Table 2.
Frequency of main themes in provider-generated descriptions of their (A) angry, (B) positive and (C) mental health encounters
|
Themes and subthemes |
Encounters | ||
|---|---|---|---|
| Total | Physicians | Nurses | |
| A. Angry encounters* | |||
| Patient behaviour | |||
| Demanding, entitled, or manipulative behaviour | 50 (53%) | 27 (54%) | 23 (52%) |
| Verbal or physical abuse towards provider (actual or threatened) | 34 (36%) | 18 (36%) | 16 (36%) |
| Frequent/high emergency department utiliser | 35 (37%) | 16 (32%) | 19 (43%) |
| Unrealistic expectations (patient expected different or more care than was possible) | 23 (24%) | 17 (34%) | 6 (14%) |
| Poor self-care (patient did not manage medical condition or refused necessary treatment) | 21 (22%) | 13 (26%) | 8 (18%) |
| Issues with family members | |||
| Situations in which a family member directed hostility or anger towards the provider or patient | 15 (16%) | 6 (12%) | 9 (20%) |
| Hospital or system issues | |||
| Patient care barriers not under direct control of emergency department provider, including issues with colleagues, the emergency department system, hospital, or healthcare in general | 24 (26%) | 11 (22%) | 13 (30%) |
| Miscellaneous (content not categorised) | 6 (6%) | 3 (6%) | 3 (7%) |
| B. Positive encounters† | |||
| Relationship with patient and/or family | |||
| Gratitude expressed towards provider | 52 (55%) | 28 (56%) | 24 (54%) |
| Patient was cooperative, positive, or understanding | 19 (20%) | 15 (30%) | 4 (9%) |
| Other meaningful connection with patient | 8 (8%) | 2 (4%) | 6 (14%) |
| Success with patient care | |||
| ’Made a difference’ or advocated for patient | 37 (39%) | 18 (36%) | 19 (42%) |
| Felt proud of own abilities | 13 (14%) | 9 (18%) | 4 (9%) |
| Felt proud of team/emergency department | 7 (7%) | 4 (8%) | 3 (7%) |
| Miscellaneous (content not categorised) | 4 (4%) | 1 (2%) | 3 (7%) |
| C. Mental health encounters‡ | |||
| Patient behaviour | |||
| Demanding, entitled, or manipulative behaviour | 49 (52%) | 19 (38%) | 30 (68%) |
| Verbal or physical abuse towards provider (actual or threatened) | 30 (32%) | 10 (20%) | 20 (45%) |
| Frequent/high emergency department utiliser | 33 (35%) | 17 (34%) | 16 (36%) |
| Poor self-care (patient did not manage medical condition or refused necessary treatment) | 16 (17%) | 8 (16%) | 8 (18%) |
| Calm, pleasant, thankful | 22 (23%) | 13 (26%) | 9 (20%) |
| Issues with family members | |||
| Situations in which a family member directed hostility or anger towards the provider or patient | 6 (6%) | 6 (12%) | 0 (0%) |
| Situations in which provider experienced sadness for a patient’s family member | 12 (13%) | 9 (18%) | 3 (7%) |
| Hospital or system issues | |||
| Patient care barriers not under direct control of emergency department provider, including issues with colleagues, the emergency department system, hospital, or healthcare in general | 36 (38%) | 21 (42%) | 15 (34%) |
| Provider emotions | |||
| Anger, frustration, irritation | 55 (59%) | 25 (50%) | 30 (68%) |
| Sadness, helplessness, empathy | 33 (35%) | 19 (38%) | 14 (32%) |
| Fear, anxiety | 12 (13%) | 5 (10%) | 7 (16%) |
| Positive emotions (appreciation, gratitude) | 8 (9%) | 3 (6%) | 5 (11%) |
| Indifference or no emotion mentioned | 12 (13%) | 8 (16%) | 4 (9%) |
| Miscellaneous (content not categorised) | 18 (19%) | 9 (18%) | 9 (20%) |
n=94 (50 physicians, 44 nurses).
*
Seventy-two stories (77%) were coded into two or more categories.
†
Forty stories (43%) were coded into two or more categories.
‡
Ninety-three stories (99%) were coded into two or more categories.