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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.
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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
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Ras IA. The factors that affect violence against nurses in emergency departments. Heliyon 2023; 9:e14306. [PMID: 36950614 PMCID: PMC10025084 DOI: 10.1016/j.heliyon.2023.e14306] [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: 08/23/2022] [Revised: 02/24/2023] [Accepted: 02/28/2023] [Indexed: 03/09/2023] Open
Abstract
Background Violence against nurses within healthcare setting is a serious issue of concern within the global healthcare sector. A considerably large percentage of nurses, 30%, in particular, have experienced or witnessed cases of violence in the workplace. Objective To conduct a scoping review on the factors influencing violence against nurses in emergency departments. Design Literature review. Settings The SLR was performed in various academic databases namely SpringerLink, Google Scholar, Science Direct, ERIC, and Academic Search Elite. Participants A total of N = 10 articles were included in the study. Methods A scoping/mapping review (SR) was performed in adherence to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis recommendations. Results The literature review consisted of 10 articles published in the English language within the last 10 yrs (between 2013 and 2022). The studies reviewed utilized various designs. Cross-sectional were 7, Case study was 1, while Qualitative retrospective descriptive studies were 2. The total sample size of all the studies recruited was N = 38, 031 participants. The reviewed literature revealed various factors that contribute to violence against nurses namely the level of a nurse's experience, low quality of service, unmet expectations, patient or colleague disruptive behaviors, delay in care or waiting time, mistakes in care/errors, degree of pain of the patient, death of a patient, class in roles among colleagues, and high workload and overcrowding. Conclusions Violence against nurses is a major problem in the healthcare sector due to its adverse consequences; however, it remains persistent. This study reveals that the main factors of violence against nurses are fewer years of experience as a nurse, level of pain of patients, quality of healthcare service, waiting time, unmet patient expectation, and disagreements among nurses in the workplace.
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Zhu Y, Zhao Z, Guo J, Wang Y, Zhang C, Zheng J, Zou Z, Liu W. Understanding Use Intention of mHealth Applications Based on the Unified Theory of Acceptance and Use of Technology 2 (UTAUT-2) Model in China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3139. [PMID: 36833830 PMCID: PMC9960455 DOI: 10.3390/ijerph20043139] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/05/2022] [Revised: 02/06/2023] [Accepted: 02/08/2023] [Indexed: 06/18/2023]
Abstract
The COVID-19 pandemic has significantly impacted the healthcare industry, especially public health resources and resource allocation. With the change in people's lifestyles and increased demand for medical and health care in the post-pandemic era, the Internet and home healthcare have rapidly developed. As an essential part of Internet healthcare, mobile health (mHealth) applications help to fundamentally address the lack of medical resources and meet people's healthcare needs. In this mixed-method study, we conducted in-depth interviews with 20 users in China (mean age = 26.13, SD = 2.80, all born in China) during the pandemic, based on the unified theory of acceptance and use of technology 2 (UTAUT-2) mode, and identified four dimensions of user needs in mHealth scenarios: convenience, control, trust, and emotionality. Based on the interview results, we adjusted the independent variables, deleted the hedonic motivation and the habit, and added the perceived trust and perceived risk as the variables. Using a structural equation model (SEM), we designed the questionnaire according to the qualitative results and collected data from 371 participants (above 18 years old, 43.9% male) online to examine the interrelationships these variables. The results show that performance expectancy (β = 0.40, p < 0.001), effort expectancy (β = 0.40, p < 0.001), social influence (β = 0.14, p < 0.05), facilitating condition (β = 0.15, p < 0.001), and perceived trust (β = 0.31, p < 0.001) had positive effects on use intention. Perceived risk (β = -0.31, p < 0.001) harmed use intention, and price value (β = 0.10, p > 0.5) had no significant effects on use intention. Finally, we discussed design and development guidelines that can enhance user experience of mHealth applications. This research combines the actual needs and the main factors affecting the use intention of users, solves the problems of low satisfaction of user experience, and provides better strategic suggestions for developing mHealth applications in the future.
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Affiliation(s)
- Yancong Zhu
- School of Biological Science and Medical Engineering, Beihang University, Beijing 100191, China
- Faculty of Psychology, Beijing Normal University, Beijing 100875, China
| | - Zhenhong Zhao
- Faculty of Psychology, Beijing Normal University, Beijing 100875, China
| | - Jingxian Guo
- Faculty of Psychology, Beijing Normal University, Beijing 100875, China
| | - Yanna Wang
- Faculty of Psychology, Beijing Normal University, Beijing 100875, China
| | - Chengwen Zhang
- Faculty of Psychology, Beijing Normal University, Beijing 100875, China
| | - Jiayu Zheng
- Faculty of Psychology, Beijing Normal University, Beijing 100875, China
| | - Zheng Zou
- Stanford Center at Peking University, Stanford University, Beijing 100871, China
| | - Wei Liu
- Faculty of Psychology, Beijing Normal University, Beijing 100875, China
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Xu J, Cao Y, Wang Y, Qiao Q. Judicial judgment and media sensation of violence against medical staff in China: A fuzzy set qualitative comparative analysis (fsQCA). PLoS One 2021; 16:e0259014. [PMID: 34679107 PMCID: PMC8535389 DOI: 10.1371/journal.pone.0259014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Accepted: 10/11/2021] [Indexed: 11/26/2022] Open
Abstract
INTRODUCTION Violence against medical staff has been prevalent in China over the past two decades. Although Chinese authorities have released many laws and regulations to protect medical staff from violence since 2011, the legal approach alone is unlikely to resolve this complex issue. In particular, several cases of violence against medical staff in China have caused great media sensation. METHOD This paper proposes an integrated model that combines the environmental stimuli theory, broken windows theory, and rational choice theory. It adopts the fuzzy set qualitative comparative analysis (fsQCA) to untangle the causal relationship between violence against medical staff, media sensation, and judicial judgment. We examined reports of medical violence on media and news websites from January 1, 2010, to January 31, 2020, and selected 50 cases with detailed information for this study. RESULTS The results show that each condition is not sufficient for the absence of judicial judgment, but when combined, they are conducive to the outcome. The conditions of hospital level, medical cost, and media sensation play important roles. The providers, patients, and environmental factors are indicators of inadequate or lack of judicial judgment, which corresponds to previous expectations. CONCLUSIONS The integrated model greatly enriches the extant theories and literature, and also yields implications for preventing violence against medical staff in China. We suggest that sustainable and innovative healthcare reform should be initiated. For example, public hospitals should remain the cornerstone of national public health security. Medical staff in public hospitals must be regarded as "civil servants". Therefore, the current legal system should be improved. The media should objectively report events concerning medical staff and improve public healthcare knowledge.
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Affiliation(s)
- Jian Xu
- School of Media and Communication and China Institute for Urban Governance, Shanghai Jiao Tong University, Shanghai, China
| | - Yongrong Cao
- School of Media and Communication, Shanghai Jiao Tong University, Shanghai, China
| | - Yangyang Wang
- School of Media and Communication, Shanghai Jiao Tong University, Shanghai, China
| | - Qingquan Qiao
- China Institute for Urban Governance, Shanghai Jiao Tong University, Shanghai, China
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Fu C, Ren Y, Wang G, Shi X, Cao F. Fear of future workplace violence and its influencing factors among nurses in Shandong, China: a cross-sectional study. BMC Nurs 2021; 20:123. [PMID: 34233678 PMCID: PMC8262060 DOI: 10.1186/s12912-021-00644-w] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2021] [Accepted: 06/23/2021] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Fear of workplace violence has become a critical issue worldwide, which can lead to burnout, low levels of job satisfaction, and turnover. However, to date, little attention has been directed toward fear of workplace violence among nurses. Accordingly, this study investigated the level of fear of future workplace violence and its influencing factors among nurses in Shandong, China. METHODS A cross-sectional study was conducted from July 30 through September 30, 2020 in Shandong Province, China. A total of 1898 nurses were enrolled from 12 tertiary hospitals. Fear of future workplace violence was measured using the Fear of Future Violence at Work scale. Demographic information, employment characteristics, social support, and experience of workplace violence were assessed. Multiple linear regression analysis was used to explore the influencing factors of fear of future workplace violence. RESULTS The average score of fear of future violence at work was 67.43 ± 17.20 among nurses. Multiple linear regression analysis showed that higher fear of future violence at work scores were reported among nurses who were female (B = 7.10, p < 0.001), married (B = 3.50, p = 0.028), with a monthly income ≥5000 Chinese yuan (CNY) (B = 3.14, p = 0.007), working in the department of internal medicine (B = 2.90, p = 0.032), surgery (B = 5.03, p < 0.001), pediatrics (B = 5.38, p = 0.003), or emergency department (B = 4.50, p = 0.010), working as a contract employee (B = 2.41, p = 0.042), or who had experienced workplace violence (B = 7.02, p < 0.001). Lower fear of future violence at work scores were found among nurses who took vacations (1-14 days: B = - 2.52, p = 0.047; ≥15 days: B = - 3.69, p = 0.007) and had a high-level of social support (B = - 2.03, p = 0.020). CONCLUSIONS There was a high level of fear of future workplace violence among nurses in Shandong, China. This should be considered an important issue by hospital administrators and government officials. Effective interventions need to be enacted to address the influencing factors of fear of future workplace violence.
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Affiliation(s)
- Chang Fu
- Department of Health Psychology, School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, No. 44 Wenhuaxilu Rd., Jinan, 250012 Shandong China
| | - Yaru Ren
- Department of Nursing Science, Shandong Provincial Qianfoshan Hospital Affiliated to Shandong First Medical University, No. 16766 Jingshilu Rd., Jinan, 250014 Shandong China
| | - Guowen Wang
- Department of Education, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, No. 324 Jingwuweiqilu Rd., Jinan, 250021 Shandong China
| | - Xiuxin Shi
- Office of Medical Quality Control, Qilu Hospital, Cheeloo College of Medicine, Shandong University, No. 107 Wenhuaxilu Rd., Jinan, 250012 Shandong China
| | - Fenglin Cao
- Department of Health Psychology, School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, No. 44 Wenhuaxilu Rd., Jinan, 250012 Shandong China
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Inequality in the last resort: how medical appraisal affects malpractice litigations in China. Int J Legal Med 2020; 135:1047-1054. [PMID: 32783158 DOI: 10.1007/s00414-020-02386-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2020] [Accepted: 08/03/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND Medical malpractice litigations affect the practices of patient safety. However, medical malpractice litigations involve highly specialized knowledge. Thus, medical appraisal is usually essential in the ascertainment of responsibility and judicial decision-making. China's judicial system is characterized by a dual-mode of medical appraisal resulting from two parallel appraisal agencies: judicial appraisal institutions and medical associations. This paper examines whether or not and how choices of different medical appraisal agencies affect malpractice lawsuit results in China. METHODS We collected and sampled a total of 2557 verdicts pertaining to medical disputes from "China Judgements Online" in 2014. We used an ordinary least square regression model and a mediating effect regression model to analyze to what extent and how different choices between two medical appraisal agencies affect malpractice litigations. RESULTS (1) Almost 81.55% (2082) of litigants resorted to medical malpractice appraisals in China in 2014. Among 2070 cases with appraisal results accepted by the court, 60.10% of the litigants chose judicial appraisal institutions (1244), as opposed to medical associations (826). (2) Among 2557 cases, 2306 (90.18%) claimed compensation and 1919 (83.22%) were awarded compensation by the courts. The proportion of compensation paid in a case is 48% on average. (3) Appraisal agencies matter in the investigation of medical errors, which in turn affects the proportion of compensation paid in a case. (4) Choosing judicial appraisal institutions will raise the proportion of compensation paid by about 10% on average. CONCLUSIONS Different choices between appraisal institutions affect malpractice litigations in China. As the last resort for remedying medical malpractice, medical appraisals in the judicial system could be a source of inequality in China's medical litigation outcomes.
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