PhD defence Y. (Yuhan) Wu

Below is a brief summary of the dissertation: 

Aggression and violence by patients and their relatives/friends towards physicians is an important challenge for healthcare systems. Overcrowded facilities, increasing patient expectations, and limited resources contribute to tensions that can lead to such incidents in Chinese hospitals. While workplace violence has been widely studied, little research has focused specifically on patient aggression and violence against physicians in China.

This thesis combined a systematic review, interviews, a Delphi study, and Q-methodology to investigate risk factors, consequences, and interventions of patient aggression and violence against physicians. The review showed up to 87.5% of physicians globally have experienced such aggression, with higher rates in developing countries. However, scant studies have explored team or organizational impacts or which risk factors are perceived as relatively most important. Therefore, interviews were conducted in China to reveal effects on team climate, communication, and hospital reputation. The Q-methodology study identified four distinct Chinese physicians’ perspectives on risk factors: unmet treatment expectations and resource limitation; patient characteristics and education; distrust and limited protection; and emotional well-being and poor interaction. To identify practical solutions, a Delphi study with Chinese experts achieved consensus on 36 interventions that are both important and feasible, such as legal aid for physicians, and staff training in managing aggression.

The findings offer practical recommendations for tailored intervention strategies that address specific risk factors identified in different hospital contexts, alongside a core package of safety measures that can be applied across hospitals to improve physician safety and reduce violence.