Addressing Risks of Violence against Healthcare Staff in Emergency Departments: The Effects of Job Satisfaction and Attachment Style

Cross-sectional study of aggression against Spanish nursing personnel and effects on somatisation of physical symptoms

INTRODUCTION

Violence against nursing personnel in their place of work is a severe problem generating important consequences for these workers. Even though there is a large body of research on the subject, the emotional impact of aggression against healthcare workers continues to be debated.

OBJECTIVES

The objective of this quantitative, observational cross-sectional study was to analyse the effects of aggression against nursing personnel and the mediating role of anxiety in somaticising physical symptoms.

METHOD

The sample was made up of 1357 nursing professionals who answered questionnaires evaluating their sensitivity to anxiety and the presence of somatic symptoms.

RESULTS

Of the professionals who indicated that they had been the victims of aggression by family members or patients in the previous year, 52.8% said it had happened to them on one occasion, 25.2% had experienced two episodes, while 6.9% and 15.1% said they had undergone three or more aggressions, respectively. Although 89.3% of the professionals affected by acts of indicated that they had not undergone physical or psychological consequences, there was a higher prevalence of somatic alteration among workers who had been victims of violence in the workplace. Furthermore, aggression at work had a direct effect on physical somatisation, which in turn acted as a mediator in the level of anxiety of nursing professionals. Thus, aggression increased the level of anxiety of nurses through the appearance of somatic symptoms.

CONCLUSIONS

The results are discussed based on some of the consequences that appeared after episodes of aggression in the healthcare sector and their relationship.

Violence on doctors. An observational study in Northern Italy

BACKGROUND

Violence in the workplace is now universally recognized as a significant global public health issue and is one of the most serious issues affecting the healthcare sector.

OBJECTIVES

To assess the prevalence of workplace violence.

METHODS

We performed a multicenter cross-sectional study using an anonymous questionnaire submitted to doctors from Northern Italy. The survey investigates socio-demographic information, the number of years of work in the health sector and the physical and verbal aggressions that occurred in the workplace in the last 12 months.

RESULTS

The sample consists of 4545 healthcare workers, of whom 2603 (57.27%) are females. The mean age of the sample is 49.79 years (SD ± 12.63). The risk of being victim of physical aggression at work in the last 12 months is significantly associated with the following independent variables: male gender (aOR 2.09, 95% CI 1.51-2.88), work in the public sector (aOR 2.57, 95% CI 1.72-3.85), being victim of verbal aggression at work in the last 12 months (aOR 22.52, 95% CI 10.97-46.20), work in the operational units of the Medical area (aOR 2.36, 95% CI 1.33-4.21) and the Territorial area (aOR 1.97, 95% CI 1.04-3.74).

DISCUSSION

The prevalence of violent behaviour is difficult to assess, because violent incidents are underreported or unreported. The results of the study suggest that increased awareness is necessary to develop effective control strategies at individual, hospital and national levels.

[Experiences of aggression and violence against ophthalmologists]

BACKGROUND

The media have reported an increased willingness of patients and relatives to use violence against medical personnel. So far a few studies have been carried out on this topic and the data situation is correspondingly weak. Ophthalmologists in particular have close contact with patients at the slit lamp and are often alone with patients.

METHODS

A questionnaire was developed based on the perception of prevalence of aggression scale (POPAS) questionnaire and the survey on aggression and violence among general practitioners. In autumn 2018, all members of the German Ophthalmological Society (DOG) and the Professional Association of Ophthalmologists (BVA) received an invitation by e‑mail to complete the questionnaire online.

RESULTS

Of the 9411 ophthalmologists contacted a total of 1508 (age 49 ± 12 years) took part in the survey (16%). Of the respondents 806 (53.7%) were female and 1139 (75.5%) participants worked in practices. A total of 1264 (83.3%) ophthalmologists had experienced aggression/violence in their work, 986 (65%) respondents had already experienced verbal assaults without threats, 363 (24.1%) doctors reported experiences with threats of physical violence and 30 (2%) participants had received medical treatment for severe physical violence. Sexual intimidation/harassment was affirmed by 322 (21.4%) of respondents, of whom 243 (75.5%) were female and 533 (47.9%) doctors felt that aggressive/violent behavior had increased in the last 5 years.

CONCLUSION

The high number of participants indicates the high relevance of the topic. The survey produced astonishing results, which should lead to further discussion and action to improve the safety of employees.

Medical vandalism: Awareness and opinions; beyond the clinician's window

Background and Aims:

Medical vandalism has become a major matter of concern in today's world. The number of violent mob attacks on doctors and other medical personnel is on the rise. This trend is having a negative impact on the proper functioning of healthcare system thus affecting the quality of care and treatment. The aim of this study is to assess the awareness and opinions of the stakeholders in healthcare facilities about vandalism in today's medical practice.

Methods:

A cross-sectional survey study was conducted in Acharya Vinoba Bhave Rural Hospital among 360 participants, comprising of nurses, patient's relatives, security personnel and non-medical staff in the Emergency Care Units and wards. A detailed questionnaire was prepared and used to assess the opinion of the subjects covering various aspects of medical vandalism such as prevalence of vandalism, experiences of vandalism at work, various factors causing medical vandalism, initiatives taken by the respondents to curb vandalism and awareness about various laws implemented by the government that help prevent vandalism.

Results:

Majority of the participants were of the opinion that medical vandalism was prevalent in India. Overcrowding of patients, inadequate skilled healthcare providers and occurrence of sudden death in casualty are among the major factors that trigger vandalism. This issue has been on the rise in both government and private setups, and nurses seem to be the major victims of such cruelness. 80% of the subjects admitted that verbal abuse was more common than physical abuse.

Conclusion:

Although violence against all healthcare professionals has been recorded since historical times, the current scenario of the country is disturbing. Immediate measures need to be taken to curb vandalism. Various laws need to be implemented to strictly punish those who create violence. Likewise, institutions must ensure the availability of adequate staff and facilities to reduce events that make the bystanders aggressive.

Psychosocial Risks and Violence Against Teachers. Is It Possible to Promote Well-Being at Work?

Teaching has been reported to be one of the most stressful occupations, with heavy psychological demands, including the need to develop positive relationships with students and their parents; relationships that, in turn, play a significant role in teachers’ well-being. It follows that the impact of any violence perpetrated by a student or parent against a teacher is particularly significant and represents a major occupational health concern. The present study examines for the first time the influence of the Job Demands-Control-Support Model on violence directed against teachers. Six hundred and eighty-six teachers working in elementary and high schools in north-east Italy completed an online, self-report questionnaire. Our findings reveal the role played by working conditions in determining teachers’ experience of violence: greater job demands are associated with most offense types, whereas the availability of diffused social support at school is associated with lower rates of harassment. Workload should be equally distributed and kept under control, and violence should gain its place in the shared daily monitoring of practices and experiences at school in order to provide a socially supportive work environment for all teachers.

Violence at School and the Well-Being of Teachers. The Importance of Positive Relationships

In the discipline of positive psychology, "well-being" is considered a fundamental aspect of "human flourishing." Inherent to this multidimensional model are emotional, psychological, and social forms of well-being, which can be grounded in positive relationships in the work environment. By adopting an interpretive framework that emphasizes these dynamics, researchers are able to focus on elements that actively help sustain the process of flourishing, rather than on negative environmental features that should be avoided if possible. Within this broader discussion, the specific question of teachers' well-being is one that has global relevance and merits greater academic attention. After all, it has significant consequences for the educational environment and students' ability to learn. The literature suggests that teachers are increasingly exposed to violence on the part of students and/or their parents. Inappropriate and/or aggressive behavior like this can reduce a teacher's occupational well-being and make it more difficult to build positive relationships in the classroom. Ultimately, it is one of the most serious work-related stress factors affecting the profession today. Previous studies have attempted to characterize the contexts in which violence occurs, and its negative impact on both the individuals involved and the broader educational climate. Less attention has been devoted to the capacity of teachers to deal with violence and develop a more resilient mindset. The positive psychology perspective focuses on well-being as a multidimensional construct wherein psychosocial and physical comfort does not simply arise provided there is an absence of suffering and violence. Rather, according to this model, such experiences can be counteracted by a capacity to endure and build positive environments. With these considerations in mind, our study presents data gathered in primary and secondary schools in northern Italy. A total 475 teachers completed an online, self-report questionnaire. The results indicate that teachers can experience occupational well-being even if they are subjected to aggressive behaviors. Supportive leadership and good relationships with colleagues may be considered valuable resources for fostering well-being among teachers.