What variables are associated with an expressed wish to kill a doctor in community and injured patient samples?

Publisher: Springer Country of Publication: United States NLM ID: 9435680 Publication Model: Print Cited Medium: Internet ISSN: 1573-3572 (Electronic) Linking ISSN: 10689583 NLM ISO Abbreviation: J Clin Psychol Med Settings Subsets: MEDLINE

Publication: New York, NY : Springer
Original Publication: New York, NY : Plenum Press, c1994-

Community Health Services* ; Hostility* ; Motivation* ; Physician-Patient Relations* ; Sick Role*; Homicide/*psychology ; Mental Disorders/*diagnosis ; Mental Disorders/*psychology ; Pain/*psychology ; Violence/*psychology ; Wounds and Injuries/*psychology; Adult ; Dangerous Behavior ; Female ; Humans ; Low Back Pain/diagnosis ; Low Back Pain/psychology ; Low Back Pain/rehabilitation ; Male ; Malpractice ; Mental Disorders/rehabilitation ; Middle Aged ; Pain/diagnosis ; Pain/rehabilitation ; Patient Satisfaction ; Personality Inventory/statistics & numerical data ; Psychometrics/statistics & numerical data ; Regression Analysis ; Reproducibility of Results ; Smoking/epidemiology ; United States ; Wounds and Injuries/diagnosis ; Wounds and Injuries/rehabilitation

Working in a health care setting has been identified as a primary risk factor for violent assault, which is often perpetrated by patients. Patient dangerousness is a multidimensional phenomenon, which may include violent ideation, homicidal planning, a history of violent acts, or overt threatening behavior. Although the verbal report of thoughts of killing a doctor is only one of many risk factors for patient dangerousness, reports of homicidal ideation are widely regarded as being sufficient to warrant concern, and to indicate a need for further assessment of the patient. In this study, 2264 subjects (1329 healthy community subjects, 158 non-healthy community subjects, and 777 rehabilitation patients) were asked if they had a desire to kill a doctor that they had seen. Subjects responding positively to this item were compared to subjects responding negatively to the item using all available demographic variables and BHI 2 scales using chi-square or t-test. Significant variables (p<.01) were then utilized in a logistic regression to generate a model for this wish. Three variables significantly predicted this wish: the Doctor Dissatisfaction (p<.001) and Borderline (p<.001) scales of the BHI 2, and injury-related litigation status (p=.002). The presence of one of these variables, especially Doctor Dissatisfaction, should prompt a more thorough assessment of potential danger to healthcare workers.

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Date Created: 20100331 Date Completed: 20100902 Latest Revision: 20211020

20240829

10.1007/s10880-010-9190-7

20352477