A Qualitative Study of Medical Social Workers’ Responses to Patient Violence In Rural China: Implications for Equitable Healthcare Systems

Background and Purpose: Patient violence in healthcare settings presents ongoing challenges to service delivery, particularly in rural areas where resources are limited and institutional support may be constrained. Within these contexts, medical social workers are often directly involved in situations of conflict and tension. This study explores how medical social workers respond to patient violence in rural China and considers the implications of their practices for more equitable and responsive healthcare.

Methods: This study adopts a qualitative case study method. In-depth interviews were conducted with ten medical social workers working in secondary and primary hospitals in rural China who had experience intervening in patient violence. The interview materials were analyzed thematically, with attention to how participants described their experiences, made sense of their roles, and interpreted the contexts in which they worked.

Results: Participants’ accounts are presented across three interrelated domains. First, medical social workers described a sense of ambivalence toward patient violence prior to intervention. Their responses were shaped by prior professional experiences as well as organizational conditions, including the presence or absence of collaborative support. Second, the intervention process brought forward tensions related to role expectations and institutional constraints. Medical social workers often positioned themselves as mediators among patients, healthcare professionals, and administrators, navigating different perspectives while attempting to maintain balance in emotionally charged situations. In doing so, they encountered both the possibilities and the limitations of their professional roles within the healthcare system. Third, participants reflected on their professional growth while also pointing to broader challenges embedded in organizational culture and the dynamics of rural acquaintance society. Intervention experiences contributed to a growing sense of professional identity, while also revealing gaps in institutional support and coordination at both organizational and community levels.

Conclusions and Implications: By centering the experiences of medical social workers, this study sheds light on how patient violence is encountered and managed in everyday practice within underserved rural healthcare settings. The findings underscore the importance of recognizing and strengthening the role of social work in navigating conflict, supporting communication, and sustaining service delivery. They also point to the need for context-sensitive institutional strategies that better support frontline practitioners, contributing to more equitable and responsive healthcare systems.