Violence against nurses in the southern region of Malawi

Violence against health care workers in a crisis context: a mixed cross-sectional study in Eastern Democratic Republic of Congo

BACKGROUND

Health Care Workers (HCWs) in conflict zones face high levels of violence while also playing a crucial role in assisting the population in distress. For more than two decades, the eastern provinces of the Democratic Republic of the Congo (DRC), have been wracked by conflict. This study aims to describe the state of violence against HCWs and the potential prevention mechanisms in eastern DRC.

METHODS

In North and South Kivu, between February 5 and 21, 2021, we conducted a mixed cross-sectional convergent study in health facilities (health centers and hospitals). An anonymized self-administered questionnaire was sent to HCWs about their experience of violence in the 12 months prior to the study. In-depth individual interviews with HCWs, present on the day of the investigation, were also done to explore their experience of violence. A descriptive analysis of the quantitative data and a thematic analysis of the qualitative data was carried out.

RESULTS

Of a total of 590 participants, 276 (45.9%) reported having experienced violence in the 12 months before the study. In North Kivu, aggressors were more frequently the patients (43.7% vs. 26.5%) and armed group members (14.3% vs. 7.9%) than in South Kivu. Most respondents (93.5%) reported verbal aggression (insults, intimidation, death threats). Other forms of physical aggression including with bare hands (11.2%), firearm (1.81%), and stabbing (4.7%). Only nearly one-tenth of the attacks were officially reported, and among those reported a higher proportion of sanctions was observed in South Kivu (8.5%) than in North Kivu (2.4%). The mechanisms proposed to prevent violence against HCWs were community initiatives and actions to strength the health system.

CONCLUSIONS

In Eastern DRC, HCWs face multiple and severe forms of aggression from a variety of individuals. The effects of such levels violence on HCWs and the communities they served could be devastating on the already pressured health system. Policy framework that defines the roles and responsibilities for the protection of HCWs and for the development and implementation of preparedness measures such as training on management of violence are possible solutions to this problem.

Self-reported incidents of violence towards nurses working in acute psychiatric units

BACKGROUND

 Acute psychiatric units are found to be stressful working environments because of the nature of illness patients present with.

OBJECTIVES

 This study aimed to determine self-reported incidents of physical and verbal violence towards nurses working in acute psychiatric units in Western Cape, South Africa.

METHOD

 A questionnaire was used to collect data. Chi-square test was performed to determine association between gender, category and experience of violence. Mann-Whitney U test was carried out to determine associations between years of employment and the likelihood of experiencing physical violence and verbal abuse.

RESULTS

 Overall physical violence 35 (34.3%) and verbal abuse 83 (83%) incidents. Most female respondents reported both physical violence (74.2%, n = 26) and verbal abuse (72.2%, n = 60), with (56.2%, n = 18) professional nurses reporting physical violence. Years of employment was statistically significantly associated with the likelihood of nurses experiencing physical violence (p = 0.007).

CONCLUSION

 Most respondents (74.2%, n = 26) were females and they mostly experienced physical violence and verbal abuse while 28.2% (n = 29) were males. Years of service were associated with the likelihood of experiencing physical violence.Contribution: The knowledge gained will add on existing knowledge about the challenge of violence experienced by nurses in the workplace and might have an influence on policymakers.

Workplace violence against nursing interns and patient safety: The multiple mediation effect of professional identity and professional burnout

BACKGROUND

Most nursing interns have suffered some form of workplace violence in clinical settings, which has been linked to the jeopardizing of patient safety. Although previous research studies have examined the effect of workplace violence on patient safety, few studies have examined whether workplace violence is associated with patient safety through professional identity and professional burnout among nursing interns.

AIMS

To test whether professional identity and professional burnout play mediating roles in the relationship of workplace violence and patient safety among nursing interns.

DESIGN

Cross-sectional study.

METHODS

The study included 466 nursing interns from three tertiary grade A hospitals. The Workplace Violence Scale, the Professional Identity Scale, the Maslach Burnout Inventory-General Survey, and the Patient Safety Behaviour Scale were used to gather data. Associations among workplace violence, professional identity, professional burnout, and patient safety were assessed by correlation and the serial-multiple mediation analysis.

RESULTS

Workplace violence, professional identity, professional burnout and patient safety were significantly correlated. Workplace violence can have a direct positive impact on patient safety of nursing interns, but also an indirect impact on patient safety through three paths: the independent mediating role of professional identity, the independent mediating role of professional burnout, and the chain mediating role of professional identity and professional burnout.

CONCLUSIONS

Our findings suggest that workplace violence can affect patient safety through decreasing professional identity and increasing professional burnout among nursing interns. Interventions aimed at decreasing workplace violence among nursing interns would be beneficial for professional attitude and patient safety.

Workplace violence and its associated factors among nurses working in public hospitals of eastern Ethiopia: a cross-sectional study

BACKGROUND

Workplace violence is one of the global health concerns. Although nurses are the backbone of the health care provision, they are highly subjected to workplace violence in healthcare. Nevertheless, there is a paucity of evidence on the extent of workplace violence against nurses in Ethiopia in general and Eastern Ethiopia in particular. Hence, this study aimed to assess the extent of workplace violence against nurses and its associated factors among nurse professionals working at public hospitals in eastern Ethiopia.

METHODS

Hospital-based cross-sectional study was conducted among 603 nurses working in public hospitals in eastern Ethiopia. Nurses were recruited using a simple random sampling method at their workplace (health facilities). A pretested self-administered questionnaire was used to collect data. Descriptive, binary and multivariable logistic regression analyses were performed. The adjusted odds ratio (AOR) with a 95% confidence interval (CI) was used to declare significant association.

RESULTS

Among the 620 estimated sample, 603(97.3%) of the nurses gave consent and completed the self-administered questionnaire. The prevalence of workplace violence against nurse professionals in the last 12 months was 64.0% (95%CI: 60.2-67.7%). Nurses who were working in surgical (AOR: 2.30, 95%CI: 1.01-5.26), psychiatric (AOR: 3.06, 95%CI: 1.11-8.46), emergency (AOR: 3.62, 95%CI: 1.46-8.98), and medical wards (AOR: 5.20, 95%CI: 2.40-11.27); being worried of workplace violence (AOR: 1.71, 95%CI: 1.09-2.69); witnessed of physical workplace violence (AOR: 5.31, 95%CI: 3.28-8.59); claimed "absence/not-aware" of reporting procedure on workplace violence (AOR: 2.24, 95%CI: 1.45-3.46); and claimed "absence/not-aware" of institutional policies against workplace violence (AOR: 2.68, 95%CI: 1.73-4.13) were factors associated with nurses' experience of workplace violence in eastern Ethiopia.

CONCLUSIONS

Workplace violence against nurses was found to be unacceptably high in the study area (eastern Ethiopia). We suggest that stakeholders could work on early risk identification and management of violent incidents, establish violence reporting and sanction mechanisms using contextual strategies to prevent workplace violence against nurse professionals.

Relations of power and oppression within the delivery room: nursing narratives

OBJECTIVE

To analyze, from the perspective of decolonial feminism, the power and oppression relations experienced by nurses in the delivery room in a hospital in Mexico.

METHOD

Qualitative study in which 15 nurses selected by theoretical sampling were interviewed. The interviews were fully transcribed and subsequently analyzed using content analysis.

RESULTS

The emerging central category was "Inter- and intragender power/oppression relations" and psychological and symbolic violence were the most frequent types. Gender was confirmed as the most important structural determinant of oppression, cutting across bodies and professional identities. The conditions contributing to intragender conflict are age, expertise, and specialization. Three coping resources were documented: defenselessness, complicity and resistance.

CONCLUSION

It is necessary to denaturalize the forms of power/oppression sustained by gender inequalities, but also to discuss other conditions that determine power/oppression relations between women and colleagues. Eradicating intra-gender and intergender violence is necessary to access safe working environments that promote creativity for the exercise of care.

Workplace violence toward emergency medicine physicians in the hospitals of Taif city, Saudi Arabia: a cross-sectional survey

BACKGROUND

Workplace violence against health care workers is an emerging concern in various global health settings and the documentation of physical and verbal attacks against physicians in tertiary hospitals in Saudi Arabia is uncommon. This study aimed to determine the incidence of workplace violence against physicians in the emergency department of selected tertiary hospitals in Taif City, Saudi Arabia from June to July 2021. Associations between the incidence of violence and interventions and type of physicians and years of experience were also investigated.

METHODOLOGY

Using a cross-sectional design, a total of 96 physicians were recruited to answer the World Health Organization Questionnaire on Violence against Health Care Workers last June to July 2021.

RESULTS

It was found out that 75 physicians (78.1%) experienced verbal violence while 14 physicians (14.6%) experienced physical violence. Most of the workplace violence happened within hospital premises (84.4%). Despite having an experience of verbal and physical violence, only 44.8% of the respondents reported the incidents. The most common instigators were patients (55.21%), their relatives (78.00%), external colleagues (9.37%) and staff members (6.25%). Most respondents took no action, or reported the incidence to the police or senior staff member. The incidence of workplace violence and type of physician showed significant association. The number of years of practice in emergency medicine also exhibited statistically significant association with the incidence of verbal attack, frequency of violence, and location of incident.

CONCLUSION

There is high incidence of workplace violence among physicians in tertiary hospitals, and younger physicians with less experience in emergency medicine were the most susceptible to both verbal and physical violence. There is a need to strengthen policies to protect physicians against workplace violence.

Relaciones de poder y opresión dentro de la sala de parto: narrativas de enfermería

RESUMEN Objetivo: Analizar desde la perspectiva del feminismo descolonial, las relaciones de poder y opresión que viven enfermeras dentro de la sala de parto en un hospital de México. Método: Estudio cualitativo en el que se entrevistó a 15 enfermeras seleccionadas por muestreo teórico. Las entrevistas transcritas en totalidad fueron sometidas posteriormente a análisis de contenido. Resultados: La categoría central emergente fue “Relaciones de poder/opresión inter e intragénericas” y las formas más frecuentes de violencia fueron psicológicas y simbólicas. El género se confirmó como el condicionante estructural más importante de la opresión, atravesando los cuerpos y las identidades profesionales. Las condiciones que contribuyen al conflicto intragénero son la edad, la expertis y la especialización. Se documentaron tres recursos para el afrontamiento: indefensión, complicidad y resistencia. Conclusión: Es necesario desnaturalizar las formas de poder/opresión sustentadas en las desigualdades de género, pero también discutir otras condiciones que determinan relaciones de poder/opresión entre mujeres y colegas. Erradicar las violencias intragenéricas e integénericas es necesario para acceder a entornos laborales seguros y que potencien la creatividad para ejercer el cuidado.

Comparative analysis of sexual harassment between male and female nurses: A cross-sectional study in Greece

AIMS

The aims of this work are to compare the frequency of sexual harassment among male and female nurses in Greece and capture the reasons for not reporting sexual harassment.

BACKGROUND

The #MeToo and #TimesUp movements have emphasized the ubiquity of sexual harassment in health care. Yet, limited studies have explored sexual harassment among male and female nurses and the reasons for not reporting it.

METHODS

An online cross-sectional survey was conducted using the Sexual Experiences Questionnaire (SEQ) to collect data from 1.264 female nurses and 507 male nurses.

RESULTS

Sixty-seven per cent of female nurses have experienced sexual harassment at least once in their working lives, whereas male nurses' exact figure was 41%. The most common type of sexual harassment for both groups was gender harassment, followed by unwanted sexual attention and sexual coercion. Female nurses experienced more severe adverse consequences, whereas male nurses experienced moderate negative consequences.

CONCLUSIONS

Policymakers and hospital managers should create mechanisms to allow victims to report their experiences and establish an independent committee to assess victims' complaints.

IMPLICATIONS FOR NURSING MANAGEMENT

Managers are called to change how hospitals deal with sexual harassment cases, modernize their management style, and support sexual harassment victims to break their silence without fear of negative consequences.

Prevalence and Effect of Workplace Violence against Emergency Nurses at a Tertiary Hospital in Kenya: A Cross-Sectional Study

INTRODUCTION

Workplace violence (WPV) is a major occupational and health hazard for nurses. It affects nurses' physical and psychological well-being and impacts health service delivery. We aimed to assess the prevalence and describe the consequences of WPV experienced by nurses working in an emergency department in Kenya.

METHODS

We conducted a descriptive cross-sectional study among emergency nurses at one of the largest tertiary hospitals in Kenya. We collected data using a structured questionnaire adapted from the 'WPV in the Health Sector, Country Case Studies Research Instruments' questionnaire. We described the prevalence and effects of WPV using frequencies and percentages.

RESULTS

Of the 82 participating nurses, 64.6% were female, 57.3% were married and 65.8% were college-educated (65.8%). Participants' mean age was 33.8 years (standard deviation: 6.8 years, range: 23-55). The overall lifetime prevalence of WPV was 81.7% (n = 67, 95% confidence interval [CI]: 71.6%-88.8%) and the 1-year prevalence was 73.2% (n = 63, 95% CI: 66.3-84.8%). The main WPV included verbal abuse, physical violence, and sexual harassment. Most incidents were perpetrated by patients and their relatives. No action was taken in 50% of the incidents, but 57.1% of physical violence incidents were reported to the hospital security and 28.6% to supervisors. Perpetrators of physical violence were verbally warned (42.9%) and reported to the hospital security (28.6%).

CONCLUSION

Workplace violence is a significant problem affecting emergency nurses in Kenya. Hospitals should promote workplace safety with zero-tolerance to violence. Nurses should be sensitised on WPV to mitigate violence and supported when they experience WPV.

Opinions of staff working in workplace-violence-related units on violence against nurses: A qualitative study

The aim of this study was to assess the opinions of staff working in workplace-violence related units on violence against nurses. A qualitative and descriptive design was used. The participants were seven nurses, one biologist, and one social worker who agreed to attend an interview and worked in employee rights unit or occupational health and safety unit. Data were collected from June to December 2017. The interviews were analyzed with content analysis. Four main themes were identified, and the themes were the following: (1) risk factors; (2) reporting of violence; (3) consequences of violence; and (4) prevention and control. In summary, factors related to the patient, the nurse, and the physical structure of the hospital were determined.

Work place violence (WPV) against healthcare workers in Africa: A systematic review

BACKGROUND

WPV amongst healthcare workers has been reported as a public health challenge across the countries of the world, with more in the developing countries where condition of care and service is very poor.

OBJECTIVES

We aimed to systematically produce empirical evidence on the WPV against health care workers in Africa through the review of relevant literature.

METHOD

We sourced for evidence through the following databases: PubMed, Science direct and Scopus from 30th November to 31st December 2019 as well as the reference list of the studies included. A total of 22 peer reviewed articles were included in the review (8065 respondents). Quality appraisal of the included studies was assessed using critical appraisal tools for cross-sectional studies.

RESULT

Across the studies, diverse but high prevalence of WPV ranging from 9% to 100% was reported with the highest in South Africa (54%-100%) and Egypt (59.7%-86.1%). The common types were verbal, physical, sexual harassment and psychological violence. The correlates of WPV reported were gender, age, shift duty, emergency unit, psychiatric unit, nursing, marital status and others. Various impacts were reported including psychological impacts and desire to quit nursing. Patients and their relatives, the coworkers and supervisors were the mostly reported perpetrators of violence. Doctors were mostly implicated in the sexual violence against nurses. Policy on violence and management strategies were non-existent across the studies.

CONCLUSION

High prevalence of WPV against healthcare workers exists in Africa but there is still paucity of research on the subject matter. However, urgent measures like policy formulation and others must be taken to address the WPV as to avert the impact on the healthcare system.

Sexual Harassment in Clinical Practice-A Cross-Sectional Study Among Nurses and Nursing Students in Sub-Saharan Africa

INTRODUCTION

Sexual harassment (SH) at the workplace is a globally discussed topic and one deserving of scrutiny. It is an issue that is often avoided although around 25% of nurses worldwide have experienced some form of SH at their workplace. Consequences of SH at workplaces can be very serious and an occupation hazard for nurses around the world. In Sub-Saharan Africa there is also a need for more studies in the field.

OBJECTIVE

The overall aim was to determine the prevalence, types, and consequences of sexual harassment among nurses and nursing students at a regional university hospital in Tanzania.

METHODS

The study has a cross-sectional design. A study specific questionnaire was distributed to a total of 200 nurses and nursing students. Descriptive statistics were used for calculation of frequencies, prevalence, including gender differences, types, and consequences of sexual harassment.

RESULTS

The result show that 9.6% of the participants had experienced some form of SH at their workplace. Regarding the female nurses and students, 10.5% had been sexually harassed at work, whereas the number for males was 7.8%, but 36% knew about a friend who had been sexually harassed. The most common perpetrator were physicians. The victims of SH were uncomfortable going back to work, felt ashamed and angry.

CONCLUSIONS

In conclusion, nearly 10% of the participants had been exposed to sexual harassment. However, an even greater number of victims was found when including by proxy victims of sexual harassment. SH can become a serious occupational hazard and stigmatization for nurses. Enhanced knowledge is needed, and hospitals and medical colleges should emphasize their possibilities to give support and assistance to the victims of SH. Education about SH in all levels and prevention methods should also be emphasized.

Prevalence and Associated Factors of Violence against Hospital Staff at Amanuel Mental Specialized Hospital in Addis Ababa, Ethiopia

Background. Violence at the workplace has become an alarming phenomenon worldwide. The real size of the problem is largely unknown and recent information shows that the current knowledge is only the tip of the iceberg. The enormous cost of violence at the workplace for person and community at large is becoming more apparent. It could be physical, sexual, and verbal in nature and could be actual or threatened. Objectives. To access prevalence and associated factors of violence against hospital staff at Amanuel Mental Specialized Hospital Addis Ababa, Ethiopia. Methods. An institution based cross-sectional study was employed in 2017. The data were collected using Workplace Violence in the Health Sector Country Case Study Questionnaire from 496 participants. Participants had been selected using simple random sampling technique and data were collected using a self-administered structured questionnaire. The collected data were entered into Epi-data version 3.1, and SPSS version 21 was used for Analysis. Binary logistic regression was fitted to identify factors associated with the outcome variable. Result. From 496 staff intended to have participated in this study, complete data were obtained from 435, making a response rate of 87.7%. This research showed high prevalence of violence and we have got that staff had been exposed to physical violence 36.8%, verbal violence 62.1%, and sexual violence 21.8 % over the past year, respectively. Age, sex, and contact with the patient were statistically significant variables (p < 0.05). Conclusion and Recommendation. According to this study, majority of AMSH staff were violated by the patient they care.

Violência ocupacional na equipe de enfermagem: prevalência e fatores associados

Resumo Objetivo Identificar a prevalência e os fatores associados à violência ocupacional na equipe de enfermagem. Métodos Trata-se de um estudo transversal realizado com uma amostra de 242 trabalhadores de enfermagem de um hospital universitário da Região Sul do Brasil. A coleta de dados ocorreu de janeiro a junho de 2018, por meio de um questionário de caracterização sociodemográfica e ocupacional e o Questionário para Avaliação da Violência no Trabalho Sofrida ou Testemunhada por Trabalhadores de Enfermagem. Os dados foram analisados por estatística descritiva e regressão logística múltipla. Resultados A prevalência de violência física foi de 20,2%; de abuso verbal, 59,1%; e a de assédio sexual foi de 12,8%. Os fatores associados à violência física foram ser testemunha de agressão física ocupacional (p<0,001; ORajustado: 5,757) e relacionamento interpessoal ruim (p=0,043; ORajustado: 2,172); ao abuso verbal, ser testemunha de violência verbal no ambiente de trabalho (p<0,001; ORajustado: 11,699), ser vítima de violência física (p=0,043; ORajustado: 2,336) e falta de reconhecimento profissional (p=0,004; ORajustado: 0,361); e ao assédio sexual, ser testemunha desse tipo de assédio (p=0,030; ORajustado: 3,422), ser vítima de abuso verbal (p=0,031; ORajustado: 3,116), trabalhar no turno noturno (p=0,036; ORajustado: 0,396) e idade mais jovem (p=0,001; ORajustado: 0,924). Conclusão A equipe de enfermagem foi vítima de diferentes tipos de violência no trabalho e associaram-se a ela, principalmente, os fatores ocupacionais, como testemunhar a violência ocupacional.