Users' Perception of Violence and Conflicts With Professionals in Primary Care Centers Before and During COVID-19. A Qualitative Study.

Background: Workplace violence is a social problem of special interest in both intervention and research. Among the sectors that most perceive this type of violence, health care professionals stand out. The most common type of violence for this professional group is the one perpetrated by the users or patients themselves. It has been reported that one out of every four acts of violence in the workplace occurs in the healthcare setting. Within the health sector, the Mental Health, Emergency and Primary Care services have been widely reported as being among the most vulnerable, with Primary Care being the least addressed of the three. Although the available literature is extensive, there are hardly any studies that explore from a qualitative perspective what are the sources of conflict in this sector from the perspective of the users, the most common being to work with professionals. Objective: The aim of this study is to examine those aspects derived from the organization, the professionals or the users of Primary Care that, from the users' point of view, cause violent situations and how they think these could be avoided. Method: The sample consisted of 80 users of the Primary Care services of the Health Service of Murcia. For data collection, a qualitative study was conducted through 10 focus groups and a subsequent thematic analysis of the data. Results: The results have allowed us to identify that, from an organizational point of view, the uncertainty in waiting times, the need to adapt the telematic or telephone appointment to the different types of users, or the management of emergencies in Primary Care are the aspects that cause most conflicts between users and professionals. In this sense, suggested improvements are aimed at providing information in the mobile application updated on the opening hours or maintaining the telephone appointment for those who need or request it, among many others. As for the professionals, users point out that the medical staff is perceived as distant and sometimes does not provide enough information on the health status of users. Another professional group widely addressed in the focus groups was the administrative staff, being described as lacking in communication skills, assertiveness, or empathy. Users recognize the existence of a demanding/aggressive profile among users, who makes instrumental use of violence to achieve privileges over users in general. We have also identified the profile of the user who makes use of Primary Care as a way of socializing or managing conflicts of a socioemotional nature. As proposals for this thematic block, users suggest group therapies, the use of audiovisual material complementary to the information provided by professionals or community interventions in psychoeducation. Conclusion: This study allows to explore conflicts between users and professionals from the Primary Care patients' perspective. Our results are complementary to the available evidence that has used the professional's approach to study the phenomenon of workplace violence. The identification of sources of conflict and the assessment and contribution of users on possible ways of improvement can serve as a basis for the design of prevention and intervention plans to improve the work environment in Primary Care centers.

Violencia de género: perspectiva de condenados y de psicólogos/as de instituciones penitenciarias. Análisis cualitativo con grupos focales / Intimate Partner Violence: perspective of convicts and psychologists of penitentiary institutions. A Qualitative analysis with focus groups

La violencia de género es un proceso complejo en el cual intervienen variables individuales, relacionales y contextuales. El presente estudio tiene como objetivo explorar las estrategias de afrontamiento y dinámicas relacionales en situaciones conflictivas en condenados por violencia de género con sus parejas. Se realizaron grupos focales con condenados por violencia de género (12 participantes) y con profesionales de la psicología (4 participantes). Los datos se exploraron mediante análisis temático siguiendo el Modelo Ecológico Anidado. El grupo de condenados muestra roles de autoridad y superioridad sobre la mujer, sensación de vulnerabilidad y rechazo ante el marco jurídico existente, miedo a sufrir arrestos por querer continuar con la relación, la necesidad de control de la pareja impulsada por lo celos, la justificación o negación de responsabilidad en las situaciones violentas o instrumentalización de los hijos/as en común. Los profesionales señalan aspectos culturales que facilitan esquemas y roles violentos en la dinámica de pareja, problemas de comunicación, negación o baja conciencia del delito, entre otros temas. Los resultados son de especial interés tanto para los profesionales que deseen conocer o profundizar en la temática como para quienes trabajen en la intervención y/o prevención en violencia de género.(AU)

Intimate Partner Violence is a complex process in which indi-vidual, relational and contextual variables intervene. The aim of this study was to explore coping strategies and relational dynamics in conflict situa-tions involving people convicted of intimate partner violence with their partners. Focus groups were conducted with convicted intimate partner violence offenders (12 participants) and with psychology professionals (4 participants). The data were explored through thematic analysis following the Nested Ecological Model. The group of convicted perpetrators showed roles of authority and superiority over the woman, a feeling of vulnerability and rejection of the existing legal framework, fear of being arrested for wanting to continue the relationship, the need to control the partner driven by jealousy, justification or denial of responsibility in violent situations or instrumentalization of the children in common. The professionals point out cultural aspects that facilitate violent patterns and roles in the couple's dynamics, communication problems, denial or low awareness of the crime, among other issues. The results are of special interest both for profession-als who wish to learn or deepen their knowledge on the subject, as well as for those who work in intervention and/or prevention of intimate partner violence.(AU)