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

Daniel Bruns, David A Fishbain, John Mark Disorbio, John E Lewis

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

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.

Original languageEnglish
Pages (from-to)87-97
Number of pages11
JournalJournal of Clinical Psychology in Medical Settings
Volume17
Issue number2
DOIs
StatePublished - Jun 1 2010

Fingerprint

Dangerous Behavior
Delivery of Health Care
Needs Assessment
Jurisprudence
Healthy Volunteers
Rehabilitation
Logistic Models
Demography
Wounds and Injuries

Keywords

  • Battery for Health Improvement 2 (BHI 2)
  • Borderline
  • Doctor Dissatisfaction scale
  • Healthcare workers
  • Homicide
  • Hostile wish to kill physicians
  • Litigation
  • Physicians
  • Predictors
  • Risk factors
  • Violence

ASJC Scopus subject areas

  • Clinical Psychology

Cite this

What variables are associated with an expressed wish to kill a doctor in community and injured patient samples? / Bruns, Daniel; Fishbain, David A; Disorbio, John Mark; Lewis, John E.

In: Journal of Clinical Psychology in Medical Settings, Vol. 17, No. 2, 01.06.2010, p. 87-97.

Research output: Contribution to journalArticle

Bruns, Daniel ; Fishbain, David A ; Disorbio, John Mark ; Lewis, John E. / What variables are associated with an expressed wish to kill a doctor in community and injured patient samples?. In: Journal of Clinical Psychology in Medical Settings. 2010 ; Vol. 17, No. 2. pp. 87-97.
@article{fa36b9f46c5d469794fc3e2cf77eae8a,
title = "What variables are associated with an expressed wish to kill a doctor in community and injured patient samples?",
abstract = "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.",
keywords = "Battery for Health Improvement 2 (BHI 2), Borderline, Doctor Dissatisfaction scale, Healthcare workers, Homicide, Hostile wish to kill physicians, Litigation, Physicians, Predictors, Risk factors, Violence",
author = "Daniel Bruns and Fishbain, {David A} and Disorbio, {John Mark} and Lewis, {John E}",
year = "2010",
month = "6",
day = "1",
doi = "10.1007/s10880-010-9190-7",
language = "English",
volume = "17",
pages = "87--97",
journal = "Journal of Clinical Psychology in Medical Settings",
issn = "1068-9583",
publisher = "Springer New York",
number = "2",

}

TY - JOUR

T1 - What variables are associated with an expressed wish to kill a doctor in community and injured patient samples?

AU - Bruns, Daniel

AU - Fishbain, David A

AU - Disorbio, John Mark

AU - Lewis, John E

PY - 2010/6/1

Y1 - 2010/6/1

N2 - 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.

AB - 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.

KW - Battery for Health Improvement 2 (BHI 2)

KW - Borderline

KW - Doctor Dissatisfaction scale

KW - Healthcare workers

KW - Homicide

KW - Hostile wish to kill physicians

KW - Litigation

KW - Physicians

KW - Predictors

KW - Risk factors

KW - Violence

UR - http://www.scopus.com/inward/record.url?scp=77954888584&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=77954888584&partnerID=8YFLogxK

U2 - 10.1007/s10880-010-9190-7

DO - 10.1007/s10880-010-9190-7

M3 - Article

C2 - 20352477

AN - SCOPUS:77954888584

VL - 17

SP - 87

EP - 97

JO - Journal of Clinical Psychology in Medical Settings

JF - Journal of Clinical Psychology in Medical Settings

SN - 1068-9583

IS - 2

ER -