Violence at work

Application of the theory of planned behaviour for predicting the determinants of workplace violence reporting behaviour among public hospital healthcare workers in Malaysia: A cross-sectional study

Introduction

Reporting workplace violence (WPV) is a crucial preventive measure. Given the great impact of WPV on mental health and well-being, this study aimed to determine the prevalence and determinants of WPV reporting among healthcare workers (HCWs).

Method

A total of 557 public hospital HCWs in Melaka were recruited via probability sampling. A questionnaire guided by the theory of planned behaviour was developed, pre-tested and distributed. Malaysians with a minimum employment period of 12 months who experienced WPV within the same period in the selected public hospitals were eligible for inclusion. Multiple logistic regression analysis was conducted to determine the association between the independent variables and WPV reporting.

Results

Psychological violence was the most common WPV (80.3%), with only 177 (31.8%) respondents reporting such. The respondents who had high subjective norm (adjusted odds ratio [AOR]=2.160, 95% confidence interval [CI]=1.32-3.53) and perceived behavioural control scores (AOR=3.976, 95% CI=2.41-6.55); were clinical (AOR=2.679, 95% CI=1.43-5.02) and non-clinical (AOR=4.271, 95% CI=2.23-8.18) support staff; experienced physical WPV (AOR=13.157, 95% CI=3.83-45.24) and both physical and psychological WPV (AOR=2.029, 95% CI= 1.13-3.65); and perceived that WPV was intentional (AOR=11.111, 95% CI=6.50-19.00) were more likely to report WPV.

Conclusion

HCWs who experience physical WPV have the highest likelihood to report, followed by those who perceive WPV as intentional. The prevalence of reported WPV among public hospital HCWs is low, potentially underestimating its true occurrence owing to underreporting. Ensuring readily available reporting mechanisms for WPV, especially the psychological type, is crucial for HCWs.

Understanding violence when the perpetrator has an intellectual disability: The perceptions of professionals

AIM

The research sought to enhance professional understanding of the violence perpetrated by some people with an intellectual disability.

BACKGROUND

The violent behaviour exhibited by some people with intellectual disabilities remains poorly understood, particularly with regard to a clear and informative definition.

DESIGN

A qualitative study investigated the views and perceptions of professionals working directly with people with an intellectual disability in different settings.

METHODS

Twenty-two semi-structured interviews were undertaken with professionals from a variety of backgrounds, and four themes were generated through data analysis.

FINDINGS

Themes produced comprised the degree of intellectual disability, impulsivity, intentionality and unpredictability. Findings indicated tension between understanding violence as purposeful and explaining it in relation to the intellectual disability and/or additional conditions.

CONCLUSION

Intellectual disability is central to understanding the impact of the other three themes, though there is a professional reluctance to use such knowledge as evidence to inform practice.

Aggression against Doctors: A Review

Although the number of doctors abused is comparatively small, the perceived risk of violence presents a major issue for the whole profession since the consequences extend to all doctors through the intimidation reports in the medical press and newspapers engender.

Violence against nurses in hospitals: prevalence and effects

There is abundant evidence to suggest that violence in healthcare settings, especially in emergency departments (EDs) and psychiatry, is escalating and that nurses are particularly vulnerable. The authors, therefore, investigated the prevalence and effects of violence against nurses in an ED in a general hospital setting in Kuwait. A 12-item frequency-weighted questionnaire was used to measure rates, frequency and severity of violence. The questions related to the experience of violent incidents during the past year. Seventy out of 81 nurses experienced verbal insults or threats of imminent violence and 13 were also physically attacked during the 1-year period. Sixty-seven out of 70 nurses suffered from one or more after-effects, including flashbacks, sleeplessness, fearfulness, depression or taking time off work. Violence in healthcare services often reflects the community in which service is provided. Our findings suggest that doctors experience more violence but nurses suffer from more after-effects of violence at work.

Violence against trainee paediatricians

BACKGROUND

Much research has looked at the extent of violence against doctors, but this has been restricted mainly to psychiatry, general practice, and accident and emergency.

AIMS

To assess the level of violence against trainee paediatricians.

METHODS

A telephone questionnaire was addressed to 25 specialist registrars/senior registrars/senior SHOs in each of three regions in the UK: Northern Ireland, South Thames, and North West England.

RESULTS

Sixty eight of 75 (90.7%) trainee paediatricians had been exposed in at least one circumstance to a violent incident, 47 of which incidents (62.3%) had occurred in the past year. Thirty one (41%) had suffered threats on at least one occasion. Although only 5.3% of the interviewees had been victims of actual physical assault, more than 10% said that an attempted assault had taken place. Most of the doctors who had experienced a violent episode (41/68) worried about the incident after return from work and yet only one was offered any counselling. Only nine (13.2%) had ever formally reported an incident to hospital management. Less than 10% of those questioned had received any formal training in the management of violent people, although 99% thought this would be a good idea.

CONCLUSIONS

Paediatric trainees are involved in high risk situations at work (for example, child protection and casualty) which frequently result in exposure to violence. Very few report these incidents officially, but often underplay them. More attention should be given to the training and counselling needs of paediatric trainees.

The occupational hazards of emergency physicians

Emergency physicians are exposed to a variety of occupational hazards. Among these are infectious diseases, such the human immunodeficiency virus, hepatitis B and C viruses, and tuberculosis. Hepatitis G virus is transmissible but may not be a cause of illness. The likelihood of being exposed to these agents appears to be higher in the ED than other medical settings but estimates of the prevalence of these diseases in the ED vary, depending on the patient population served. Estimates of risk for contracting these infections are reviewed. Measures to prevent these exposures can reduce risk, but compliance is low, particularly for those involving changes in the behavior of emergency physicians (such as not recapping needles). Latex allergy is a hazard of health care workers. Its prevalence is reported to be quite high, but these findings are difficult to interpret in the absence of a universally accepted definition of the condition. Its prevalence in emergency physicians is not known. Other noninfectious hazards include workplace violence and exposure to nitrous oxide. The health effects of rotating shift work may put emergency physicians at increased risk of coronary artery disease and impaired reproductive health. Emotional stress is another hazard of emergency physicians, and may lead to burnout.

Violence towards doctors: prevalence and effects

Violence against doctors has already been identified as a matter of particular concern. Both the severity and the psychological sequelae of violence are difficult to quantify. This study was aimed at measuring the rates and severity, and determining the effects, of violence in doctors working in a general hospital.

Work-related physical assault

Violence in the workplace is a serious public health problem. Yet, to date, little has been documented relevant to non-fatal events associated with physical assault. The aim of the present study was to identify the magnitude of work-related physical assault in Minnesota and to identify potential risk factors; both fatal and non-fatal cases were included. Minnesota workers' compensation records, relevant to assault, were used to identify 712 cases involving more than three days of lost work time for 1992; six homicide cases were included. Assault rates were calculated by industry and occupation. Women had an assault rate twice that of men (51 versus 26 per 100,000 workers). Workers in industries of social services (340), health services (202), and transportation (914) had the highest rates of assault per 100,000 full-time employees. The fact that in addition to overall workers' compensation costs of $1.6 million, the average lost time for closed compensated cases was 54 days (median, 14 days) and time to reach maximum medical improvement for 44% of the cases reporting was 156 days (median, 83 days), indicates a major problem. The findings suggest that specific groups of workers are at risk for physical assault on the job. Further research is essential to identify specific risk factors that will enable the development of appropriate prevention strategies.

Reviews in accident and emergency medicine: the past and the future

OBJECTIVE

To determine whether reviews published in the past 10 years are as helpful as they could be to their readers, and to explain why future reviews should meet certain methodological criteria.

METHODS

The quality of 16 reviews published in two journals dealing with accident and emergency medicine over 10 years was objectively assessed using 11 currently recommended criteria.

RESULTS

The median number of methodological criteria satisfied was two. Only five of the reviews posed a specific question or problem and then answered this with conclusions based on evidence presented.

CONCLUSIONS

If reviews are to enhance patient care, the way in which they are performed, written and used must change.

Aggression against doctors: a review

Although the number of doctors abused is comparatively small, the perceived risk of violence presents a major issue for the whole profession since the consequences extend to all doctors through the intimidation reports in the medical press and newspapers engender.