医疗场所职场暴力的言语降级技术：一项系统综述

SYSTEMATIC REVIEW article

Front. Psychiatry

Sec. Public Mental Health

Abstract

Background: Workplace violence (WPV) remains a significant and escalating challenge across healthcare settings, threatening the safety, well-being, and retention of frontline healthcare providers (HCPs). Verbal de-escalation is widely promoted as a first-line strategy to prevent or manage aggressive patient behaviour. However, the scope, implementation, and effectiveness of these techniques have not been consistently synthesized. Methods: This systematic review was conducted in accordance with PRISMA guidelines. Studies were eligible if they examined verbal de-escalation as a primary strategy for preventing or managing WPV in healthcare settings, including hospitals, emergency departments, psychiatric units, long-term care, and outpatient clinics. All study designs were considered, including empirical research and structured descriptive guidance relevant to clinical practice. Searches were conducted in Ovid MEDLINE, Embase, Emcare, PsycINFO, and CINAHL from database inception, with results downloaded on August 29, 2024, and updated on January 30, 2026. Of 15,987 records identified, 9,096 were screened following duplicate removal, 439 underwent full-text review, and 36 studies met inclusion criteria. Methodological quality was appraised using the Mixed Methods Appraisal Tool (MMAT). Results: Substantial heterogeneity was observed in how verbal de-escalation was defined, delivered, and evaluated. Intervention studies commonly assessed structured training programs delivered through didactic sessions, interactive workshops, simulation-based education, technology-enhanced learning, or clinical unit–based training. These studies frequently reported improvements in staff knowledge, confidence, and preparedness to manage aggression. Observational and descriptive studies emphasized communication behaviours used during escalated encounters and highlighted recurring strategies, such as empathetic listening, calm verbal tone, validation, and collaborative problem-solving. Outcome measures varied considerably across studies, limiting direct comparison. Conclusions: Verbal de-escalation represents a central component of WPV prevention in healthcare, yet implementation approaches and evaluation methods remain inconsistent. The evidence suggests associations with improved provider confidence, reduced patient agitation, and enhanced perceptions of safety. Healthcare organizations can use these findings to strengthen training curricula, integrate de-escalation within broader safety frameworks, and support sustainable workforce protection strategies.

Keywords

clinicians, Communication strategies, Occupational Health, patient aggression, verbal de-escalation, violence prevention, Workplace violence prevention (WPV)

Received

27 February 2026

Accepted

21 September 2026

Copyright

© 2026 Seiyad, Nimako, Singh, Lyver, Villavicencio, Anderson, Whiteside, Shannon, Chandler, Vaughan, Toppings, Styra and Schulz-Quach. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

*Correspondence:

Disclaimer

All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.