NhSn thirc va thai ve hanh vi bao lyc doi voi nhan vien y te hien (Qua nghien cuu mot so benh vien a Ha Noi) Nguyln DO?c Tuyen*, Phi Hai Nam** Tom t^t: Tren co sd dii lieu dinh tinh cua mgt De tai cap Co sd nam 2019, bai vilt khao sat nhan thiic va thai cua ngudi dan va nhan vien y te ve bao luc ddi vdi nhan vien y te Ket qua khao sat cho thay nhan thiic ve bao luc ciia ngudi dan va nhan vi8n y tl diu kha ro rang ca vl bao luc tinh thin va bao luc thi chit Ve thai dg, hau hit ngudi tham gia khao sat bay td thai khdng chap nhan bao luc, mgt so it cham chudc cho bao luc tinh thin ttong mgt sd trudng hgp, nhimg khdng thong cam vdi bao luc the chat Nhm chung, nhSn vien y tl cd thai chip nhan, chiu dung, tranh a€ (nhimg khdng diu tranh) ddi vdi cac hanh vi bao luc; mgt sd ngudi khong chiu dung dugc da bd viec hoac di lam noi khac' Tir khoa: Bao luc doi vdi nhSn vien y te; Nhan thirc ve bao luc; Thai doi vdi b^o luc Ngay nhan bai: 10/2/2020; chinh siia: 24/2/2020; duyet dang: 2/3/2020 Dat van d e Tinh trang bao lyc ddi vdi nhan vien y t l (NVYT) la mdt vin d l dang nhan dugc sy quan tam cua the gidi vi "Theo cdng bd cua Td chiec Y ti the gi&i (WHO), cd - 38% nhdn viin y ti timg bi bgo hdnh & noi lam viec" (Lam Trin, 2019) Viet Nam, viec bao hanh nhan vien y t l da khong cdn xa la, nd dang diln cang nghiem ttgng va gia tang theo nam Ly giai v l nguyen nhan cua tuih ttang tten, mdt sd y kien cho la sy xudng d p dao diic cua mdt bd phan ngudi dan, su manh ddng ciia mdt sd ddi ttrgng, tinh thilu chuyen nghiep frong dilu tri, giao tiep, img xii cua NVYT (Minh Khue, 2018), ngoai cdn an ninh benh vien chua dam bao, khung phap ly chua dii siic ran de ' ThS.,Vien Nghien cmi Gia dinh va Gioi, Vien Han lam Khoa hgc xa hpi ViSt Nam " ThS,,Vi?n Nghien cihi Gia dinh va Giai, Vien Han lam Khoa hoc xa hpi Vipt Nam ^ ' Bai vigt la san phim ciia Di tai d p Co sa "Nhan thiic va thai dp va hanh vi bao lyc doi vai nhan vien y te hien qua nghien cuu mOt s6 b ^ vien tai Ha Npi" ciia Vi?n Nghien cuu Gia dinh va Giai thuc hien nam 2019 90 Nghi§n cu-u Gia dinh va Gio-i Quyen 30, so 1, tr 89-95 Nain 2019, Vien Nghien cim Gia dinh va Gidi da thyc hien dl tai "Nhan thiec vd thdi dp ve hdnh vi bgo luc ddi v&i nhdn vien y ti hien qua nghien cuu mot sd benh viin tgi Hd Ndi" nham tun hilu nhan thiic va thai cua NVYT va ngudi benh/ngudi dan vl hanh vi bao luc ddi vdi NVYT Nghign cim dugc thyc hien dua fren phuang phap khao sat dinh tmh, vdi mau nghien cim gdm 20 phdng vin sau (cac trich din phdng van sau ttong bai la san phim cua dl tai), cu thi, 10 nhan vien y tl (2 can bd quan ly, bac sy va dilu dudng vien) va 10 ngudi dan (2 benh nhan, ngudi nha cham sdc benh nhan va ngudi dan cd nhieu kinh nghiem/thdng tin vl hoat ddng cua co sd y tl) Nghien ciiu tign hanh khao sat tai mdt benh vien cap phd va mdt benh vien elp huyen thudc dia ban Ha Ndi Tren ca sd cac ket qua nghien cim cua dl tai, bai vilt tun hilu ve nhan thiic va thai cua ngudi dan va nhan vien y te ve bao luc ddi vdi nhan vien y te, ddng thdi dua cac khuyen nghi nham day manh cdng tac tuyen truyen nang cao nhan thiic cua ngudi dan ve chdng bao hanh ttong linh vuc y te va cac tap huan nang cao ky nang phdng ngira, ngan chan va hda giai bao luc cua ddi ngu nhan vien y te K8t qua nghien cmi thirc dia 1.1 Tong quan vdn de nghien cuu Van de ngan chan bao lyc ddi vdi NVYT da dugc quy dinh cy the ttong Luat Kham benh, chiia benh (2009) tai Khoan 1, Dieu ve viec cam thyc hien cac hanh vi gay tdn hai den siic khde, tinh mang, danh du, nhan phim cita ngudi hanh nghi Luat ciing quy dinh nghia vu ciia ngudi benh Dieu 14, Muc 2, Chuong II la phai "tdn frgng va khdng dugc cd hanh vi xam pham danh du, nhan phim, siic khde, tinh mang cua ngudi hanh nghe va nhan vien y te khac" Tuong ty, Khoan 2, Dilu 35, Chuang III cua Luat khing dinh ngudi hanh nghi kham benh, chiia benh cd quyen "dugc bao ve siic khde, tinh mang, danh dy, than thi" Khoan 5, Dieu 35 quy dinh cac co sd kham b§nh, chiia benh cd ttach nhiem "bao dam viec thuc hien cac quyln va nghia vy cua ngudi benh, ngudi hanh nghi dugc quy dinh tai Luat nay." Trong Bd luat Hinh sy nam 2018, Dilu 148, 155, 156 cd quy dinh tang nang hinh phat pham tdi ddi vdi ngudi chiia benh, cham sdc cho minh Nhu vay, phap luat da nghiem elm ro rang hanh vi bao lyc ddi vdi NVYT va nhung hinh phat tang nang ddi vdi sy vi pham Hanh vi tieu eye ddi vdi NVYT d nudc ta dugc tim thiy fren bao chi, cac bao cao va cac tai lieu nghien ciiu la kha da dang ve loai hinh, bao gdm: lang ma, cd y xiic pham danh dy, nhan phim, cd lap, xua dudi hoac gay ap luc thudng xuyen vl tam ly gay bau qua nghiem trgng, ngan can viec thyc hien quyln cua nhan vien y tl, hanh ha, ngugc dai, danh dap hoac cac hanh vi cd y xSm hai den siic khoe, tinh mang ciia nhan vien y tl va diu dugc xac dinh la bao lyc theo dinh nghTa cua Td chiic Y t | thi Nguyen DIIC Tuyen & Phi Hai Nam 91 gidi (WHO): "viec c6 y su dung siic manh co the hoac quyen luc, de dga hoac thyc tl da chdng lai chinh minh hoac ngudi khac, hoac chdng lai mgt nhdm hoac cdng ddng, dan din hau qua hoac cd kha nang cao gay thuang tich, hi vong, ton thuong tam ly, phat triln khilm khuylt hoac bi mat quyln" (Krug et al., 2002:5) Dua vao tinh chat ciia cac hanh vi bao luc tren, nghien ciru phan tich, so sanh nhan thiic, thai ddi vdi hai nhdm hinh thiic bao luc sau: - Bgo luc tinh thdn: La nhiing hanh vi gay anh hudng vl mat tinh thin ddi vdi nhan vien y te, gdm: mang chui, dga nat, lang ma, xiic pham nhan pham din nhan vien yte - Bgo luc the chdt: La nhiing hanh vi gay anh hudng vS the chit ddi vdi nhan vien y te, gdm: tiim cd ao, tat, dam da, g&y thuong tich/anh hudng den than the nhan vien y tl 1.2 Nhgn thuc vd thdi dg, hdnh vi v&i bgo luc tinh than Nhgn thiec vd thdi dp cua NVYT ve bgo luc tinh thdn Ket qua nghien ciiu cho thay, ve nhan thiic, ca NVYT va ngudi dan deu xac dinh dugc cac haiih vi nhu: mang chiri, dga nat, lang ma, xiic pham nhan pham den nhan viSn y te, v.v la hanh vi bao lyc ddi vdi NVYT Nhu vay, nhan thiic cua ngudi dan va nhan vien y te ve bao lyc tinh than la kha ro rang Ve miic phd bien, hau het ngudi dugc khao sat, bao gdm ca nhan vien y te va ngudi dSn, deu cdng nhan rang hinh thiic bao luc vdi nhan vien y te chu yeu la bao lyc tinh than Mdt Phd giam ddc Benh vien tuyen huyen cho biet, theo quan sat ciia dng, mdy nam gSn day chieu hudng bao lyc tinh thin cd ve tang len Mdt sd nhan vien y te chiing tdi phdng van ciing xac nhan dieu nay, va them rang: "Hinh thuc vdng l&i chui tuc chui bai nhdn vien y te la phd bien nhdt" (Nu, dieu dudng vign, 29 tudi); "Hg dpa ngt: Chung mdy khdng lam cho tao thi bpn tao chem chit! Md cdng khdng thdy hdnh ddng chem Dpa la chinhV (Nii, dieu duong vien, 26 tudi); "Xucphgm bdng led ndi la phd biin nhdf (Nam, dieu dudng vien, 28 tudi) Noi xay bao lyc nhilu nhit la Khoa Cip ciiu hdi siic D6i tugng bi bao lyc chu ygu la cac dieu duong vien bdi hg "la ngu&i tiip xiic nhiiu nhdt v&i benh nhdn nen la di bi bgo hdnh nhdt" (Nii, dilu dudng vien, 29 tudi); "vi bpn em chdm sdc benh nhdn, gdn gUi benh nhdn nhdt" (Nam, dieu duong vien, 28 tudi) Nhan thiic vl doi tugng gay bao luc, blu hit diu xac nhan ring ddi tugng gay bao lyc tinh than khdng phai la ngudi benh ma thudng la ngudi nha/ban be benh nhan Nguyen nhan cd nhieu, bao gdm ddi hdi vugt miic chua tri (thudc, cac xet nghiem, chan doan hinh anh ), khdng tdn ttgng trinh cua bac sy, ddi hdi xet chuyen tuyen Cac yeu cau cua ngudi nha benh nhan thudng vugt qua kha nang ciia benh vien (do ban che 92 Nghien ci>u Gia dinh vh Giai Quyen 30, so 1, tr 89-95 ve ttang thilt bi ) va nhilu khdng cin thilt (bac sy da cd nghiep vu cho bilt khdng cin thilt, nhung ngudi nha khdng bilt cii ddi hdi) Lanh dao, quan ly benh vien tuyln huyen cho bilt, dugc huin luyen ky cang ve cac tinh hudng xay xung dot ttong mdi trudng y te ciing nhu dugc ddng vien thudng xuyen ve mat tinh than, cae NVYT tai co sd diu tuan thii diing vdi dao diic ngudi thay thudc, cd thai vi tha, thdng cam vdi benh nhan, hilu dugc sy biic xiic ciia ngudi nha Chinh vi the, d noi day, cho du ttong tinh huong bi bao luc tir phia ngudi benh hay tir ngudi nba benh nhan, cac y bac sT d noi day van coi viec chua benh, ciiu ngudi la uu tien hang dau Qua khao sat, nhiing nhan vien y te ma chiing tdi tiep xiic deu xac dinh thai cd ttach nhiem, lam diing chiic ttach, nhiem vy cho du nhieu khdng yen tam: "Sp nhung cdng viec cua minh lam thi vdn phdi lam " (Nu, bac sy, 35 tudi) Nhieu NVYT cdn cd thai nhudng nhin, chiu dyng, coi viec biic xiic cua benh nhan/ngudi nha la "dieu khdng trdnh khdi", la "tai ngn cua nghe", tir dd ty Idem che ban than: "Cd nhimg tru&ng hpp gdy buc xiic thi nhimg minh kiim chi duac, minh vdn phdi ddi xu tic tdn Noi chung minh phdi thdp minh xudng Xdc dinh chuyen bgo luc la binh thu&ng rdi" (Nu, dieu dudng vien, 26 tudi) Tuy nhien, bao luc tinh than da gay nhiing tdn thuang tam ly vdi nhan vien y te: "Nhiiu liic cUng sp chic g" (Nu, dieu dudng vien, 35 tudi) Chac chan bao luc tinh than khdng chi gay nhiing tdn thuang tam ly, tac dgng tieu eye den siic khoe the chat ciia nhan vien y te ma cdn anh hudng den dgng lyc lam viec cua hg Hau qua la lam anh hudng den thai phuc vu, chat lugng cham sdc va hieu qua chiia fri cua benh vien Nhgn thicc, thdi dp ciia ngu&i ddn ve bgo luc tinh thdn Hau bet ngudi dan ciing nhan thiic dugc cac hinh thiic bao luc tinh thin, cy thi gdm, ldi ndi to tieng, xuc pham, quat nat, chiri mang, hanh vi dga nat: "Loi ndi, cu chi khdng duac ddng hodng" (Nam, ngudi nha benh nhan, 53 tudi); "Ngodi cdn thii hdn, de dpa, chdn du&ng" (Nam, benh nhan, 55 tudi); "Qudt ngt ciing la bgo luc vi phgm Chui mdng, ddnh dap " (Nam, ngudi nha benh nhan, 63 tudi) Theo ngudi dan, vl tin suit, nhiing hanh vi bao luc khdng phai la qua nhieufrongco sd y tl, cd ngudi dugc phdng vin xac nhan chimg kien hanh vi bao luc tinh than, nhien, nhilu ngudi khac chua chiing kiln cho du hg da nhieu lan den trung tam y te Ngudi dan nhan thiic ring ngudi gay bao luc tinh thin thudng khdng phai la ngudi benh ma la ngudi nha/ngudi than ciia benh nhan: "Thu&ng Id ngu&i nhd Benh nhdn thi chi nam thdi Ngu&i nhd vdo gdy dp luc " (Nam, ngudi nha benh nhan, 63 tudi) Ngudi dan ciing nhan thiic dugc bao luc tinh than la vi pham phap luat, hg cd thai phan ddi vdi cac hinh thiic bao lyc doi vdi NVYT, ttong dd cd cac hanh vi bao luc tinh thin: "Biec xuc cua ngu&i nhd v&i nhdn viin y ti la khdng dung" (Nam, benh nhan 55 tudi) Tuy nhien, frong mdt chimg muc nao do, hg cung cd thai bien minh, thdng Nguyen Due Tuyen & Phi Hai Nam 93 cam vdi ngudi gay bao luc tinh than, cho rang vi hoan canh ngudi nha nguy d p , tinh thin hoang loan, va cho rang hanh vi bao luc mgt phan nguyen nhan dugc cho la tu nhiing biic xuc vdi boat dgng chuyen mdn cua nhan vien y te: "Cd thi buc xuc vi cdn benh ddi v&i ngudi nhd chdng hgn Vi du: mdu chay, rdng rai qudn rdch td toi " (Nam, benh nhan, 55 tudi); ngudi nha benh nhan cd sy lo ling vi phai chd dgi, thyc hi|n nhung quy dinh, thii tuc ma ddi vdi hg la su bit tien, cham tte, rudm hoac lam anh hudng den viec dieu fri ciia ngudi nha cua hg Cd trudng hgp tham chi cdn ldi hoac biic xiic vdi viec hieu qua chua tri cua benh vien: "Ngu&i khde din benh vien lgi yeu " Giai thich ve dieu nay, mgt lanh dao benh vien cho bilt "Thuc ra, binh nhdn da mang binh, nhung biiu Men vdn cdn khde; din binh vien thi benh phdt trien den giai doan nang hon, ro ret han Niu khdng bi benh thi din binh vien lam gi? " (Lanh dao Benh vien) Cac phdng van sau cho thay hau het chua cd thai san sang can thiep ddi vdi cac trudng hgp bao luc tinh than: "Tdi chua gap tru&ng hap (tru&ng hop cd ngu&i can thiep) dy " (Nam, ngudi nha benh nhan, 63 tudi) Mac du chua cd hanh ddng ngan chan hay giai quyet bao luc, nhung hg cd thai thdng cam vdi ngudi NVYT: "Chuyin bgo luc la ngodi ria, ngodi le, ngu&i ta [nhdn viin y ti] khdng nghi din " (Nam, benh nhan, 55 tudi) "Da sd bdc sy dimg im, cdi la bdc sy dung im, khdng phdn img gi Ki, viec lam cic lam " (Nam, ngudi nha benh nhan, 63 tudi) 1.3 Nhgn thurc vd thdi dg ve bgo luc the chdt Nhgn thicc, thdi dp cua NVYT ve bao luc the chdt Khao sat cho thay lanh dao benh vien nhan thiic sau sac miic nghiem ttgng cua bao lyc, nhat la ddi vdi bao luc the chat bdi thyc te da xay cac hanh vi nhu nem dung cu y te vao ngudi NVYT hay dudi danh, nang hon la tat, tiim tdc, turn cd ao, tham chi gay thuong tich cho NVYT Chinh vi thi, d benh vien, nhung hoat dgng, phuang an phdng ttanh bao luc thi chit da dugc triln khai thyc hien nham dam bao an toan cho NVYT Trong khoang nam gin day, bao luc the chat rat hiem xay va cd xu hudng giam Dac biet, hau het cac vy bao lyc giai quyet xong ngudi nha benh nhan thudng xin ldi bac sy hieu ra, nhan thiic dugc hanh vi sai ttai (Phd Giam ddc Benh vien) Doan phdng van sau ttong Hop la vi dy cho thay bao luc dien bat ngd Khi bao lyc the chit xay ra, nhung ngudi xung quanh, kl ca NVYT va ngudi nha khac cua benh nhan diu can thiep (khdng nhu bao luc tinh than, it ngudi can thiep), cho thay nhan thiic ve sy nghiem ttgng cua bao lyc thi chit rit cao Cdn NVYT bi bao lyc thg chat thudng khdng lam gi, cbi franh, chay dl ttanh su tang manh ciia bao lyc, va sau dd thudng chiu nhin ngai huy ddng cac luc lugng co quan, doan the vao giai quyet vu viec dugc cho la khdng Idn va la mgt phin rui ro ciia viec lam Ddi vdi cac hanh vi bao luc, nhilu NVYT thd hien thai chiu dung hoac thai 94 Nghi§n ciJu Gia dinh va Gib-i Q u y l n 30, so 1, tr 89-95 bmh thudng hda su viec: "co; la mpt phdn cda cdng viec" Cd thi hanh vi bao lyc diln d noi ma tinh mang ngudi phai dugc dat len hang diu, doi tugng gay bao luc ban khien cho nhieu nhan vien y t l chip nhan va cd ging ttanh ne miic sy viec xay manh hon H g p Mot trufffng hop nhSn vien y t l da bi bao lire the c h i t Ddp: Hdm em true khoa cdp cuu, khodng gi& chieu, hai ngu&i uong ruau bi ddnh, vdo ddy Do Id binh nhdn cua khoa ngogi, bpn em don tiip npi khoa thoi, nhimg bpn em vdn don dip vd dua vdo cdng Em bdo ngu&i nhd dua benh nhdn di theo em sang khoa ngogi, nhung ngu&i nhd chdc say ruau bdo "Mdy co dua ngu&i nhd tao di khong " Em bdo di theo em nhieng hp khong nghe hay dy hp nhdy vdo hp ddnh minh luon Hdi: Anh chi em xung quanh? Ddp: Co can thiep Ki cd ngudn nhd binh nhdn cUng can ngdn Nguai nhd can ngu&i ddnh em the Id ngu&i thoi khong ddnh nica Hoi: O day co biin phdp, phuang dn gi can thiep khong? Ddp: Chua cdn Minh tugidi quyit theo suy nghi cUa minh (Nam, dilu dudng vien, 28 tudi) NVYT d noi day the hien manh tinh than doan ket frong viec ngan chan bao luc frd len nguy hiem va lan rdng, cd the theo nhieu each nhu: ttg giiip va cd mat de kip thdi ngan chan bao lyc; hoac, giam bdt sy phat ttien cua bao lyc; hoac, giiip ve tinh than, an ui nhau, chia se them nhiing kinh nghiem img phd sau bao lyc Ciing khdng the franh khdi mgt sd trudng hgp can bd y te da khdng kiem che dugc buc xuc, nhien hg khdng td thai tieu cue nhu chdng ddi benh nhan "vi nhu thi chi ddu vdo lua ", ma biic xuc l i m thi da cd trudng hgp bd lam, chuyen nghe sang lam cac cdng viec khac: "Cd chic anh Cdm thdy dp luc qud ngu&i ta mudn di ngodi tim viec m&i, hodc phdng khdm khde" (Nam, dieu dudng vien, 28 tudi), "mpt cd cdn mpt ndm nica vi huu gid da xin nghi viec" (Nu, bac sy, 35 tudi) Nhgn thiec, thdi dp cua nguai ddn vi bgo luc the chdt Nhm tir gdc tam ly, nhiing tdn thuang vat ly bj dudi danh, tat, him cd ao hay nang ban la gay thuong tich cho NVYT la nhung thiet hai ma cung thiy dugc, cho nen da sd nhm nhan va thua nhan la hanh vi bao luc cue ky nghiem frgng Vi vay, khdng cd frong ddi tugng khao sat xem nhe tinh nghiem frgng ciia bao lyc thi chat Khi y thiic rd tinh nghiem trgng cua bao lyc, ngudi dan hau bit la td thai khdng chip nhan, nhit la bdi day la banh vi bao luc cua ngudi bi benh ddi vdi chinh ngudi chiia benh cho hg Ngudi nha benh nhan va benh nhan td thai phan ddi rd ret vdi cac hanh vi bao Nguyen Diic Tuy^n & Phi Hai Nam 95 lyc: "hdnh vi bgo luc ddi v&i nhdn vien y ti la khd chdp nhan, cdn len dn vd xuphgt", "nhimg hdnh vi la khdng the chdp nhan duoc" Nhiing nhan xet bay td thai khdng ddng tinh vdi hanh vi b£io lyc ve the chat dugc the hien rd d gin nhu tit ca cac cudc phdng van sau ddi vdi ngudi dan Khdng nhu bao lyc tinh thin, ddi vdi bao luc thi chit, khdng dd Idi cho bac sy, ca ngudi gay bao luc cung thudng nhan ldi vl phia minh: "Trong liic ndng gian thi hdnh dpng thieu suy nghT; nhimg sau thdy dn hgn, nhgn sai sdt vd xin ldi bdc sy" (Nam, ngudi nha benh nhan, 63 tudi) M^t so ket luSn va khuyen ngh| Ket qua nghien ciiu cho thay nhan vien y tl nhan thiic ro ban cac hanh vi bao luc tinh than va thi chit so vdi ngudi dan, nhien, phin Idn trudng hgp NVYT khdng td tiiai phan ddi ma lya chgn phuang an chiu dyng, nhiing khdng chiu dyng dugc thi tinh den chuyen bd viec, bd nghe Ngudi dan thudng cd thai cham chudc, thdng cam vdi bao luc tinh thin; nhung vdi bao lyc the chSt cd thai phan ddi va ciing cd nhiing trudng hgp can tbiSp, ngan chan Ket qua khao sat cho thay can day manh cdng tac tuyen truyen nang cao nhan thiic cua ngudi dan ve viec chdng bao hanh frong ITnh vuc y te, ngoai ra, ciing can phd bien kien thiic y hgc, quy trinh kham chiia benh cho ngudi dan Ddng thdi, tiep tuc trien khai md rdng cac lop tap huan cho NVYT ve phuong an phdng ngira va ngan chan bao lyc, cy the la nang cao ky nang giao tiep va ky nang tim kiem cac phuong an hd frg tai chd ddng nghiep gap bao luc Ngoai cung can chii frgng nhung lieu phap tam 1^, nhung sy dgng vien ve tinh than tir phia co quan, ddng nghiep ddi vdi nhiing NVYT da timg bi bao lyc Tai lieu trich dan Krug RG [et al.] eds 2002 World Report on Violence and Health Geneval: World Health Organization - xxii,346 p Lam Tran 2019 Bgo hdnh benh vien: Bdt binh thdi, chua du! Nhan dan dien tir, https://nhandan.com.vn/y-te/item/42051002-bao-hanh-benh-vien-bat-binh-thoi-chuadu.html Minh Khue 2018 Khi bgo luc "tiin vdo" benh vien Lao ddng thu dd, http://Iaodangthudo.vn/khi-bao-luc-tien-vao-benh-vien-69670.html ... gdm: lang ma, cd y xiic pham danh dy, nhan phim, cd lap, xua dudi hoac gay ap luc thudng xuyen vl tam ly gay bau qua nghiem trgng, ngan can viec thyc hien quyln cua nhan vien y tl, hanh ha, ngugc... hanh vi cd y xSm hai den siic khoe, tinh mang ciia nhan vien y tl va diu dugc xac dinh la bao lyc theo dinh nghTa cua Td chiic Y t | thi Nguyen DIIC Tuyen & Phi Hai Nam 91 gidi (WHO): "viec c6 y. .. te chu yeu la bao lyc tinh than Mdt Phd giam ddc Benh vien tuyen huyen cho biet, theo quan sat ciia dng, mdy nam gSn day chieu hudng bao lyc tinh thin cd ve tang len Mdt sd nhan vien y te chiing