1
|
Dookeeram D, Seetharaman H, Taylor L, Stoute C, Toppin T, Thomas C, Trim J, Thomas K, Stoute S, Caton K. The Prevalence of Violence Against Healthcare Workers in Trinidad and Tobago. Cureus 2024; 16:e58182. [PMID: 38741873 PMCID: PMC11089584 DOI: 10.7759/cureus.58182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/13/2024] [Indexed: 05/16/2024] Open
Abstract
BACKGROUND Abuse of healthcare workers (HCWs) and lack of public trust threaten the foundation of the physician-patient relationship. This growing global problem creates an even more difficult professional environment and hinders the delivery of high-quality clinical care. OBJECTIVE The primary aim was to determine the prevalence of violence against Trinbagonian HCWs in the public sector. Secondary objectives included determining risk factors for violence and mistrust between the public and providers. METHOD A cross-sectional analysis of 434 HCWs in the public sector of Trinidad and Tobago was conducted using a modified World Health Organization (WHO) data collection tool, distributed via social media and administrative emails, and snowballed for two months. Fifteen semi-structured interviews were conducted regarding trust in the healthcare system with patients selected from communities. RESULTS Of the 434 respondents, 45.2% experienced violence and 75.8% witnessed violence against HCWs in the past two years. Verbal abuse (41.5%) was most common. Perpetrators were patients (42.2%) and patients' relatives (35.5%). Chi-square analysis highlighted that HCWs with the highest probability of being abused were aged 25-39 (63.8%), had two to five years of work experience (24.9%), specialized in emergency and internal medicine (48.6%), and cared for psychiatric and physically disabled patients (p-value < 0.001). HCWs believed the threat of violence negatively impacted performance (64.5%), and further action was necessary for mitigation (86.4%). Patients interviewed doubted physicians' altruism and competence (80%) and honesty (53.3%), expressed mistrust in their physician (46.7%), and cited poor infrastructure/management (66.7%) and dissatisfaction with care (60.0%) as factors that contributed to violence. CONCLUSION Analysis revealed that violence against Trinbagonian HCWs in the public sector deteriorated patient experience and adversely affected psychological well-being, efficiency, and job satisfaction. Results suggested mistrust of HCWs by the population. Interventions should be instituted to support at-risk HCWs and educate the public to avoid recurrence.
Collapse
Affiliation(s)
- Darren Dookeeram
- School of Pharmacy, The University of the West Indies, St. Augustine, TTO
- Department of Emergency Medicine, Eastern Regional Health Authority, Sangre Grande, TTO
| | | | - Lake Taylor
- Faculty of Medical Sciences, The University of the West Indies, St. Augustine, TTO
| | - Cherelle Stoute
- Faculty of Medical Sciences, The University of the West Indies, St. Augustine, TTO
| | - Takiyah Toppin
- Faculty of Medical Sciences, The University of the West Indies, St. Augustine, TTO
| | - Cassy Thomas
- Faculty of Medical Sciences, The University of the West Indies, St. Augustine, TTO
| | - Jakeilia Trim
- Faculty of Medical Sciences, The University of the West Indies, St. Augustine, TTO
| | - Kirtesha Thomas
- Faculty of Medical Sciences, The University of the West Indies, St. Augustine, TTO
| | - Sade Stoute
- Faculty of Medical Sciences, The University of the West Indies, St. Augustine, TTO
| | - Kanisha Caton
- Faculty of Medical Sciences, The University of the West Indies, St. Augustine, TTO
| |
Collapse
|
2
|
Singh A, Ranjan P, Agrawal R, Kaur T, Upadhyay AD, Nayer J, Chakrawarty B, Sarkar S, Joshi M, Kaur TP, Mohan A, Chakrawarty A, Kumar KR. Workplace Violence in Healthcare Settings: A Cross-Sectional Survey among Healthcare Workers of North India. Indian J Occup Environ Med 2023; 27:303-309. [PMID: 38390487 PMCID: PMC10880831 DOI: 10.4103/ijoem.ijoem_267_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: 10/06/2022] [Revised: 02/25/2023] [Accepted: 02/28/2023] [Indexed: 02/24/2024] Open
Abstract
Background Workplace violence (WPV) is a significant problem in both developed and developing countries, especially among healthcare workers. It has widespread implications for their overall health and well-being. Objective The study was conducted to assess the problem of violence among doctors and other healthcare workers in healthcare settings. Material and Methods A cross-sectional survey was conducted using a validated questionnaire from August 21 to September 18, 2021, based on purposive and snowball-sampling techniques for data collection. Appropriate statistical methods were applied to study the association between sociodemographics and characteristics of violence. Results A total of 601 responses were analyzed. The results showed that approximately 75% of the participants experienced violence in some form at their workplace. These episodes lead to a significant impact on the physical and mental health of these workers. Around one-third of the participants felt uncomfortable reporting these incidents. Some of the most common risk factors and mitigation strategies were also reported by the participants. Conclusion The findings of this study can be used by the legislators, administrators, and policymakers to develop strategies that can help in mitigating these episodes of violence for the better functioning of the healthcare system.
Collapse
Affiliation(s)
- Amandeep Singh
- Department of Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Piyush Ranjan
- Department of Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Ramesh Agrawal
- Department of Medicine, Lady Hardinge Medical College, New Delhi, India
| | - Tanveer Kaur
- Department of Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Ashish D. Upadhyay
- Department of Biostatistics, All India Institute of Medical Sciences, New Delhi, India
| | - Jamshed Nayer
- Department of Emergency Medicine, All India Institute of Medical Sciences, New Delhi, India
| | | | - Siddharth Sarkar
- Department of Psychiatry and National Drug Dependence Treatment Centre, All India Institute of Medical Sciences, New Delhi, India
| | - Mohit Joshi
- Department of Surgical Disciplines, All India Institute of Medical Sciences, New Delhi, India
| | - Tarang P. Kaur
- Department of Obstetrics and Gynaecology, All India Institute of Medical Sciences, New Delhi, India
| | - Ajay Mohan
- Department of Surgery, All India Institute of Medical Sciences, New Delhi, India
| | - Avinash Chakrawarty
- Department of Geriatric Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - K. Raju Kumar
- Department of Medicine, All India Institute of Medical Sciences, New Delhi, India
| |
Collapse
|
3
|
Sari H, Yildiz İ, Çağla Baloğlu S, Özel M, Tekalp R. The frequency of workplace violence against healthcare workers and affecting factors. PLoS One 2023; 18:e0289363. [PMID: 37506128 PMCID: PMC10381052 DOI: 10.1371/journal.pone.0289363] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Accepted: 07/17/2023] [Indexed: 07/30/2023] Open
Abstract
BACKGROUND Workplace violence has become a global issue, especially among healthcare workers. This study aimed to determine the influencing factors and legal processes of workplace violence incidents, as well as the frequency of workplace violence in a tertiary hospital. METHODS This observational, descriptive, retrospective frequency study was conducted between January 2020 and March 2022. This study examined the workplace violence records of 135 healthcare professionals at a tertiary hospital's Patient Rights and Employee Safety and Law departments. Factors affecting workplace violence were categorized as noncompliance with the procedure, communication, and dissatisfaction. RESULTS Workplace violence frequency was observed in the cumulative total of 10821 healthcare workers at 1.2%. In terms of workplace violence types, 71.9% were verbal and 28.1% were physical. In terms of exposure to workplace violence, doctors accounted for 62.3%, nurses for 20%, and medical secretaries for 7.4%. Most cases were observed in outpatient clinics (34.8%), followed by emergency departments (25.9%). Among the main reasons for workplace violence against healthcare workers, non-compliance with procedures (49.6%), communication (27.4%), and dissatisfaction (23.1%) were identified. Legal aid was provided to all notifications of workplace violence. 37.1% were not prosecuted, 55.5% were under investigation, 4.4% were accepted indictments, and 3.0% were punished by a judicial fine. CONCLUSION This study can provide significant contributions to the formulation of workplace violence prevention policies and programs by analyzing white-code notifications for workplace violence frequency and preventable factors. Healthcare workers may have underreported workplace violence events due to the length of the proceedings and the perceived lack of protection from legal regulations.
Collapse
Affiliation(s)
- Hıdır Sari
- Dicle University Faculty of Medicine, Department of Public Health, Diyarbakır, Turkey
| | - İsmail Yildiz
- Dicle University Faculty of Medicine, Department of Biostatistics and Medical Informatics, Diyarbakır, Turkey
| | | | - Mehmet Özel
- Department of Emergency Medicine, Diyarbakır Gazi Yasargil Training and Research Hospital, University of Health Sciences, Diyarbakır, Turkey
| | - Ronay Tekalp
- Dicle University, Office of Legal Affairs, Diyarbakır, Turkey
| |
Collapse
|
4
|
Spencer C, Sitarz J, Fouse J, DeSanto K. Nurses' rationale for underreporting of patient and visitor perpetrated workplace violence: a systematic review. BMC Nurs 2023; 22:134. [PMID: 37088834 PMCID: PMC10122798 DOI: 10.1186/s12912-023-01226-8] [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: 06/12/2022] [Accepted: 02/28/2023] [Indexed: 04/25/2023] Open
Abstract
BACKGROUND Patient and visitor perpetrated workplace violence (WPV) is a problem within healthcare and is known to be underreported by nurses and other healthcare workers. However, there are multiple and diverse reasons identified in the literature as to why nurses do not report. This systematic review aimed to investigate nurses' reasons and rationale related to underreporting of violence that occurs in the workplace. METHODS Following PRISMA guidelines for systematic review reporting, studies conducted between 2011 and early 2022 were identified from MEDLINE, CINAHL, APA PsychInfo, and Psychological and Behavioral Sciences Collection via EBSCOHost. Quantitative studies related to patient and visitor perpetrated violence containing explanations, reasons, or rationale related to underreporting were included. RESULTS After quality appraisals, 19 studies representing 16 countries were included. The resulting categories identified nursing, management, and organizational factors. The most prominent nursing factors included nurses' fear of consequences after reporting, nurses' perceptions, and their lack of knowledge about the reporting process. Common management factors which contributed to nursing underreporting included lack of visible changes after reporting, non-supportive culture in which to report, and the lack of penalties for perpetrators. Organizational factors included the lack of policies/procedures/training for WPV, as well as a lack of an efficient and user-friendly reporting system. Supportive interventions from management, organizations, and community sources were summarized to provide insight to improve nurse reporting of WPV events. CONCLUSION Underreporting of WPV is a complex and multi-faceted problem. An investigation into the rationale for underreporting a workplace violent event illustrates nurses, management, and organizations contribute to the problem. Clear and actionable interventions such as educational support for staff and the development of a clear and concise reporting processes are recommended to encourage staff reporting and to help address WPV in healthcare.
Collapse
Affiliation(s)
| | - Jamie Sitarz
- UCHealth Cancer Center, Highlands Ranch, CO, USA
| | - June Fouse
- University of Colorado Hospital, Aurora, CO, USA
| | - Kristen DeSanto
- University of Colorado Anschutz Medical Campus, Strauss Health Sciences Library, Aurora, CO, USA
| |
Collapse
|
5
|
Julia GJ, Rajkumar E, Romate J. Prevalence of violent communication within Indian organisations- A systematic review and meta-analysis. Heliyon 2022; 8:e12336. [PMID: 36636211 PMCID: PMC9830179 DOI: 10.1016/j.heliyon.2022.e12336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Revised: 07/10/2022] [Accepted: 12/07/2022] [Indexed: 12/24/2022] Open
Abstract
Background Considering the normalisation of moderate aggression within organisations and the concern of violent occurrences being under-reported in India, violence reflected through coercive language appears to be more frequent than explicit acts of organisational violence. Aim To bring-forth consolidated evidence on the prevalence of violent communication within Indian organisations. Method 1433 articles obtained from four major databases (PubMed, Scopus, Science Direct, Web of Science and Google scholar), complemented by 4 records identified through manual searching, were screened according to the PRISMA guidelines. Thirty-four finalised cross-sectional studies (published since 2000) reporting significant findings on the prevalence of violent communication within Indian organisations, underwent a systematic review (by narrative synthesis) and meta-analysis (using the random-effects model in STATA version 17). Results The pooled prevalence of any type of violent communication was 41%. The prevalence of violent communication was higher among males than females (44% vs 28%). Verbal violence was more prevalent than non-verbal violence (36% vs 20%). Subgroup analysis proved prevalence estimate to remain consistent irrespective of the organisational sector, type of organisation, sample size and publication year. However, meta-regression analysis confirmed the sampling method and type of violent communication as potential variables influencing the prevalence rates reported across the studies. All the identified factors influencing the occurrence of violent communication and the corresponding detrimental consequences faced by victims within each organisational sector, endeavour scope for the development of more context-specific prevention strategies. Conclusion As evident from the results, the prevalence of any type of violent communication within Indian organisations is quite high. The present review informs Indian entrepreneurs about the necessity for advocating practices to protect their human resources from the experience of violent communication. Practical implications have been presented for healthcare and educational organisations.
Collapse
|
6
|
Kumari A, Singh A, Ranjan P, Sarkar S, Kaur T, Upadhyay AD, Verma K, Kappagantu V, Mohan A, Baitha U. Development and Validation of a Questionnaire to Evaluate Workplace Violence in Healthcare Settings. Cureus 2021; 13:e19959. [PMID: 34976540 PMCID: PMC8713433 DOI: 10.7759/cureus.19959] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/27/2021] [Indexed: 11/16/2022] Open
Abstract
Introduction This study aims to develop and validate a questionnaire to assess workplace violence (WPV) domains in the healthcare setting. Methods The study used a mixed-method design. In Phase 1, qualitative methods for developing the questionnaire were employed, including literature review, focus-group discussion, expert evaluation, and pre-testing. During Phase 2, quantitative methods were employed for establishing the construct validity of the questionnaire. In Phase 1, experts from departments like emergency medicine, medicine, obstetrics and gynecology, psychiatry, trauma, anesthesia, and critical care unit participated. For Phase 2, data were collected from 213 participants; mean age (30.48±5.95) in metropolitan cities. Results The questionnaire consists of 37 items in five domains: (A) Forms of violence, (B) Impact of violent incidences, (C) Reporting of incidence, (D) Mitigation strategies, and (E) Risk factors. The Cronbach’s alpha value of the questionnaire is 0.86, suggesting an excellent internal consistency. Conclusion A reliable and valid tool for gathering information regarding WPV in the healthcare system from around the world has been developed. The tool can be used to study the elements that may contribute to violence and its consequences, which will help policymakers curate various mitigation methods to safeguard WPV victims.
Collapse
|
7
|
Lakshmikantha N, Nayak BS, Kashinkunti M, Javali SB, Mukherjee S. Sensitivity towards patient's presence to avoid violent situations in hospitals: An observatory study. J Family Med Prim Care 2021; 10:1359-1363. [PMID: 34041179 PMCID: PMC8140260 DOI: 10.4103/jfmpc.jfmpc_842_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2020] [Revised: 09/09/2020] [Accepted: 09/28/2020] [Indexed: 11/21/2022] Open
Abstract
Context: The process of communication includes intense observation based on which opinions are formed or situations are created. A patient whose is in state of panic due to the health conditions feels neglected and becomes skeptical about the treatment hi/she is going to receive. Aims: The aim of the study is to understand the need for being sensitive towards patient's presence while communicating. Settings and Design: It was conducted in the outpatient wing of clinics at three different cities of Karnataka using a Sequential Observatory Study design. Materials and Methods: Based on the results obtained from the pilot study a final schedule was prepared and sent to people using google drive during the month of Dec 2019. Out of 200 filled forms only 55 patients/relatives were qualified for analysis. SPSS version 17.0 software, Microsoft word and Excel were used in data handling and analysis. Textual analysis was used for presenting interview data. Results: The qualitative analysis of the questionnaires found four emerging themes that disturbed the patients psychologically and such situations could lead to violence. The results prove that patients/relatives observe both verbal and nonverbal communication in the hospital from the time of their entry to exit. Conclusion: The communication intended or unintended made some impact on the perceptions of the patients about the way they are going to be treated. This indicates that the workforce should be conscious of their behaviour.
Collapse
Affiliation(s)
- Nandini Lakshmikantha
- Manipal Institute of Communication, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - B Shivananda Nayak
- Department of Preclinical Sciences, Faculty of Medical Sciences, The University of the West Indies, Trinidad and Tobago.,Department of Biochemistry, Subbaiah Institute of Medical Sciences, Shimoga, India
| | - Mohan Kashinkunti
- Department of General Medicine, SDM College of Medical Sciences and Research Center, Dharward, Karnataka, India
| | - Shivalingappa B Javali
- Department of Community Medicine (Statistics), USM KLE International Medical Program, Belagavi, Karnataka, India
| | - Sananda Mukherjee
- Manipal Institute of Communication, Manipal Academy of Higher Education, Manipal, Karnataka, India
| |
Collapse
|
8
|
Song C, Wang G, Wu H. Frequency and barriers of reporting workplace violence in nurses: An online survey in China. Int J Nurs Sci 2020; 8:65-70. [PMID: 33575447 PMCID: PMC7859538 DOI: 10.1016/j.ijnss.2020.11.006] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2020] [Revised: 11/23/2020] [Accepted: 11/29/2020] [Indexed: 11/08/2022] Open
Abstract
Objectives This study aimed to explore the reporting of workplace violence against nurses and the reasons why they did not reported. Methods A self-designed questionnaire regarding workplace violence and reporting was used to conduct a cross-sectional survey on nurses who submitted a manuscript to a Chinese nursing journal from 2016 to 2017. A total of 324 nurses agreed to participate in this study and 266 participants from 165 hospitals in 72 cities returned questionnaires. Results A total of 172 nurses (64.7%) experienced violent incidents during the past year. Of these incidents, 45.5% were reported; and the reporting rate of physical assaults (69.0%) was higher than those of verbal abuse (36.9%), threatening behavior (51.7%), and sexual harassment (60.0%). Formal reporting accounted for 25.4% (15.4% in written form and 10.0% through a computer-assisted reporting system). Almost half of the nurses (49.6%) stated that the hospital had no reporting system or they were uncertain about the reporting system. For reasons of not reporting, 51.9% of the nurses were unware of how and what types of violence to report, and 50.6% of the nurses believed that the hospital paid greater attention to patients rather than staff. Conclusions A clear definition of workplace violence and reporting procedures, establishment of a facile system for reporting, and supervisory support following a reporting are urgently required.
Collapse
Affiliation(s)
- Chunyan Song
- Department of Nursing, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Gaili Wang
- Department of Cardiac Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Hongyan Wu
- Department of Nursing, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| |
Collapse
|