Changes in prevalence of workplace violence against doctors in all medical specialties in Norway between 1993 and 2014: a repeated cross-sectional survey

Work Reward Moderates the Association Between Work Effect and Workplace Violence Among Medical Staff in China

Purpose

Workplace violence (WPV) against healthcare workers is a significant public health issue in China and globally. Although the effort-reward imbalance theory claimed that work rewards may moderate the relationship between work effort and WPV, the quantitative evidence is limited. This study aimed to examine if work reward could moderate the associations between work effort and WPV against medical staff based on the effort-reward imbalance theory.

Methods

This is a cross-sectional study, which was conducted in 12 hospitals in Shandong, China. Data collected from 3426 medical staff were analyzed in this study. Work effort was evaluated by working hours and night shift work times per month (NSWM), and work reward was evaluated by monthly income and perceived social status. WPV, occupational characteristics, physical disease, and social-demographic variables were also evaluated in this study.

Results

There were 1788 (52.2%) medical staff, who reported the experience of workplace violence. Working hours, NSWM, and perceived social status were associated with WPV (all p<0.001). Monthly income could moderate the associations between monthly income and WPV or verbal violence (p<0.05), and perceived social status could moderate the associations between NSWM and WPV (p<0.001).

Conclusion

Monthly income could moderate the associations between monthly income and WPV (verbal violence), and perceived social status could moderate the associations between NSWM and WPV, which could be explained by the effort-reward imbalance model. These findings also can be translated into practices to control WPV against medical staff.

Workplace Violence Against Primary Care Clinicians: A Narrative Review

Workplace violence (WPV) is a commonly reported occupational hazard in healthcare and its prevalence is increasing. WPV occurs in all types of practice settings, but little is known about WPV in primary care settings in the United States (US). Because primary care practice settings differ from the inpatient settings, further examination of WPV in primary care is warranted. Our objective was to summarize the available literature highlight important gaps. We conducted a search using Pubmed and OVID for US studies of WPV in US-based adult primary care practices. Studies including only pediatric populations were excluded. Due to the lack of available literature conducted in US primary care settings, we expanded our search to include international studies. We identified 70 studies of which 5 were US based. Due to the lack of significant numbers of US-based studies, we opted to conduct a narrative review of all available studies. The evidence shows that WPV is a common occurrence in primary care settings in many countries and that the majority of primary care clinicians have experienced at least some form of non-physical violence in their careers. Most of the studies conducted were cross-sectional in design and reported on both non-physical and physical forms of WPV. There was not a consistent trend between genders in experiencing the major forms of WPV, but women were consistently more likely to be subjected to sexual harassment. Potential root causes for WPV could generally be categorized as patient-level, clinician-level, clinical encounter specific, and operational root causes. While most WPV was found to be non-physical, it still had significant emotional and job-related impacts on clinicians. These troubling results highlight the need for further studies to be conducted in the US.

Workplace violence in radiology: results of a systematic review

BACKGROUND

Workplace violence (WPV) is a growing issue in health care with far-reaching consequences for health workers' physical and psychological well-being. While some medical specialities like emergency medicine have always been considered at higher risk for WPV, several studies have also reported its occurrence in radiology.

AIMS

This systematic review aimed to comprehensively synthesize the types of WPV in radiology, its psychological impact, and the underlying risk and protective factors.

METHODS

We searched five electronic databases (PubMed, Web of Science Core Collection, Scopus, PsycINFO and CINAHL) and additional literature, including grey literature, and established weekly search alerts. Two reviewers independently conducted all methodological steps, involving a third reviewer in case of disagreement.

RESULTS

Of the 12 205 retrieved records, 103 full-text articles were evaluated, and 15 studies were included. Across studies, verbal aggression, sexual harassment (mostly against women) and physical violence were experienced by up to 100%, 85% and 46% of health workers, respectively. Perpetrators were patients and patients' caregivers, followed by co-workers. Victims suffered from various psychological symptoms, such as anxiety (22%-54%), fear (6%-39%), depression (32%) and repeated disturbing memories (21%). Risk factors included female gender, understaffing, worker inexperience, poor communication and lengthy waiting times. Social support and security personnel presence were among the identified protective factors.

CONCLUSIONS

Health workers are at high risk of experiencing WPV in the radiological setting, with a strong psychological impact. Radiological departments should create a safe healthcare environment that actively manages the identified risk factors and offers psychological support to affected workers.

Systematic Violence Monitoring to Reduce Underreporting and to Better Inform Workplace Violence Prevention Among Health Care Workers: Before-and-After Prospective Study

BACKGROUND

Monitoring workplace violence (WPV) against health care workers (HCWs) through incident reporting is crucial to drive prevention, but the actual implementation is spotty and experiences underreporting.

OBJECTIVE

This study aims to introduce a systematic WPV surveillance in 2 public referral hospitals in Italy and assess underreporting, WPV annual rates, and attributes "before" (2016-2020) and "after" its implementation (November 2021 to 2022).

METHODS

During 2016-2020, incident reporting was based on procedures and data collection forms that were neither standardized between hospitals nor specific for aggressions. We planned and implemented a standardized WPV surveillance based on (1) an incident report form for immediate and systematic event notification, adopting international standards for violence definitions; (2) second-level root cause analysis with a dedicated psychologist, assessing violence determinants and impacts and offering psychological counseling; (3) a web-based platform for centralized data collection; and (4) periodic training for workforce coordinators and newly hired workers. We used data from incident reports to estimate underreporting, defined as an observed-to-expected (from literature and the "before" period) WPV ratio less than 1, and the 12-month WPV rates (per 100 HCWs) in the "before" and "after" periods. During the latter period, we separately estimated WPV rates for first and recurrent events.

RESULTS

In the "before" period, the yearly observed-to-expected ratios were consistently below 1 and as low as 0.27, suggesting substantial violence underreporting of up to 73%. WPV annual rates declined in 1 hospital (from 1.92 in 2016 to 0.57 in 2020) and rose in the other (from 0.52 to 1.0), with the divergence being attributable to trends in underreporting. Available data were poorly informative to identify at-risk HCW subgroups. In the "after" period, the observed-to-expected ratio rose to 1.14 compared to literature and 1.91 compared to the "before" period, consistently in both hospitals. The 12-month WPV rate was 2.08 (95% CI 1.79-2.42; 1.52 and 2.35 in the 2 hospitals); one-fifth (0.41/2.08, 19.7%) was due to recurrences. Among HCWs, the youngest group (3.79; P<.001), nurses (3.19; P<.001), and male HCWs (2.62; P=.008) reported the highest rates. Emergency departments and psychiatric wards were the 2 areas at increased risk. Physical assaults were more likely in male than female HWCs (45/67, 67.2% vs 62/130, 47.7%; P=.01), but the latter experienced more mental health consequences (46/130, 35.4% vs 13/67, 19.4%; P=.02). Overall, 40.8% (53/130) of female HWCs recognized sociocultural (eg, linguistic or cultural) barriers as contributing factors for the aggression, and 30.8% (40/130) of WPV against female HCWs involved visitors as perpetrators.

CONCLUSIONS

A systematic WPV surveillance reduced underreporting. The identification of high-risk workers and characterization of violence patterns and attributes can better inform priorities and contents of preventive policies. Our evaluation provides useful information for the large-scale implementation of standardized WPV-monitoring programs.

The impact of clinical experience on working tasks and job-related stress: a survey among 1032 Norwegian GPs

BACKGROUND

General practice is a generalist discipline fraught with complexity. For inexperienced physicians, it may be demanding to get to grips with the clinical challenges. The purpose of this article is to describe possible differences in the range of tasks between inexperienced and experienced general practitioners (GPs), and the extent to which clinical experience affects the way in which GPs perceive their daily work.

METHODS

An online questionnaire was sent to all regular GPs in Norway (N = 4784) in 2018. The study sought to document the tasks performed during a typical working day and how the GPs perceived their working situation. In this study, we compare the tasks, working situation and occurrence of potentially conflictual consultations among 'less experienced physicians' (≤ 5 years of experience in general practice) versus 'more experienced physicians' (> 5 years of experience). The findings are discussed in light of theories on development of expertise.

RESULTS

We received responses from 1032 GPs; 296 (29%) were less experienced and 735 (71%) more experienced. The two groups reported virtually the same number of consultations (19.2 vs. 20.5) and clinical problems handled (40.4 vs. 44.2) during the study day. The less experienced physicians reported a higher proportion of challenging and/or conflictual consultations, involving prescriptions for potentially addictive medication (5.7% vs. 3.1%), sickness certification (4.1% vs. 2.4%) and referral for medical investigations on weak clinical indication (8.1% vs. 5.6%). For other clinical issues there were minor or no differences. Both GP groups reported high levels of work-related stress with negative effect on self-perceived health (61.6% vs 64.6%). GPs who felt that high job demands harmed their health tended to handle a slightly higher number of medical issues per consultation and more consultations with elements of conflict.

CONCLUSIONS AND IMPLICATIONS

Inexperienced GPs in Norway handle a workload comparable to that of experienced GPs, but they perceive more conflictual consultations. These findings have relevance for training and guidance of future GP specialists. Irrespective of experience, the GPs report such high levels of negative work-related stress as to indicate an acute need for organisational changes that imply a reduced workload.

Analysis of physical violence incidents against physicians in Turkey between 2008 and 2018

BACKGROUND

Violence against physicians is a global issue that causes impaired physical and mental health, declined work quality, resignations, and even suicides. Studies regarding violence against physicians are very limited. Therefore, our aim is to investigate the physical violence incidents against physicians presented in print media between 2008 and 2018.

METHODS

A total of 8612 news reports acquired in national news database via 45 keywords were assessed. Five hundred and sixty-four of the reports met the inclusion criteria and were retrospectively analyzed.

RESULTS

Of 5964 news reports, 3754 (62.9%) were reprimands and protests against violence incidents. In 11 years, 560 individual incidents occurred where 647 physicians were physically assaulted, with 2267 news reports written on those incidents. The number of incidents increased over the years, and in 2012 both the number of incidents (n=91) and news reports count per incident were found highest. About 77.7% of assaulted physicians were male, and incident rate was higher in Western Turkey (42.15%). In 11 years, ten dedicated physicians have lost their lives in the line of duty. Emergency medicine (20.4%), primary care (9.89%) were the departments most exposed to physical violence. The claim of receiving inadequate medical attention was noted to be the primary allegation of the assailants.

CONCLUSION

The frequency of physical violence incidents against physicians is increasing. Throughout the study period, news reports containing condemnations, critiques, and protests are also more frequently, yet not adequately, placed in print media. Thus, social and public awareness ought to be enhanced through national and global media outlets. Furthermore, extensive measures must be taken by governments in order to prevent and eliminate violence.

Analysis of Career Stage, Gender, and Personality and Workplace Violence in a 20-Year Nationwide Cohort of Physicians in Norway

IMPORTANCE

Workplace violence (WPV) is a worldwide problem in health services. Several studies have pointed to organizational factors, such as working in psychiatry and work stress. However, there is a lack of long-term longitudinal cohort studies with respect to trends during the career and individual factors among physicians.

OBJECTIVE

To investigate WPV trends during Norwegian physicians' careers and assess individual and work-related factors associated with WPV in a long-term longitudinal study.

DESIGN, SETTING, AND PARTICIPANTS

This cohort study involved 2 nationwide medical student cohorts who graduated 6 years apart and were surveyed at graduation (T1: 1993-1994 and 1999) and 4 years later (T2), 10 years later (T3), 15 years later (T4), and 20 years after graduation (T5). Generalized estimated equations were used. Statistical analysis was performed from January to September 2020.

EXPOSURES

Medical career during 20 years in Norway.

MAIN OUTCOMES AND MEASURES

WPV was measured as threats or acts of violence from a patient or visitor experienced at least twice, at each of the stages after leaving medical school. Individual factors were obtained at T1 and work-related factors at T2 through T5. We analyzed WPV by repeated measures.

RESULTS

At T1, a total of 893 participants (with a mean [SD] age of 28 (2.83) years; 499 [56%] women) responded to the questionnaire. The prevalence of multiple threats of violence was 20.3% (156 of 769) at T2, 17.1% (118 of 691) at T3, 11.2% (66 of 588) at T4, and 8.6% (46 of 536) at T5; and the prevalence of multiple acts of violence was 4.3% (33 of 763) at T2, 5.2% (36 of 687) at T3, 3.1% (18 of 584) at T4, and 2.2% (12 of 532) at T5. There was a decline from T2 to T5 of both multiple threats (β = -1.06; 95% CI, -1.31 to -0.09; P < .001) and acts of violence (β = -1.13; 95% CI, -1.73 to -0.53; P < .001). In adjusted analysis, factors associated with multiple threats of violence were male gender (odds ratio [OR], 2.76; 95% CI, 1.73 to 4.40; P < .001), vulnerability trait (neuroticism) (OR, 0.90; 95% CI, 0.82 to 0.99; P = .03), young physician cohort (OR, 1.63; 95% CI, 1.04 to 2.58; P = .04), and working in psychiatry (OR, 7.50; 95% CI, 4.42 to 12.71; P < .001). Factors associated with multiple acts of violence in adjusted analysis were male gender (OR, 3.37; 95% CI, 1.45 to 7.84; P = .005), young physician cohort (OR, 6.08; 95% CI, 1.68 to 21.97; P = .006), and working in psychiatry (OR, 12.34; 95% CI, 5.40 to 28.23; P < .001). There were no interactions with gender or cohort in the significant associated factors.

CONCLUSIONS AND RELEVANCE

Higher rates of multiple threats and acts of violence were observed during early medical careers, among male physicians, and in psychiatry. Low levels of the vulnerability trait (neuroticism) were associated with the experience of multiple threats. There was an association between the young physician cohort and WPV. Preventive efforts should include early-career and male physicians, with additional emphasis on personality.

Aggressive Behavior and Psychiatric Inpatients: a Narrative Review of the Literature with a Focus on the European Experience

PURPOSE OF REVIEW

We summarized peer-reviewed literature on aggressive episodes perpetrated by adult patients admitted to general hospital units, especially psychiatry or emergency services. We examined the main factors associated with aggressive behaviors in the hospital setting, with a special focus on the European experience.

RECENT FINDINGS

A number of variables, including individual, historical, and contextual variables, are significant risk factors for aggression among hospitalized people. Drug abuse can be considered a trans-dimensional variable which deserves particular attention. Although mental health disorders represent a significant component in the risk of aggression, there are many factors including drug abuse, past history of physically aggressive behavior, childhood abuse, social and cultural patterns, relational factors, and contextual variables that can increase the risk of overt aggressive behavior in the general hospital. This review highlights the need to undertake initiatives aimed to enhance understanding, prevention, and management of violence in general hospital settings across Europe.

The effect of workplace violence on depression among medical staff in China: the mediating role of interpersonal distrust

OBJECTIVE

Workplace violence has been recognized globally as a serious occupational hazard in health service occupations, and existing studies have identified that workplace violence can significantly lead to depression. Interpersonal distrust, an important topic, has also been proved associated with workplace violence and depression. However, the mediating effect of interpersonal distrust has not been tested before. Results of such testing can help us to understand further the effect mechanism of workplace violence on depression.

METHODS

In the current study, we collected 3426 valid questionnaires based on a cross-sectional design distributed among medical staff in Chinese hospitals. Depression, workplace violence, interpersonal distrust, social support, physical diseases, and some other social-demographic variables were evaluated. SPSS macros program (PROCESS v3.3) was used to test the mediating effect of interpersonal distrust on the association between workplace violence and depression.

RESULTS

The data analyzed in the current study demonstrated that 52.2% of medical staff had experienced workplace violence before. Experiencing verbal violence (β = 2.99, p < 0.001), experiencing physical violence (β = 3.70, p < 0.01), experiencing both kinds of violence (β = 4.84, p < 0.001), high levels of interpersonal distrust (β = 0.22, p < 0.001), working as a nurse (β = 1.10, p < 0.05), working as a manager (β =  - 1.72, p < 0.001), suffering physical disease (β = 3.35, p < 0.001), and receiving social support (β =  - 0.23, p < 0.001) were significantly associated with depression. Workplace violence had not only positive direct effects on depression, but also an indirect effect on depression through interpersonal distrust as a mediator.

CONCLUSION

Interpersonal distrust can mediate the association between workplace violence and depression. Increasing interpersonal trust or reducing workplace violence would be beneficial to promoting mental health status among medical staff.

Extent and risk factors of psychological violence towards physicians and Standardised Residency Training physicians: a Northern China experience

Purpose

Physicians and Standardised Residency Training physicians (SRTPs) have relatively high exposure to psychological violence. Its adverse effects are far greater than those of physical violence. However, no previous research has paid attention to the problem of psychological violence among them. This study aims to evaluate the extent, characteristics, and risk factors of psychological violence among SRTPs in comparison to physicians, and also to highlight the psychological violence experienced by SRTPs and suggest preventive measures.

Methods

A cross-sectional survey was conducted in northern China. 884 physicians and 537 SRTPs completed a questionnaire which compiled by the ILO, ICN, WHO and PSI in 2003 to measure violence in the workplace. Descriptive statistics and logistic regression analysis were used to analyse results.

Results

The effective response rates of physicians and SRTPs were 63.1%(884/1400) and 86.3%(537/622) respectively. 73.0%(645/884) of physicians and 24.8%(133/537) of SRTPs suffered psychological violence in the past year. Compared to physicians (29/645, 4.5%), SRTPs (42/133, 31.6%) experience more internal violence. Further, after experiencing psychological violence, physicians are willing to talk to family and friends, but SRTPs generally take no action. Shift work was a risk factor for both physicians (OR 1.440, 95% CI 1.014–2.203) and SRTPs (OR 1.851, 95% CI 1.217–2.815) suffering from psychological violence. In contrast, no anxiety symptoms protected physicians (OR 0.406, 95% CI 0.209–0.789) and SRTPs (OR 0.404, 95% CI 0.170–0.959) against psychological violence.

Conclusions

SRTPs and physicians in northern China have a high risk of experiencing psychological violence, and physicians experience more. Meanwhile, there are obvious differences in responses to psychological violence and risk factors between them. Therefore, medical institutions should pay more attention to psychological violence, especially among SRTPs, such as supporting the reporting of psychological violence, strengthening team relationships, and providing psychological comfort and counselling.

Trial registration number (Project Identification Code: HMUIRB20160014), Registered May 10, 2016.

Workplace violence against hospital healthcare workers in China: a national WeChat-based survey

BACKGROUND

Workplace violence (WPV) is a serious issue for healthcare workers and leads to many negative consequences. Several studies have reported on the prevalence of WPV in China, which ranges from 42.2 to 83.3%. However, little information is available regarding the correlates of WPV among healthcare workers and the differences across the different levels of hospitals in China. This study aimed to explore the correlates of WPV and career satisfaction among healthcare workers in China.

METHODS

A self-designed WeChat-based questionnaire was used that included demographic and occupational factors. The Chinese version of the Workplace Violence Scale was used to measure WPV. Career satisfaction was assessed using two questions about career choices. Descriptive analyses, chi-square tests and multivariate logistic regressions were used.

RESULTS

A total of 3706 participants (2750 nurses and 956 doctors) responded to the survey. Among the 3684 valid questionnaires, 2078 (56.4%) reported at least one type of WPV in the last year. Multivariate logistic regressions revealed that male sex, shift work, bachelor's degree education, a senior professional title, working more than 50 h per week and working in secondary-level hospitals were risk factors associated with WPV. Healthcare workers who had experienced higher levels of WPV were less likely to be satisfied with their careers.

CONCLUSIONS

WPV remains a special concern for the Chinese healthcare system. Interventions to reduce WPV should be implemented by health authorities to create a zero-violence practice environment.

[Experiences of aggression and violence against ophthalmologists]

BACKGROUND

The media have reported an increased willingness of patients and relatives to use violence against medical personnel. So far a few studies have been carried out on this topic and the data situation is correspondingly weak. Ophthalmologists in particular have close contact with patients at the slit lamp and are often alone with patients.

METHODS

A questionnaire was developed based on the perception of prevalence of aggression scale (POPAS) questionnaire and the survey on aggression and violence among general practitioners. In autumn 2018, all members of the German Ophthalmological Society (DOG) and the Professional Association of Ophthalmologists (BVA) received an invitation by e‑mail to complete the questionnaire online.

RESULTS

Of the 9411 ophthalmologists contacted a total of 1508 (age 49 ± 12 years) took part in the survey (16%). Of the respondents 806 (53.7%) were female and 1139 (75.5%) participants worked in practices. A total of 1264 (83.3%) ophthalmologists had experienced aggression/violence in their work, 986 (65%) respondents had already experienced verbal assaults without threats, 363 (24.1%) doctors reported experiences with threats of physical violence and 30 (2%) participants had received medical treatment for severe physical violence. Sexual intimidation/harassment was affirmed by 322 (21.4%) of respondents, of whom 243 (75.5%) were female and 533 (47.9%) doctors felt that aggressive/violent behavior had increased in the last 5 years.

CONCLUSION

The high number of participants indicates the high relevance of the topic. The survey produced astonishing results, which should lead to further discussion and action to improve the safety of employees.

NURSE’S MANAGEMENT OF WORKPLACE VIOLENCE SITUATIONS IN THE FAMILY HEALTH STRATEGY

ABSTRACT Objectives: to identify situations of violence in the daily work of the health professionals of the Family Health Strategy and to describe the conducts adopted by these professionals in relation to the situations of violence identified. Method: a qualitative, descriptive and exploratory study whose scenario was a Family Clinic of the city of Rio de Janeiro. Eighteen health professionals participated. Data was collected through semi-structured interviews and subjected to content analysis. Results: three thematic categories emerged: Situations of workplace violence in the Family Health Strategy; Consequences of workplace violence on the Family Health Strategy; The nurse's role as leader of the Family Health Team and the strategies adopted in the face of workplace violence. Conclusions: situations of interpersonal violence and collective violence were identified, exemplified by the contact with armed violence in the territory, racial discrimination, peer violence and violence suffered by the user, such as domestic violence, directly affecting the professional. The importance is highlighted of the nurse's role as leader of the Family Health Strategy team, envisioning the management of violence situations, often neglected.

Workplace Violence and Sanctioning of Family Medicine Physicians Due to the Rules of Health Insurance Funds in the Western Balkan

INTRODUCTION

After family medicine's famous beginnings in the early 60's through introduction of the world's first family medicine specialization, with transitional changes and war also come changes in former Yugoslavia's healthcare systems.

AIM

The primary aim of this article is to analyze frequency and causes of sanctioning of family physicians by Health insurance funds in the countries of former Yugoslavia. The secondary aim is to evaluate frequency and types of workplace violence family physicians experienced due to insurance boundaries for patients.

METHODS

The comparative, cross-sectional survey was carried out from October 2017 to February 2018. Study participants were general practitioners' (GPs), family physicians (FPs) and those without a specialty designation but providing family medicine services in one of the five Western Balkans countries: Croatia, Slovenia, Serbia, Macedonia and Bosnia and Herzegovina (B&H). The questionnaire was designed for the purpose of the study.

RESULTS

Forty-nine percent of participating physicians have been sanctioned by Health Insurance Fund and 77. 5% has been exposed to workplace violence. The most common type of violence was verbal (76.6%). Financial penalties according to the scale had the highest rates in Macedonia (73.9%) and Slovenia (43.9%).

CONCLUSION

It is necessary to educate creators of healthcare policies, doctors and patients for the purpose of establishing partner relations which would lead to strengthening of primary healthcare, but also to a more efficient healthcare system.

Le aggressioni al personale sanitario, uno studio osservazionale nei medici dell’Ordine di Roma

INTRODUCTION

Aggressions to healthcare personnel are a growing and underestimated phenomenon. The damage to the individual and to the community is real, since the assaults increase work stress and can also lead to sickness absence. Moreover, the consequences on the quality of care and economic repercussions need to be taken into account.

OBJECTIVE

To estimate the prevalence of violence towards medical personnel of the College of Physicians and Surgeons of Rome and to evaluate its association with socio-demographic variables.

METHODS

Cross-sectional study. espondents completed an online questionnaire composed of 30 questions on personal information, work, any aggression suffered and opinions about the phenomenon. Descriptive statistical analysis, univariate, bivariate and multivariate analyses were performed.

RESULTS

Out of 956 responders, 66.5% experienced at least one episode of aggression during their working life. Women were more likely victims than men (71%), especially due to verbal aggression (OR 1.53, 95%CI: 1.16-2.02). Age acts as a protective factor (OR 0.97; 95%CI: 0.96-0.99). The subjects with a full time position (OR 2.1; 95%CI: 1.46-3.05) seem to be more at risk. In addition, the doctors employed in the territorial structures of the National Health System (OR 2.08; 95%CI: 1.36-3.18), as well as in the local emergency services (OR 3.39; 95%CI: 1.14-10.05) and in social security institutions (OR 9.58; 95%CI:1.2-76.41) were more at risk.

CONCLUSIONS

The results of this study reveal that the phenomenon of aggression is not negligible, and that awareness on the issue and staff training is essential.

User violence in mental health services: Adaptation of an instrument. Healthcare-workers' Aggressive Behavior Scale-Users-Mental Health Version (HABS-U-MH)

Background/Objetive

According to the World Health Organization, one out of every four violent workplace acts takes place in the health setting. The aims of the study are to adapt the Healthcare-workers’ Aggressive Behavior Scale-Users (HABS-U) to mental health professionals, to establish the frequency of exposure to hostile indicators and to determine which professional group is most exposed.

Method

Study through qualitative and quantitative methodology in MH professionals of the Region of Murcia (Spain). In the qualitative phase, 12 in-depth interviews were conducted, and during the quantitative phase, the instrument was applied to 359 professionals of Mental Health Services (MHS).

Results

Non-medical and nursing staff were found to be the professional group most exposed, as well as Brief Psychiatric Inpatient and Medium-Stay Inpatient Services.

Conclusion

The resulting scale shows excellent psychometric properties. The distribution of user violence is not homogeneous among the different professional groups of MHS. The adaptation of the scale may be useful to detect user violence, as well as to evaluate the efficacy of intervention programs.

The association between workplace violence and physicians' and nurses' job satisfaction in Macau

Background

This paper describes the association between workplace violence and job satisfaction among physicians and nurses in Macau. Convenience sampling was sourced from six health centers under the Macau Health Bureau.

Methods

This study uses a cross-sectional self-administrative survey. The study used case studies research instruments for workplace violence in the health sector by country (from the ILO, ICN, WHO, PSI), the Minnesota Satisfaction Questionnaire and Perceived Stress Scale. The data collection period spanned from August to December, 2014.

Data analysis

Multiple logistic regression examines levels of intrinsic and extrinsic satisfaction in physicians and nurses and significant correlates affecting their job satisfaction.

Results

A total of 720 (14.9% physicians) participants were recruited. 57.2% of participants reported physical and psychological workplace violence in the preceding year. The most common forms of workplace violence were verbal abuse (53.4%), physical assault (16.1%), bullying / harassment (14.2%), sexual harassment (4.6%) and racial harassment (2.6%). Nurses were at a significantly higher risk of physical assault and verbal abuse compared to physicians. Patients, patients’ relatives, and colleagues were the main perpetrators. Worry about WPV, on-call duty and shift work, experience of bullying and verbal abuse and employment sector emerged as significant correlates affecting the intrinsic and extrinsic job satisfaction of physicians and nurses. Frontline staff, aged 30 and 39, coming from an ethnic minority, and perceived stress were significant correlates affecting nurses’ job satisfaction.

Conclusions

WPV remains a significant concern in healthcare settings in Macau. Stakeholders should legally enforce a zero-tolerance policy towards WPV within healthcare workplaces. WPV is detrimental to healthcare professionals’ mental wellbeing, risking irreversible physical and psychological harm for its victims.