An Evaluation of Verbal, Physical, and Sexual Violence Against Healthcare Workers in Ankara, Turkey

The moderation effect of mentalization in the relationship between impulsiveness and aggressive behavior

Aggressive behavior is a growing problem across many contexts. Thus, searching for its predictors is important. The aim of the current study was to analyze the moderator effect of mentalization in the relationship between impulsiveness and both verbal and physical aggressive behavior, using a sample of 583 participants gathered from the general Spanish population (MAge  = 34.60, SDAge  = 12.99). In our sample, 182 were male and 401 were female. The results showed significant bivariate relationships among aggression, impulsiveness, and mentalization. Moderation structural equation modeling (MSEM) showed a significant moderation effect, so whereas the value of mentalization is not relevant in cases of people with low impulsiveness, high mentalization abilities allow those people with high impulsiveness to behave less aggressively than people with high impulsiveness and low mentalization abilities. Practical implications and limitations of the study are discussed.

Aggression against Nursing Personnel during the First Wave of COVID-19 Pandemic: An Internet-Based Survey

(1) Background: health care workers, particularly nurses, have been regularly assaulted during the COVID-19 pandemic. Purpose: to evaluate the prevalence and location of assaults against nursing personnel in Latin America, and to determine predictor factors for aggression against nurses. (2) Methods: A cross-sectional online survey was answered by 374 nurses working in health care during the COVID-19 pandemic. The aggression against nurses was estimated using the Victimization Scale. (3) Results: A total of 288 nurses were included in this study. The victimization scale showed that 52.1% of nurses have suffered aggression by the general population during the COVID-19 pandemic. Males were more likely to be attacked than females (p < 0.05). Additionally, males were attacked more frequently on public transport (x2 = 6.72, p = 0.01). The home neighborhood and markets were other locations with a higher risk of being assaulted (OR: 3.39, CI: 1.53-7.50). (4) Conclusions: Our results indicate that nurses in Latin America who work during the COVID-19 pandemic and social isolation have been frequently assaulted by the general public. Males are more frequently attacked than females and the main places of aggression are public transportation, their home neighborhood and supermarkets. Implications for nursing practice: it is necessary to create and implement protocols and guidelines to support nursing personnel during the COVID-19 pandemic. This study was retrospectively registered at the Juarez Autonomous University of Tabasco (103/CIPDACS/2020) on the (08/2020).

Does workplace violence affect healthcare workers' turnover intention?

AIMS

This study aimed to explore the association between workplace violence and turnover intention among Chinese healthcare workers and explore the role of gender as a moderator in this relation.

METHODS

A cross-sectional survey recruited 692 healthcare workers from a single center in a Chinese province. The content included a questionnaire regarding workplace violence, authoritarian leadership, and turnover intention. The moderated mediation effects were analyzed using the PROCESS tool in SPSS and bootstrap method was used to extract 5000 samples to estimate the 95% confidence interval of each effect.

RESULTS

The results indicated that the effect of workplace violence on turnover intention was mediated by authoritarian leadership. In addition, gender moderated the association between authoritarian leadership and turnover intention.

CONCLUSIONS

Healthcare worker managers should establish a workplace violence intervention system and change the leadership style of direct leaders to reduce healthcare workers' turnover intention.

ViSHWaS: Violence Study of Healthcare Workers and Systems-a global survey

OBJECTIVE

To provide insights into the nature, risk factors, impact and existing measures for reporting and preventing violence in the healthcare system. The under-reporting of violence against healthcare workers (HCWs) globally highlights the need for increased public awareness and education.

METHODS

The Violence Study of Healthcare Workers and Systems study used a survey questionnaire created using Research Electronic Data Capture (REDCap) forms and distributed from 6 June to 9 August 2022. Logistic regression analysis evaluated violence predictors, including gender, age, years of experience, institution type, respondent profession and night shift frequency. A χ2 test was performed to determine the association between gender and different violence forms.

RESULTS

A total of 5405 responses from 79 countries were analysed. India, the USA and Venezuela were the top three contributors. Female respondents comprised 53%. The majority (45%) fell within the 26-35 age group. Medical students (21%), consultants (20%), residents/fellows (15%) and nurses (10%) constituted highest responders. Nearly 55% HCWs reported firsthand violence experience, and 16% reported violence against their colleagues. Perpetrators were identified as patients or family members in over 50% of cases, while supervisor-incited violence accounted for 16%. Around 80% stated that violence incidence either remained constant or increased during the COVID-19 pandemic. Among HCWs who experienced violence, 55% felt less motivated or more dissatisfied with their jobs afterward, and 25% expressed willingness to quit. Univariate analysis revealed that HCWs aged 26-65 years, nurses, physicians, ancillary staff, those working in public settings, with >1 year of experience, and frequent night shift workers were at significantly higher risk of experiencing violence. These results remained significant in multivariate analysis, except for the 55-65 age group, which lost statistical significance.

CONCLUSION

This global cross-sectional study highlights that a majority of HCWs have experienced violence, and the incidence either increased or remained the same during the COVID-19 pandemic. This has resulted in decreased job satisfaction.

Workplace violence against physicians in intensive care units in Turkey: A cross-sectional study

Background Although there are many studies on violence against physicians in the literature, there are few studies on violence against physicians working in intensive care units (ICUs). We aimed to investigate the frequency, type and underlying factors of violence against physicians working in ICUs in Turkey in the past 1 year. Methods We collected data by sending a questionnaire about violence against physicians working in ICUs via e-mail and WhatsApp between 1 and 15 May 2022. IBM SPSS Statistics V.24.0 was used for data analysis. The chi-square test and Fisher precision test were used to compare categorical data. Results Over one-third (38.6%) of the 354 physicians participating in our study reported that they had been exposed to violence in the past year, while 20.7% reported that they had been exposed to violence more than once in the past year. There was a significant relationship between the frequency of exposure to violence, female gender, age group, title, subspecialization status, working style and duration of working in the ICU (p<0.05). There was no relationship between the working area, type of hospital and ICU and exposure to violence (p>0.05). The presence of restriction and control points at the entrance to ICUs prevented violence (p<0.05). Conclusion Physicians working in ICUs encounter violence against them. The frequency of violence increased after the Covid-19 pandemic. A significant relationship was found between the frequency of violence and female gender, age group, title, subspecialization status, working style and duration of working in ICUs.

The relationship between spirituality and aggression in the workplace during the COVID-19 pandemic: A cross-sectional study among Iranian nurses

BACKGROUND

Aggression towards nurses in the workplace arises from various reasons, reportedly increasing during the COVID-19 pandemic. Where aggression can be maintained by spiritual well-being, as it is said that spirituality is a coping skill and psychological well-being maintainer-but there is little known, especially during the pandemic. Thus, this study explored the effect of spirituality on aggression among the nurses working in the COVID-19 wards.

METHODS

This cross-sectional data from 200 nurses involved in the COVID-19 patient treatment were collected using a random sampling method from four hospitals in East Mazandaran province, Iran. Responses were collected based on socio-demographics, Buss-Perry Aggression Questionnaire, and Paloutzian & Ellison Spiritual Well-being Scale. T-test, ANOVA, Pearson correlation coefficient, and multiple linear regression were applied for data analysis.

RESULTS

The mean age of nurses was 31.49±6.88 (range: 21-48) years. Nurses working in the COVID-19 wards have a mean score of spiritual health of 67.21±12.84 (out of 120), whereas 51.77±10.96 (out of 116) was for aggression. The results showed a significant negative weak correlation between aggression and spiritual health (r = -.285, p<0.01). As per regression analysis, spiritual health [β = -.264], age [β = -.374], and working experience [β = 4.156] were the significant factors associated with aggression (p<0.05).

CONCLUSIONS

It is evident that nurses who consider spirituality in their life actions are in a state of reduced negative emotions, such as aggression. Thus, policymakers and managers of the healthcare settings are suggested to promote spirituality among the nurses through spiritual care education, providing the ground for promoting spirituality and a positive attitude towards it.

Violence against physicians and nurses: a systematic literature review

Background

Violence against physicians and nurses is a global public health problem. This study explored violence against physicians and nurses using a systematic literature review.

Methods

Pubmed and Scopus were searched using search words 'violence' OR 'aggression' 'against' 'physicians' AND 'nurses'. Articles published between 2010 and 2020 in the English language, excluding review/systemic review articles, were included in the study. We used the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines for literature search and reporting and assessed the quality of the article based on the JBI checklist for analytical cross sectional studies.

Results

A total of 22 studies were included. The majority of the studies showed that there was a significant violent incident within every setting, often directly involving patients or their relatives. Workers of emergency departments were more likely to be exposed to violence. Verbal abuses were the highest among all settings. Physicians were more likely to face physical violence, while nurses were more prone to sexual harassment. Lack of communication plays a significant role. Fewer reports of violence were noted due to lack of action taken previously.

Conclusion

Adequate policy making and implementation and operational research are required to further mitigate the episodes of violence.

Causes of workplace violence against nurses from patients and their relatives: A qualitative study

BACKGROUND

Nurses are frequently exposed to violence in workplaces. Although the causes of workplace violence have been widely analyzed, there are only a limited number of qualitative studies dealing with violence against nurses from patient and their relatives with a comprehensive and multi-directional approach.

AIM

This study aimed to explore the causes of violence against nurses exercised by patients and/or their relatives in different departments of Turkish hospitals.

METHODS

This study utilized a qualitative descriptive design. Participants were chosen with purposive sampling and maximum variation sampling method from five different hospitals. Semi-structured in-depth interviews were conducted with 34 nurses working in different positions and departments. The interviews were recorded with audio recorders and the data were analyzed with a content analysis.

RESULTS

Four major themes emerged from the nurses' perspective concerning causes of workplace violence including the followings: (1) health care system, (2) health institutions, (3) health professionals, and (4) patients and their relatives. The themes "health care system" and "health institutions" include four subthemes, "health professionals" include five subthemes and "patients and their relatives" include twelve subthemes.

CONCLUSION

There are various causes why nurses are exposed to violence in the workplace by patients and/or their relatives. Since the causes of violence are a multifaceted issue, prevention strategies of violence against nurses should be planned and implemented accordingly.

Validity and reliability of the Turkish version of the General Work Stress Scale

AIM

To test the validity and reliability of the Turkish version of the General Work Stress Scale.

BACKGROUND

Nursing is one of the most stressful professions. The primary measure that should be taken to ensure that nurses can cope with stress is determining their stress levels.

METHOD

The General Work Stress Scale was translated into Turkish via back-translation. Its reliability and validity were analysed via item analyses, content and construct validities, exploratory and confirmatory factor analyses, Cronbach's alpha and Spearman-Brown reliability coefficients. Average and standard deviations of the scale items and the overall scale were calculated.

RESULTS

The study was conducted with 276 nurses. The Cronbach's alpha of the whole scale was 0.91, and the Spearman-Brown reliability coefficient was 0.89. According to the resulting one-dimensional structure, the factor loadings of the scale items were between 0.67 and 0.82, and this structure alone explained 58.72% of the total variance. The confirmatory factor analysis revealed perfect and good-fit indices (χ² /df = 1.96; RMSA = 0.06; CFI = 0.99; IFI = 0.99; GFI = 0.97; RMR = 0.04; NFI = 0.99). The mean total score was 2.55 ± 0.87, while the items' means ranged from 2.10 ± 1.15 to 3.33 ± 1.13.

CONCLUSION

The Turkish version of the General Work Stress Scale is a valid and reliable tool for assessing nurses' general work stress. Nurses largely feel that their work makes them so stressed that they wish they had a different job. The items with high means suggest opportunities for improvement.

IMPLICATIONS FOR PRACTICE

The nurses or nursing services and units with low or high stress levels can be determined with the General Work Stress Scale. If necessary, measures aimed at eliminating or reducing the negative effects of those nurses or nursing services and units with high stress levels can be taken in a timely manner.