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Ayaz B, Dozois G, Baumann AL, Fuseini A, Nelson S. Perpetrators of gender-based workplace violence amongst nurses and physicians-A scoping review of the literature. PLOS GLOBAL PUBLIC HEALTH 2024; 4:e0003646. [PMID: 39240832 PMCID: PMC11379169 DOI: 10.1371/journal.pgph.0003646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/22/2024] [Accepted: 08/02/2024] [Indexed: 09/08/2024]
Abstract
In healthcare settings worldwide, workplace violence (WPV) has been extensively studied. However, significantly less is known about gender-based WPV and the characteristics of perpetrators. We conducted a comprehensive scoping review on Type II (directed by consumers) and Type III (perpetuated by healthcare workers) gender based-WPV among nurses and physicians globally. For the review, we followed the Preferred Reporting Items for Systematic and Meta Analyses extension for Scoping Review (PRISMA-ScR). The protocol for the comprehensive review was registered on the Open Science Framework on January 14, 2022, at https://osf.io/t4pfb/. A systematic search in five health and social science databases yielded 178 relevant studies that indicated types of perpetrators, with only 34 providing descriptive data for perpetrators' gender. Across both types of WPV, men (65.1%) were more frequently responsible for perpetuating WPV compared to women (28.2%) and both genders (6.7%). Type II WPV, demonstrated a higher incidence of violence against women; linked to the gendered roles, stereotypes, and societal expectations that allocate specific responsibilities based on gender. Type III WPV was further categorized into Type III-A (horizontal) and Type III-B (vertical). With Type III WPV, gendered power structures and stereotypes contributed to a permissive environment for violence by men and women that victimized more women. These revelations emphasize the pressing need for gender-sensitive strategies for addressing WPV within the healthcare sector. Policymakers must prioritize the security of healthcare workers, especially women, through reforms and zero-tolerance policies. Promoting gender equality and empowerment within the workforce and leadership is pivotal. Additionally, creating a culture of inclusivity, support, and respect, led by senior leadership, acknowledging WPV as a structural issue and enabling an open dialogue across all levels are essential for combating this pervasive problem.
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Affiliation(s)
- Basnama Ayaz
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada
| | | | - Andrea L Baumann
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada
| | - Adam Fuseini
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada
| | - Sioban Nelson
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada
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Nelson S, Ayaz B, Baumann AL, Dozois G. A gender-based review of workplace violence amongst the global health workforce-A scoping review of the literature. PLOS GLOBAL PUBLIC HEALTH 2024; 4:e0003336. [PMID: 38954697 PMCID: PMC11218983 DOI: 10.1371/journal.pgph.0003336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/26/2023] [Accepted: 05/20/2024] [Indexed: 07/04/2024]
Abstract
Workplace violence (WPV) impacts all levels of the health workforce, including the individual provider, organization, and society. While there is a substantial body of literature on various aspects of WPV against the health workforce, gender-based WPV (GB-WPV) has received less attention. Violence in both the workplace and broader society is rooted in gendered socio-economic, cultural, and institutional factors. Developing a robust understanding of GB-WPV is crucial to explore the differing experiences, responses, and outcomes of GB-WPV with respect to gender. We conducted a scoping review and report on the prevalence and risk factors of GB-WPV in healthcare settings globally. The review followed the Preferred Reporting Items for Systematic and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). We registered the scoping review protocol on the Open Science Framework on January 14, 2022, at https://osf.io/t4pfb/. A systematic search was conducted of empirical literature in five health and social science databases. Of 13667, 226 studies were included in the analysis. Across the studies, more women than men experienced non-physical violence, including verbal abuse, sexual harassment, and bullying. Men experienced more physical violence compared to women. Younger age, less experience, shifting duties, specific clinical settings, lower professional status, organizational hierarchy, and minority status were found to be sensitive to gender, reflecting women's structural disadvantages in the workplace. Given the high prevalence and impact of GB-WPV on women, we provided recommendations to address systemic issues in clinical practice, academia, policy, and research.
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Affiliation(s)
- Sioban Nelson
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada
| | - Basnama Ayaz
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada
| | - Andrea L. Baumann
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada
| | - Graham Dozois
- Princess Margaret Cancer Centre, Toronto, Ontario, Canada
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Brown JM, Wellman ML. Yoga as an Adjunct Therapy for Musculoskeletal Pain and Burnout in Orthopedic Surgery: A Trainee's Perspective. Int J Yoga 2022; 15:250-253. [PMID: 36949830 PMCID: PMC10026344 DOI: 10.4103/ijoy.ijoy_129_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2022] [Revised: 08/22/2022] [Accepted: 08/24/2022] [Indexed: 01/18/2023] Open
Abstract
Orthopedic surgeons face significant physical and psychosocial stressors during their training as surgical residents and throughout their career. Aside from occupational hazards intrinsic to the profession, two notable and treatable concerns are musculoskeletal pain and emotional burnout, which have a reported prevalence as high as 97% and 56%, respectively, among orthopedic residents. Management of musculoskeletal pain and burnout is essential for promoting surgeon well being, education, and longevity as well as avoiding medical errors and compromises to patient care. This perspective manuscript describes the occupational challenges faced by orthopedic surgeons and promotes a habitual practice of yoga as an adjunct therapy for managing musculoskeletal pain and emotional burnout, and furthermore, introduces the need to reconsider gendered perceptions surrounding orthopedics and the practice of yoga in a profession largely comprised of men.
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Affiliation(s)
- Jeffrey Mark Brown
- Department of Orthopaedics and Oncological Sciences, Huntsman Cancer Institute, Salt Lake City, Utah, USA
- Department of Orthopaedic Surgery, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Mariah L. Wellman
- Department of Communications, University of Illinois Chicago, Chicago, Illinois, USA
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Liu C, Liu W, Jiao M, Li Y, Zhang G, Wei L, Zhou S, Li Y, Sha Z, Hao Y, Wu Q. A combined behavioural economics- and simulation-based medical education to promote effectiveness among medical residents in coping with workplace violence in Northern China: a quasi-experimental study. BMC Public Health 2022; 22:1090. [PMID: 35650559 PMCID: PMC9156828 DOI: 10.1186/s12889-022-13497-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Accepted: 05/18/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Workplace violence is internationally recognised as a major concern for the workforce, which entails serious consequences, and research shows that medical residents are more likely than other doctors to experience violence in the workplace. This study first examines the effectiveness of simulation-based medical education, and then simulation-based medical education combined with behavioural economics as interventions in medical residents' perception of, attitude toward, and self-efficacy in coping with violence in the workplace. METHODS A quasi-experimental design was used, 190 participants were randomised into three study groups to respectively test the effect of simulation-based medical education only and simulation-based medical education plus behavioural economics interventions, compared with a control group. Data were obtained from structured questionnaires, including (1) a perception of aggression scale, a management of aggression and violence attitude scale, a general self-efficacy scale, and (2) socio-demographic characteristics. RESULTS The results show that the scores attained by simulation-based medical education (SBME) and simulation-based medical education combined with behavioural economics (SBME + BE) interventions for perception, attitude, and self-efficacy were significantly higher than those in the control group (p < .01). The SBME + BE group recorded a greater improvement in perception, which could be ascribed to the behavioural economics effect. Furthermore, the higher perception of workplace violence is correlated with single residents and those with more work experience, prior experiences of violence in the workplace, and training related to workplace violence. A higher positive correlation of workplace violence was recorded by female and widowed residents,and a higher level of self-efficacy related to violence in the workplace correlated with male, widowed,and senior (third-year) residents. CONCLUSIONS This study contributes important evidence regarding changes in the perception, attitude, and self-efficacy of subjects following both the SBME + BE and SBME interventions among medical residents in coping with workplace violence, the biggest perception change having been recorded after the SBME + BE intervention, which can be explained by the inclusion of behavioural economics.
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Affiliation(s)
- Chao Liu
- Department of Health, Policy and Hospital Management, School of Public Health, Harbin Medical University, Harbin, 150081 China
| | - Weijing Liu
- Department of Internal Medicine, Heilongjiang Academy of Chinese Medicine Science, Harbin, 150081 China
| | - Mingli Jiao
- Department of Health, Policy and Hospital Management, School of Public Health, Harbin Medical University, Harbin, 150081 China
| | - Ye Li
- Department of Health, Policy and Hospital Management, School of Public Health, Harbin Medical University, Harbin, 150081 China
| | - Gangyu Zhang
- Department of Health, Policy and Hospital Management, School of Public Health, Harbin Medical University, Harbin, 150081 China
| | - Lifeng Wei
- Department of Health, Policy and Hospital Management, School of Public Health, Harbin Medical University, Harbin, 150081 China
| | - Shuang Zhou
- Department of Health, Policy and Hospital Management, School of Public Health, Harbin Medical University, Harbin, 150081 China
| | - Yuanheng Li
- Department of Health, Policy and Hospital Management, School of Public Health, Harbin Medical University, Harbin, 150081 China
| | - Zhuowa Sha
- Department of Health, Policy and Hospital Management, School of Public Health, Harbin Medical University, Harbin, 150081 China
| | - Yanhua Hao
- Department of Social Medicine, School of Public Health, Harbin Medical University, Harbin, 150081 China
| | - Qunhong Wu
- Department of Social Medicine, School of Public Health, Harbin Medical University, Harbin, 150081 China
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Workplace Hazards in Orthopaedic Surgery Training: A Nationwide Resident Survey Involving Sharps-related Injuries. J Am Acad Orthop Surg 2022; 30:428-436. [PMID: 35171846 DOI: 10.5435/jaaos-d-21-00941] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Accepted: 01/07/2022] [Indexed: 02/01/2023] Open
Abstract
INTRODUCTION Surgical specialties are at an increased risk for occupational hazards, including sharps-related injuries. The objective of this study was to report the frequency of sharps injuries and evaluate which characteristics influence the number of injuries and reporting behaviors. METHODS A web-based, anonymous survey was available for 10 weeks to 46 US orthopaedic surgery residency programs (1,207 potential residents) participating in an education research collaborative. The survey was divided into the following areas: demographics, training and attitudes concerning occupational hazards, and sharps injuries and reporting. Logistic regression was used to evaluate the association between the above variables on experiencing sharps injuries with significance threshold set at P < 0.05. RESULTS In this study, 518 surveys were included yielding a response rate of 42.9% (518/1,207). Nearly 80% of the residents recalled some form of safety training during intern orientation and 62% of the respondents felt that they received adequate occupation safety training specifically related to orthopaedic surgery. Four hundred seventeen residents (80.5%) experienced a sharps injury (mean 2.8). Nearly 20% of the respondents experienced ≥5 sharps injuries. Needle sticks (38.8%) were responsible for the greatest percentage of injuries, followed by Kirschner wires (33.6%), scalpel (22.5%), and bone (17.3%). Only 42% of the residents consistently reported all injuries. Reasons included feelings of no risk (63.1%), too much hassle (58.9%), embarrassment (14.5%), other (8.7%), forgot (5.8%), and unclear what to do (3.3%). Inadequate safety training specific to orthopaedic surgery (odds ratio, 2.32 [95% confidence interval, 1.20 to 4.46]; P = 0.012) and greater training seniority (odds ratio, 2.04 [95% confidence interval, 1.64 to 2.52]; P < 0.0001) were associated with acquiring five or more sharps injuries. DISCUSSION Sharps injuries are a prevalent and concerning reality for orthopaedic surgical trainees. Despite this common occurrence, only 42% of the residents always reported their injuries. Inadequate training specific to orthopaedic surgery and each subsequent year of postgraduate training are associated with increased sharps injuries. STUDY TYPE Level III, retrospective observational survey.
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