医疗机构工作场所暴力倾向调查问卷-PLOS.DOC

Workplace Violence in the Health Sector Case Study--Questionnaire Please complete the questionnaire by either ticking boxes or writing in the spaces provided. If you don’t know how to answer one question, just go on to the next one. A. PERSONAL AND WORKPLACE DATA A 1 Age: A 2 Gender: ( Male ( female A 3 what is your Marital status: ( Single ( Married ( living with partner ( Separated/ Divorced ( widow/Widower A 4 How many years of work experience in the health sector do you presently have: _______ A 5 Education: (Postgraduate (Undergraduate (College (Technical secondary school education and below A 6 Ethnic group： A 7 Professional title: ( Senior ( Intermediate ( Junior ( No title A 8 Occupation: ( Doctor department ( Nurse department A 9 Company name______________ __ A 10 Do you work in shifts? ( Yes ( No A 11 Do you work anytime between 18h00 (6 PM) and 07h00 (7 AM)? ( Yes ( No A 12 Do you interact with patients/clients during your work? No, please go to question A 14 12.1. Do you have routine direct physical contact (washing, turning, lifting) with patients/clients? ( Yes ( No 12.2. The patients/clients you most frequently work with are (tick all appropriate boxes): ( Newborns/Infants ( Children/Adolescents (10-18 years of age) ( Adults ( Elderly 12.3. The sex of the patients you most frequently work with are： ( Male ( Female ( Male and female A 13 How worried are you about violence in your current workplace? (Please rate: 1 = not worried at all; 5 = very worried): (1 (2 (3 (4 (5 A 14 Are there procedures for the reporting of violence in your workplace? If NO, please go to question A 17 ( Reporting only if suffered physical injuries ( Reporting if suffered verbal threats or injuries ( No 14.1. If YES, do you know how to use them? ( Yes ( No A 15 Is there encouragement to report workplace violence?If NO, please go to next section ( Yes ( No