio de la violencia de usuarios

Laburpena

Abstract In this doctoral thesis, a study on exposure to type II violence is carried out, that is, that which is exercised by users, patients or relatives, in primary healthcare professionals. The aims are: a) Validate and analyze the psychometric properties of the adaptation of the "Hospital Aggressive Behavior Scale-Users" to Primary Care; b) to know the frequency of exposure to workplace violence in Primary Care professionals; c) identify sociodemographic and labor variables related to exposure to violence; d) determine the professional group most exposed to user violence; e) examine the relationship between exposure to user violence and Burnout; and f) analyze the impact of exposure to user violence, job satisfaction and empathy on the psychological well-being of professionals. To carry out the research, a two-stage cluster sampling was performed: the population was stratified by primary healthcare centers (clusters) and 39 centers were selected through simple random sampling. Consequently, using a fixed ratio pattern, we selected from the alphabetical listing of all the professionals from each center those who were numbered with multiples of three. A self-administered and anonymous questionnaire was distributed to a sample of 670 professionals, obtaining a final sample of 574 (response rate of 85.7%). The results show that the scale adapted to Primary Care (HABS-U-PHC) consists of 14 items (Cronbach's ?= .91). After confirmatory factor analysis, the structure of the scale was verified, obtaining two factors: Non-physical violence and Physical violence. 90.1% of professionals are exposed, with a minimum annual frequency, to some of the indicators of non-physical violence included in the scale and, in terms of physical violence, the annual prevalence is 17.3%. Significant differences were found in aggressions received according to gender, professional tenure, continuing education and the professional group. Likewise, it has been obtained that both factors of user violence are directly related to the dimensions of Burnout, Emotional Exhaustion and Cynicism. Finally, it is identified that exposure to violent behaviors of users, job satisfaction and the empathy of professionals influence, depending on the professional group, in the psychological well-being scores (total GHQ) of Primary Care professionals. In conclusion, the distribution of the risk of exposure to violence is not homogeneous in primary healthcare, so it is important to detect the groups and professional characteristics associated with greater exposure in order to establish and prioritize preventive measures. Keywords: Workplace violence; Users violence; Primary healthcare professionals; Occupational Health; Job satisfaction; Burnout; Empathy; Psychological well-being (GHQ).