Thesis (M.A.) - Simon Fraser University, 2005. / Theses (School of Criminology) / Simon Fraser University. Also issued in digital format and available on the World Wide Web.

Thesis (Ph.D.)--University of Nebraska-Lincoln, 2008. / Title from title screen (site viewed May 5, 2009). PDF text: xiv, 150 p. : ill. (some col.) ; 842 Kb. UMI publication number: AAT 3341672. Includes bibliographical references. Also available in microfilm and microfiche formats.

The aim of this study was to understand how social workers perceive and understand violence and threats of violence from clients, and how it effect their working environment. It seems that the respondents understand the violence and threats of violence from clients as a result of the clients background problems, vulnerability, dependency and from “the reason" that the client is currently in the contact with the organization. How respondents interpret the client´s behaviour based on the above-mentioned factors, seem to determine how the respondents perceive and define the violence and threats of violence by clients directed against them. Interestingly enough, although all respondents in the study experienced violence and threats of violence from clients, none of them perceived themselves as exposed at work. The answer to this is consensual. The respondents argue that they “knew what they got into" and thus violence and threats of violence from clients can be considered as part of the work, that the social workers must be aware of in order to work within the organization.   A further aim of this study was to examine how the social workers views the matter of who’s responsible for the threats and violent incidents and how to "best" encounter the violence and threats of violence within the organization. The respondents argue that it is when the social workers communicate in a wrong way, use their power or give "bad decisions" to the clients that most threats and violent incidents occur. The role that the respondents construct for themselves can be understood as they need to ,in their professional role "withstand a little bit" of violence and threats of violence from clients. The respondents then becomes mainly responsible for the threats and violent incidents, because they communicated in a wrong way, used the "unnecessary" exercise of power, or gave "bad decisions" to clients. The clients responsibility is then reduced due to the fact that the client merely reacts to how the respondent acted towards the client. The key element in the prevention of violence and threats of violence seems to be the way the respondents builds relations to the client. However, it also appears that the respondents expect a certain amount of violence and threats of violence from clients. Violence and threats of violence therefore run the risk of becoming something that the respondents get used to and sometimes expect, and something that they to some extent can protect themselves from, but never fully avoid or prevent.

Violence in the workplace is a serious and growing problem both in Sweden and internationally (Menckel & Viitasara, 2002). Especially in the caring professions where users or clients is in a dependent position, and deprived of their liberty in some way, threats and violence proved to be particularly prevalent (Hallberg, 2011). In Sweden, according to Menckel & Viitasara (2002), six in ten reports regarding threats and violence in the workplace come from people working in the care sector, but despite extensive searches in the area it seems to be difficult to find specific studies on precisely how threats and violence affect staff within the LVM- care (compulsory treatment for addicts). The purpose of this study is to increase knowledge and understanding of what the work situation might look like for people who work with people sentenced to LVM-compulsory treatment and their perceptions of how threats, harassment and violence in the workplace affect them. This by answering the following questions: How can the treatment staff experience threats and violence in the workplace, How can the treatment staff experience regulations and guidelines regarding threats and violence at the workplace and What strategies are taken at the workplace for the purpose of securing the safety and health of the staff?   The study is based on semi-structured interviews, based on 31 predefined questions, with five employees who work in a business where they care for both women and men, sentenced to compulsory care under the law of LVM.   The results show that the majority of the participants have been exposed to threats or veiled threats and some form of violence in their work place, either personally or by watching a co-worker be exposed, which the participants also experience as stressful and a cause for worry and alertness. The respondents states that they feel they have adequate control over their worksituation but that they often are understaffed or overcrowded. They handle aggressive behavior by keeping a closely knitted workteam through careful communication between colleagues and by support from co-workers and leadership.

Purpose: the aim with this study was to examine how managers in healthcare services, focusing on people with functional variants, work with threats and violence that users exercise against caretakers. Method: Study was conducted through qualitative interviews based on the theoretical framework; hermeneutics. To collect empirical data seven managers in personal assistance and LSS housing in southern Sweden were interviewed. Theory: The results shows that the managers need discretion to handle threat and violence that occur within their operations. The discretion is partly controlled by the conditions that exist in the organization and the managers therefore deem that they need to look at all aspects of the situation. Results: The result shows that there are different variants of threats and violence in the managers operations and that the severity level differs. Further emerges that the managers perception of the incidents is for example based on their knowledge of the functional variant that the users have or on the caretakers treatment towards them. The result also shows that the managers are responsible for creating routines, guidelines, action plans and investigating incidents. Furthermore, they are responsible for ensuring that employees can handle situations that arise. It appears in the result that the caretakers are responsible for following routines, guidelines and action plans that have been established and for reporting incidents that occur to their manager. However, reporting is not always done for various reasons. When incidents have been reported to the managers the result shows that the managers assessments differ. This means that the statistics on reports could be misleading. Circumstances that the respondents believe can make preventative work more difficult are, among other things, lack of time, finances, knowledge, unclear directives from the work environment authority and large staff turnover.

<p>Hot och våld mot vårdpersonal är ett ökande problem inom hälso- och sjukvården. Tidigare forskning visar på att olika konfliktmönster kan leda till våld. Korrekt bemötandet av dessa konfliktmönster och kunskap om dem förhindrar att våldet uppstår. Syftet med studien var att undersöka de faktorer som påverkar sjuksköterskans bemötande i det våldsamma eller hotfulla mötet. En litteraturstudie genomfördes och 16 studier granskades. Resultaten kategoriserades.</p><p>Resultatet visar att sjuksköterskans bemötande och attityder har stor inverkan på förekomsten av våld. Patienter kan bli aggressiva när de inte deltar i sin egen vård. Sjuksköterskans auktoritet kan, om den används fel skapa konflikt. Vårdmiljön påverkar förekomsten av våld. Eftersviterna av hot eller våld påverkar sjuksköterskor negativt. Det saknas utbildning i hot och våld och sjuksköterskor upplever att erfarenhet är ett viktigt verktyg i sitt bemötande av hot och våld.</p><p>Mer utbildning behövs i såväl sjuksköterskeutbildningen som i klinisk verksamhet. Forskning på området behöver bedrivas i flera olika former av vård, på grund av att större delen av forskningen bedrivs inom psykiatrin. En standardiserad definition av hot och våld bör tas fram.</p>

Hot och våld mot vårdpersonal är ett ökande problem inom hälso- och sjukvården. Tidigare forskning visar på att olika konfliktmönster kan leda till våld. Korrekt bemötandet av dessa konfliktmönster och kunskap om dem förhindrar att våldet uppstår. Syftet med studien var att undersöka de faktorer som påverkar sjuksköterskans bemötande i det våldsamma eller hotfulla mötet. En litteraturstudie genomfördes och 16 studier granskades. Resultaten kategoriserades. Resultatet visar att sjuksköterskans bemötande och attityder har stor inverkan på förekomsten av våld. Patienter kan bli aggressiva när de inte deltar i sin egen vård. Sjuksköterskans auktoritet kan, om den används fel skapa konflikt. Vårdmiljön påverkar förekomsten av våld. Eftersviterna av hot eller våld påverkar sjuksköterskor negativt. Det saknas utbildning i hot och våld och sjuksköterskor upplever att erfarenhet är ett viktigt verktyg i sitt bemötande av hot och våld. Mer utbildning behövs i såväl sjuksköterskeutbildningen som i klinisk verksamhet. Forskning på området behöver bedrivas i flera olika former av vård, på grund av att större delen av forskningen bedrivs inom psykiatrin. En standardiserad definition av hot och våld bör tas fram.

I denna studie uppmärksammas hotfulla och våldsamma situationer i kriminalvården. Syftet har varit att undersöka vilka känslor som uppstår hos kriminalvårdare i dessa situationer. I samband med detta har studien syftat till att få en djupare förståelse för vilken betydelse kollegor har för de känslor som uppstår och för hur känslorna hanteras. Studien bygger på kvalitativa intervjuer av halvstrukturerad karaktär. Totalt genomfördes tio intervjuer med yrkesverksamma kriminalvårdare från häktesverksamheten i Stockholm och Uppsala. Gemensamt för kriminalvårdarna var att de upplevt hot och våld i arbetet. För att få en djupare förståelse för kriminalvårdarnas beskrivningar har dessa analyserats utifrån Arlie Russell Hochschilds teori om emotioner samt Randall Collins teori om interaktionsritualer. Gemensamt för dessa teorier är att de belyser aspekter av hantering av känslor, både på individ- och gruppnivå. Studiens resultat visar att olika känslor uppstår hos kriminalvårdarna vid hotfulla och våldsamma situationer samt att kollegors närvaro har betydelse hur dessa känslor hanteras. Förväntningar från kollegor påverkar kriminalvårdarna att trycka undan känslor som oro, stress och rädsla. Istället uppvisar kriminalvårdarna lugn och kontroll för att agera i linje med gruppens förväntningar. Resultatet visar även att god sammanhållning inom arbetsgruppen leder till känslor av trygghet och lugn hos kriminalvårdarna i hotfulla och våldsamma situationer. I dessa situationer är gruppens sammansättning även av betydelse. Vilka samt hur många kollegor som närvarar påverkar kriminalvårdarnas hantering av känslor. Resultatet visar att kollegor även har betydelse för hur kriminalvårdarna hanterar sina känslor efter att de utsatts för hot och våld. Här beskrevs debriefing som ett effektivt verktyg för att ventilera känslor med kollegor. Hur debriefing används i praktiken skiljde sig åt i kriminalvårdarnas beskrivningar. / This study highlights threats and violence within correctional facilities, where the focus is directed towards the correctional officers' feelings that arise in these situations. The aim of this study has been to examine if colleagues' presence has an impact on the emotions that the correctional officers experience and on how these emotions are handled. The study is based on qualitative interviews of semi-structured character. A total of ten interviews were conducted with correctional officers from correctional facilities in Stockholm and Uppsala. What the correctional officer's has in common is that they all have experienced threats and violence at their workplace. The correctional officers' descriptions have been analyzed on the basis of Arlie Russel Hochschild's theory of emotions and Randall Collins's theory of interaction rituals. Both theories highlight aspects of the management of emotions, on an individual as well as on a group level. The result of the study indicates that the correctional officers experience different feelings in threatening and violent situations. In these situations the presence of colleagues is significant when it comes to how correctional officers are handling their emotions. Expectations from colleagues seem to affect the correctional officers to hide feelings such as anxiety, stress and fear. Instead the correctional officers show feelings of calm and control which, according to them, complies with the colleagues' expectations. The result also shows that good cohesiveness within the working group affects the correctional officers to feel calm in threatening and violent situations. Other factors that seem to affect the emotions that correctional officers experience and how the emotions are handled are which colleagues the correctional officers are working with and how many colleagues that attends in the situation. Furthermore the result indicates that colleagues have a significant importance when it comes to handling emotions after threatening and violent situations. Debriefing was described as important, by the correctional officers, to vent their emotions after a critical situation. How the debriefing was applied in practice differed among the correctional officers.

Bakgrund: Hot och våld riktat mot vårdpersonal är idag ett växande problem över hela världen. Vårdpersonal tillhör en av de yrkeskategorier där det föreligger en ökad risk att bli utsatt för hot och våld från patienter. Vårdpersonal är de som står för omvårdnaden av patienterna och forskning visar att om personalen blir utsatta för hot och våld kan det uppstå konsekvenser för både vårdpersonal och patienter. Syfte: Syftet med denna litteraturstudie var att belysa upplevelsen av hot och våld hos vårdpersonal inom hälso- och sjukvården. Metod: I litteraturstudien har 8 vetenskapliga, kvalitativa artiklar sammanställts och analyserats med kvalitativ innehållsanalys med induktiv ansats. Artikelsökning har skett i databaserna Cinahl, PsycINFO, PubMed och Scopus. Resultat: Resultatet visar att upplevelsen av att utsättas för hot och våld leder till en mängd starka känslor hos den som blivit utsatt. Känslorna är för det mesta av negativ karaktär och kan handla om känslan av att uppleva sig vara hotad och rädd, att känna både subjektiv ilska samt ilska riktad mot patienterna, känna maktlöshet och att känna hopplöshet och nedstämdhet. Hot och våld leder till konsekvenser för personalen. Det omfattar bland annat att motivationen sänks, personalen “tar med sig jobbet hem” och privatlivet drabbas. Det uttrycktes en stark önskan av stöd, kunskap och utbildning. Slutsats: Litteraturstudiens resultat visar att upplevelsen av att bli utsatt för hot och våld leder till många svåra konsekvenser för de som blir drabbade. För att förbättra hanteringen av konsekvenserna krävs utbildning och stöd till vårdpersonalen samt vidare forskning inom området både för att förebygga och hjälpa personal som blivit utsatt. / Background: Threats and violence against healthcare workers is today a growing problem worldwide. Healthcare personnel are at an increased risk of being subjected to threats and violence by their patients. Health workers are caregivers and advocates for their patients and if they become subject to threats or violence, previous research has shown that the consequences can be many both for caregivers and patients. Aim: The aim of this study was to illuminate the experiences of threat and violence by patients on healthcare personnel. Method: This literature review study included 8 scientific, qualitative articles compiled and analyzed with a description of qualitative content analysis with inductive approach. Article search was performed in the databases Cinahl, PsycINFO, PubMed and Scopus. Results: The results show that the experience of being subjected to threats and violence leads to a lot of strong feelings for the victimized health care worker. Feelings are, for the most part, of negative character and include feeling of threatened and afraid, feeling both anger in general and anger directed toward patients, feeling powerless and feeling hopelessness and depression. Threats and violence also lead to other negative consequences for the staff. These include, among other things, that motivation is lowered, and that workers find themselves “taking their work home with them”, which affects their private lives, often in detrimental ways. Affected workers also expressed a strong desire for support for victims, and knowledge and training for coping skills and tactics for dealing with difficult patients. Conclusion: The results of the literature review study shows that the experience of being subjected to threats and violence leads to many serious consequences for those who are affected. In order to improve the management of the consequences, education and support for healthcare personnel and further research in the area, to be able to prevent further incidents and help the healthcare workers who have been subjected, are required.

In Sweden, threats and violence has become a serious psychosocial work environment problem within the workplaces of health and social care. Several studies show the need to pay attention to how the workers psychosocial work environment is affected by the risk of threats and violence. Women are more exposed of threats and violence because the professions were most women work, the threats and violence occur. The purpose of this study is to investigate what legal obligations the employer holds to prevent threats and violence in the working environment and what consequences it can have if the employer does not fulfill these obligations. For a deeper knowledge in threats and violence as a psychosocial work environment problem other factors that can affect are included. To fulfill the purpose and answer the research questions in this study the doctrinal method is used to describe, systematize and interpret the legislation, case law and literature.   The results of this study show that the legal actions that the employer is obliged to take is far-reaching. The preventive work is central considering the psychosocial work environment were threats and violence occur. If the employer fails to take the actions that is obliged there are different legal consequences depending on what type of actions the employer, deliberately or accidently, failed to take. Due to the extent of threats and violence in health and social care and some differences in the formulation of the legislation, future studies would be required to investigate if the legislation on this matter is enough.