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Pien LC, Cheng Y, Lee FC, Cheng WJ. The effect of multiple types of workplace violence on burnout risk, sleep quality, and leaving intention among nurses. Ann Work Expo Health 2024:wxae052. [PMID: 38888222 DOI: 10.1093/annweh/wxae052] [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: 01/10/2024] [Accepted: 05/30/2024] [Indexed: 06/20/2024] Open
Abstract
OBJECTIVE The aim of our study is to explore the associations between multiple types of workplace violence (WPV) and burnout risk, sleep problems, and leaving intention among nurses. METHODS This cross-sectional survey recruited 1,742 nurses, and data on WPV experiences were collected through self-administered questionnaires. Work conditions, burnout risk scales, sleep quality, and leaving intentions were also evaluated. Multivariate logistic regression analyses were performed to examine the associations of WPV with burnout risk, sleep quality, and leaving intentions, adjusting for demographic characteristics and work conditions. RESULTS The study found that 66.7% of nurses reported experience of WPV, with 26.9% experiencing both physical and nonphysical forms. Those who experienced multiple types of WPV reported worse work conditions, higher burnout risk, poorer sleep quality, and a stronger leaving intention compared to those without such experiences. Adjusting for working conditions, logistic regression analysis showed that nurses who experienced multiple types of WPV had 2.12-fold higher odds of high personal burnout risk, 2.36-fold higher odds of high client-related burnout risk, 1.95-fold higher odds of poor sleep quality, and 1.80-fold higher odds of high leaving intention, compared to those without WPV experiences. CONCLUSIONS Strategies by hospital managers and policymakers to monitor and reduce workplace violence are vital for sustaining nurses' mental health, well-being, and preventing early attrition from the profession.
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Affiliation(s)
- Li-Chung Pien
- Post-Baccalaureate Program in Nursing, College of Nursing, Taipei Medical University, 250 Wuxing St., Taipei, 11031, Taiwan
- Psychiatric Research Center, Wanfang Hospital, Taipei Medical University, No. 111, Sec. 3, Xinglong Rd., Taipei, 116079, Taiwan
- Department of Nursing, Wanfang Hospital, Taipei Medical University, No. 111, Sec. 3, Xinglong Rd., Taipei, 116079, Taiwan
| | - Yawen Cheng
- Institute of Health Policy and Management, College of Public Health, National Taiwan University, 17 Xuzhou Road, Taipei 100, Taiwan
| | - Fang-Chun Lee
- Nursing Department, Taipei City Hospital Songde Branch, 145 Zhengzhou Rd., Taipei, 103212, Taiwan
| | - Wan-Ju Cheng
- National Center for Geriatrics and Welfare Research, National Health Research Institutes, 35 Keyan Rd., Zhunan, Miaoli County, 35053, Taiwan
- Department of Psychiatry, China Medical University Hospital, 2 Yude Rd., Taichung, 404327, Taiwan
- Department of Public Health, China Medical University, 100 Sec. 1, Jingmao Rd., Taichung, 706040, Taiwan
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Li C, Fu C. Workplace violence and depressive symptoms: the mediating role of fear of future workplace violence and burnout among Chinese nurses. BMC Psychiatry 2024; 24:379. [PMID: 38773476 PMCID: PMC11110276 DOI: 10.1186/s12888-024-05827-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2024] [Accepted: 05/09/2024] [Indexed: 05/23/2024] Open
Abstract
BACKGROUND The mechanisms underlying the relationship between workplace violence (WPV) and depressive symptoms in nurses have been less studied. This study aims to examine the mediating role of fear of future workplace violence (FFWV) and burnout in the association between WPV and depressive symptoms. METHODS We conducted a cross-sectional web survey at 12 tertiary hospitals in Shandong province, China, in 2020. The Center for Epidemiologic Studies Depression Scale (CESD-10), the Chinese version of the Maslach Burnout Inventory-General Survey and the Fear of Future Violence at Work Scale were used to collect data. Descriptive statistics, independent sample t-test, one-way analysis of variance, Pearson's correlation coefficient, and ordinary least squares regression with bootstrap resampling were used to analyze the data. RESULTS The prevalence of depressive symptoms was 45.9% among nurses. The regression model showed that FFWV and burnout mediated the relationship between WPV and depressive symptoms. The total effects of WPV on depressive symptoms (3.109, 95% bootstrap CI:2.324 - 3.713) could be decomposed into direct (2.250, 95% bootstrap CI:1.583 - 2.917) and indirect effects (0.769, 95% bootstrap CI:0.543 - 1.012). Indirect effects mediated by FFWV and burnout were 0.203 (95% bootstrap CI:0.090 - 0.348) and 0.443 (95% bootstrap CI:0.262 - 0.642), respectively. Furthermore, serial multiple mediation analyses indicated that the indirect effect mediated by FFWV and burnout in a sequential manner was 0.123 (95% bootstrap CI:0.070 - 0.189). CONCLUSION The prevalence of depressive symptoms among Chinese nurses was high. The WPV was an important risk factor for depressive symptoms and its negative effect was mediated by FFWV and burnout. The importance of decreasing WPV exposure and level of FFWV and burnout was emphasized to prevent depressive symptoms among nurses. The findings implied that hospital managers and health policy makers should not only develop targeted interventions to reduce exposure to WPV in daily work among all nurses, but also provide psychological support to nurses with WPV experience to reduce FFWV and burnout.
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Affiliation(s)
- Chaofan Li
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, No. 44 Wenhua Xilu Road, Jinan, Shandong, China
- NHC Key Lab of Health Economics and Policy Research, Shandong University, No. 44 Wenhua Xilu Road, Jinan, Shandong, China
| | - Chang Fu
- Department of Health Service and Management, School of Health Management, Binzhou Medical University, No. 346 Guanhai Road, Yantai, Shandong, 264003, China.
- Department of Health Psychology, School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, No. 44 Wenhua Xilu Road, Jinan, Shandong, 250012, China.
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ČELOFIGA A, KOPRIVŠEK J, GREGORIČ KUMPERŠČAK H, KORES PLESNIČAR B. Incidence, Severity and Characteristics of Patients' Aggression in Acute Psychiatric Wards: Data from a Slovenian National Survey. Zdr Varst 2023; 62:190-197. [PMID: 37799416 PMCID: PMC10549252 DOI: 10.2478/sjph-2023-0027] [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: 06/06/2023] [Accepted: 09/14/2023] [Indexed: 10/07/2023] Open
Abstract
Aim To evaluate the incidence, severity and characteristics of aggressive behaviour in patients hospitalized in acute psychiatric wards, as well as the association between patient characteristics and the incidence of recurrent aggressive behaviour. Methods A multicentre prospective study included all twelve acute wards in Slovenian psychiatric hospitals with a total capacity of 232 beds. Over five consecutive months, data on the number of treatment episodes involving aggressive behaviour and the number of aggressive incidents, their severity and characteristics were obtained using the Staff Observation Aggression Scale-Revised (SOAS-R). Patient- and event-based incident rates of verbal and physical aggression were calculated. The association between patient characteristics and recurrent aggressive behaviour was analysed. Patient characteristics data were extracted from hospital databases. Results 3,190 treatment episodes were included during a 5-month period. Aggressive behaviour was observed in 13.4% of treatment episodes, and 922 aggressive incidents were recorded, which resulted in 3.98 incidents per 100 occupied bed days and 9.48 incidents per bed per year. 74.1% of incidents were severe, and more than half of incidents included physical aggression. 75.5% of incidents were directed against medical staff. 5.9% of treatment episodes were involved in multiple aggressive incidents. Compared to patients with single incidents, patients with recurrent aggression had a less frequent main diagnosis of substance use disorders and a longer duration of hospitalization. Conclusion Monitoring the frequency and characteristics of aggressive behaviour allows comparisons with other studies and, more importantly, it is necessary for planning and assessing the effectiveness of preventative aggression management strategies.
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Affiliation(s)
- Andreja ČELOFIGA
- University Medical Centre Maribor, Department of Psychiatry, Ljubljanska 5, 2000Maribor, Slovenia
| | - Jure KOPRIVŠEK
- University Medical Centre Maribor, Department of Psychiatry, Ljubljanska 5, 2000Maribor, Slovenia
| | - Hojka GREGORIČ KUMPERŠČAK
- University Medical Centre Maribor, Child and Adolescent Psychiatry Unit, Ljubljanska 5, 2000Maribor, Slovenia
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Lu DW, Zhan T, Bilimoria KY, Reisdorff EJ, Barton MA, Nelson LS, Beeson MS, Lall MD. Workplace Mistreatment, Career Choice Regret, and Burnout in Emergency Medicine Residency Training in the United States. Ann Emerg Med 2023; 81:706-714. [PMID: 36754699 DOI: 10.1016/j.annemergmed.2022.10.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Revised: 09/22/2022] [Accepted: 10/11/2022] [Indexed: 02/10/2023]
Abstract
STUDY OBJECTIVE The influence of workplace mistreatment on the well-being and career satisfaction of emergency medicine residents is unknown. This study examined the relationships between burnout, career choice regret, and workplace mistreatment in a national sample of emergency medicine residents. METHODS This was a secondary analysis of a survey study on the prevalence of workplace mistreatment among emergency residents. Residents who reported emotional exhaustion or depersonalization at least once per week were considered to have burnout. Residents who reported dissatisfaction with their decision to become an emergency physician were considered to have career choice regret. Respondents also reported the type (discrimination, abuse, sexual harassment) and frequency of mistreatment over the academic year. Multivariable logistic regression, adjusting for program characteristics, was used to examine resident characteristics associated with burnout and career choice regret, with the frequency of mistreatment as a covariate. RESULTS Of the 8,162 eligible residents, 7,680 (94.1 %) participated. About a third of respondents reported burnout (2,188 of 6,902, 31.7%), whereas a minority (224 of 6,923, 3.2%) reported career choice regret. Of the 7,087 responses on mistreatment frequency, 2,117 (29.9%) reported "a few times per year," and 1,296 (18.3%) reported "a few times per month or more." Compared with residents who never experienced mistreatment, residents who reported increasing frequencies of mistreatment were associated with having burnout-from mistreatment a few times per year (OR [odds ratio],1.6; 99% CI [confidence interval], 1.3 to 1.9) to a few times per month or more (OR, 3.3; 99% CI, 2.7 to 4.1). Compared with residents without burnout, residents who reported burnout were associated with having career choice regret (OR, 11.3; 99% CI, 7.0 to 18.1). After adjusting for burnout, there were no significant relationships between the frequency of mistreatment and career choice regret. CONCLUSIONS Workplace mistreatment is associated with burnout, but not career choice regret, among emergency medicine residents. Efforts to address workplace mistreatment may improve emergency medicine residents' professional well-being.
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Affiliation(s)
- Dave W Lu
- Department of Emergency Medicine, University of Washington, Seattle, WA.
| | - Tiannan Zhan
- Department of Surgery, Northwestern University, Chicago, IL
| | | | | | | | - Lewis S Nelson
- Department of Emergency Medicine, Rutgers University, New Brunswick, NJ
| | | | - Michelle D Lall
- Department of Emergency Medicine, Emory University, Atlanta, GA
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5
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Molero Jurado MDM, Gázquez Linares JJ, Pérez‐Fuentes MDC, Martos Martínez Á. Aggression and burnout in nurses during COVID-19: A cross-sectional study. Nurs Health Sci 2022; 25:130-140. [PMID: 36495247 PMCID: PMC9877851 DOI: 10.1111/nhs.13001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Revised: 10/27/2022] [Accepted: 12/02/2022] [Indexed: 12/14/2022]
Abstract
Workplace violence against nurses, an ever-present problem in the healthcare workplace, has been increasing with COVID-19 and affects occupational health. This study analyzed the consequences of COVID-19 on violence against nurses, identifying its association with burnout, emphasizing the importance of work-related variables. A total of 1013 actively employed nurses in Spain with a mean age of 34.71 years filled out a computer-assisted web interviewing survey. Aggression as a consequence of their work was reported by 73.44% of the nurses. Those most affected were in primary care, and verbal aggression by patients and their families was the most frequent. Nurses who were attacked scored significantly higher in emotional exhaustion and depersonalization. Furthermore, 83.22% said that COVID-19 was an important factor in the increase in violence toward healthcare workers. Analysis showed that a perceived secure environment was a mediator between the belief that COVID-19 was an influential factor in the increase of violence and the depersonalization dimension of burnout. Increasing perceived security in the work environment among nurses can be effective in promoting well-being, work performance, and commitment to the profession.
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Affiliation(s)
| | | | - María del Carmen Pérez‐Fuentes
- Department of Psychology, Faculty of PsychologyUniversity of AlmeríaAlmeríaSpain,Department of PsychologyUniversidad Politécnica y Artística del ParaguayAsunciónParaguay
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6
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Xiao Y, Chen TT, Zhu SY, Zong L, Du N, Li CY, Cheng HF, Zhou Q, Luo LS, Jia J. Workplace violence against Chinese health professionals 2013-2021: A study of national criminal judgment documents. Front Public Health 2022; 10:1030035. [PMID: 36339236 PMCID: PMC9627169 DOI: 10.3389/fpubh.2022.1030035] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2022] [Accepted: 10/05/2022] [Indexed: 01/29/2023] Open
Abstract
Objectives Patient-initiated hospital violence is a global problem which threatens the safety of health professionals and is indicative of doctor-patient tensions, impeding health system quality and access. The current study aimed to improve the understanding of medical workplace violence (WPV) in China, using authoritative and nationally representative judgment records, and to approach violence prevention strategies. Methods All litigation records relating to violence against health professionals between 2013 and 2021 were extracted from the China Judgment Online System. Basic case information, victim characteristics, perpetrator characteristics and the nature of the violence were collated. The relationship between different treatment outcomes and violence was also explored. Results Numbers of cases of hospital violence gradually increased from 2013 to a peak in 2016 before gradually decreasing in the following years. The most common perpetrators were patients' relatives (58.2%), followed by patients themselves (38.2%). Only 9 perpetrators had a confirmed history of mental illness and only two were intoxicated with alcohol. More than half of the cases (52.5%) occurred in rural areas and this percentage is even greater for primary health care institutions (71.4%) and secondary hospitals (73.5%). On a departmental level, the highest incidence of medical WPV was found in the emergency (18.9%), pediatrics (13.2%) and obstetrics (11.5%) departments. Violent behaviors, such as stalking, mass occupation of the ward and sharp instrument injury were significantly related to cases not involving patient death (p < 0.05). Disruptive behavior, such as hanging banners, blocking hospital passages, placing flower wreaths and burning paper money were significantly correlated with cases involving patient death (p < 0.01). The interval between a patient's death and the ensuing violence was short, happening on the same day in 54.8% of cases. Conclusions A comprehensive overview of medical WPV in China is presented and may have utility for the formulation of prevention strategies.
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Affiliation(s)
- Yu Xiao
- Psychosomatic Medical Center, The Fourth People's Hospital of Chengdu, Chengdu, China,Psychosomatic Medical Center, The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuroinformation, University of Electronic Science and Technology of China, Chengdu, China,*Correspondence: Yu Xiao
| | - Ting-ting Chen
- Nursing School, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Shao-yi Zhu
- Department of Psychiatry, Shantou University Mental Health Center, Shantou, China
| | - Ling Zong
- Department of Judicial Expertise, Zhongshan Third People's Hospital, Zhongshan, China
| | - Na Du
- Psychosomatic Medical Center, The Fourth People's Hospital of Chengdu, Chengdu, China
| | - Chun-ya Li
- Psychosomatic Medical Center, The Fourth People's Hospital of Chengdu, Chengdu, China
| | - Hao-fei Cheng
- Psychosomatic Medical Center, The Fourth People's Hospital of Chengdu, Chengdu, China
| | - Qi Zhou
- Institute (College) of Integrative Medicine, Dalian Medical University, Dalian, China
| | - Li-shi Luo
- Psychosomatic Medical Center, The Fourth People's Hospital of Chengdu, Chengdu, China
| | - Juan Jia
- Psychosomatic Medical Center, The Fourth People's Hospital of Chengdu, Chengdu, China
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7
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Mele F, Buongiorno L, Montalbò D, Ferorelli D, Solarino B, Zotti F, Carabellese FF, Catanesi R, Bertolino A, Dell'Erba A, Mandarelli G. Reporting Incidents in the Psychiatric Intensive Care Unit: A Retrospective Study in an Italian University Hospital. J Nerv Ment Dis 2022; 210:622-628. [PMID: 35394976 PMCID: PMC10860884 DOI: 10.1097/nmd.0000000000001504] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
ABSTRACT To evaluate the characteristics of the reported workplace violence in a psychiatric intensive care unit (PICU) by analyzing an electronic hospital incident reporting system (IRS). One hundred thirty reports were retrieved from January 2017 to June 2020, referring to assaults committed by patients (71% males) with an average age of 29.8 years (SD, 14.9). The most frequent psychiatric diagnosis was a neurodevelopmental disorder (33%). Physical aggression (84%) was more frequent than the other types of aggression. Nurses and unlicensed assistive personnel were the most frequent victims (65%). Aggressions were more frequent on Friday (18%) and between 4 p.m. and 8 p.m. (35%). A total of 64.9% of the incidents happened in the first 5 days of hospitalization. A significant association between physical aggression and diagnosis of neurodevelopmental disorder emerged. IRS could be helpful to identify high-risk patient groups and develop clinical strategies to reduce adverse events in clinical practice.
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Affiliation(s)
- Federica Mele
- Section of Legal Medicine, Interdisciplinary Department of Medicine
| | - Luigi Buongiorno
- Section of Legal Medicine, Interdisciplinary Department of Medicine
| | | | - Davide Ferorelli
- Section of Legal Medicine, Interdisciplinary Department of Medicine
| | - Biagio Solarino
- Section of Legal Medicine, Interdisciplinary Department of Medicine
| | - Fiorenza Zotti
- Section of Legal Medicine, Interdisciplinary Department of Medicine
| | - Felice Francesco Carabellese
- Section of Criminology and Forensic Psychiatry, Interdisciplinary Department of Medicine, University of Bari Aldo Moro, Policlinico di Bari Hospital, Bari, Italy
| | - Roberto Catanesi
- Section of Criminology and Forensic Psychiatry, Interdisciplinary Department of Medicine, University of Bari Aldo Moro, Policlinico di Bari Hospital, Bari, Italy
| | | | | | - Gabriele Mandarelli
- Section of Criminology and Forensic Psychiatry, Interdisciplinary Department of Medicine, University of Bari Aldo Moro, Policlinico di Bari Hospital, Bari, Italy
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8
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Hähnle S, Fegert JM, König E, Hoffmann U. [Burnout Symptoms Among Child and Adolescent Psychiatric/Psychotherapy Professionals During the 2020/2021 Winter Lockdown of the Covid-19 Pandemic]. ZEITSCHRIFT FUR KINDER-UND JUGENDPSYCHIATRIE UND PSYCHOTHERAPIE 2022; 50:300-311. [PMID: 35481771 DOI: 10.1024/1422-4917/a000876] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Burnout Symptoms Among Child and Adolescent Psychiatric/Psychotherapy Professionals During the 2020/2021 Winter Lockdown of the Covid-19 Pandemic Abstract. Question: Professionals in clinics and Departments of Child and Adolescent Psychiatry/Psychotherapy are often confronted with stress during their daily work. Such psychological pressure can cause stress symptoms such as burnout. This article examines the consequences of burnout symptoms at the institutional level, such as staff turnover. Method: We examined the connection between burnout symptoms and the institutional consequences of presenteeism, absenteeism, turnover tendency, and reduced quality of job performance during the winter lockdown (2020/2021) of the Covid-19-pandemic at psychiatric hospitals or departments for children and adolescents in Germany using a sample of N = 172 professionals. Results: The results show that signs of burnout symptoms impact the turnover tendency, presenteeism, and job performance of professionals. In addition, evidence emerged that professionals were more stressed during the winter lockdown (2020/2021) of the Covid-19 pandemic, and that this influenced turnover tendency, presenteeism, and absenteeism as well as the quality of job performance. Conclusion: Work-related stress of professionals should be addressed early to protect clinics and departments for child and adolescent psychiatry/psychotherapy from potential consequences, and to ensure care connectivity and quality of care.
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Affiliation(s)
- Sarah Hähnle
- Klinik für Kinder- und Jugendpsychiatrie/Psychotherapie, Universitätsklinikum Ulm, Deutschland
| | - Jörg M Fegert
- Klinik für Kinder- und Jugendpsychiatrie/Psychotherapie, Universitätsklinikum Ulm, Deutschland
| | - Elsa König
- Klinik für Kinder- und Jugendpsychiatrie/Psychotherapie, Universitätsklinikum Ulm, Deutschland
| | - Ulrike Hoffmann
- Klinik für Kinder- und Jugendpsychiatrie/Psychotherapie, Universitätsklinikum Ulm, Deutschland
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9
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Bykov KV, Zrazhevskaya IA, Topka EO, Peshkin VN, Dobrovolsky AP, Isaev RN, Orlov AM. Prevalence of burnout among psychiatrists: A systematic review and meta-analysis. J Affect Disord 2022; 308:47-64. [PMID: 35398112 DOI: 10.1016/j.jad.2022.04.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Revised: 02/20/2022] [Accepted: 04/02/2022] [Indexed: 12/11/2022]
Abstract
BACKGROUND Burnout is a consequence of chronic occupational stress exposure. Psychiatrists are prone to burnout due to specific work-related factors. This study examined the burnout prevalence among psychiatrists. METHODS The study protocol was registered in PROSPERO (CRD42020204615). We searched MEDLINE, EMBASE, CENTRAL, PsycINFO, Web of Science, ClinicalTrials.gov, and OpenGrey for relevant publications. Random-effect meta-analysis was performed. We used subgroup analysis and meta-regression to reveal any association of geographical region, survey year, participants' age, gender, and response rate with burnout. RESULTS Thirty-six studies involving 5481 participants were included. The prevalence of overall burnout was 25.9% [11.1%-40.7%] as measured by a Maslach Burnout Inventory (MBI) and 50.3% [30.9%-69.8%] as measured by a Copenhagen Burnout Inventory (CBI). The pooled prevalence was 43.5% [27.9%-59%] for high emotional exhaustion (EE), 28.2% [17.5%-38.9%] for high depersonalization (DP), and 32.4% [3.4%-61.3%] for low personal accomplishment (PA). The mean scores of 22-item MBI subscales were 21.51 [18.64%-24.38%] for EE, 6.57 [5.53%-7.62%] for DP, and 31.83 [25.73%-37.94%] for PA. European psychiatrists revealed (p = 0.045) lower EE score (20.82; 95% CI 7.24-24.41) measured by 22-item MBI compared to their non-European colleagues (24.99; 95% CI 23.05-26.94). Other results include mean scores for 16-item MBI-General Survey, burnout rates, and scores in CBI subscales. LIMITATIONS The main limitation was high heterogeneity in terms of statistics, screening methods, burnout definitions, and cut-off points utilized in included studies. CONCLUSIONS Burnout is highly prevalent among psychiatrists. Future research should focus on finding consensus on burnout screening, longitudinal evaluation of psychiatrists' burnout predictors, and development of effective intervention strategies.
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Affiliation(s)
- Kirill V Bykov
- Peoples' Friendship University of Russia (RUDN University), Moscow, Russian Federation.
| | - Inna A Zrazhevskaya
- Peoples' Friendship University of Russia (RUDN University), Moscow, Russian Federation
| | - Elvira O Topka
- Mental Hospital №13, Moscow Healthcare Department, Moscow, Russian Federation
| | - Valery N Peshkin
- Peoples' Friendship University of Russia (RUDN University), Moscow, Russian Federation
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10
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Chen Y, Wang P, Zhao L, He Y, Chen N, Liu H, Liu Y, Liu T, Tang YL, Jiang F, Zhu J. Workplace Violence and Turnover Intention Among Psychiatrists in a National Sample in China: The Mediating Effects of Mental Health. Front Psychiatry 2022; 13:855584. [PMID: 35782425 PMCID: PMC9240432 DOI: 10.3389/fpsyt.2022.855584] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2022] [Accepted: 05/13/2022] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Workplace violence (WPV) in healthcare has received much attention worldwide. However, scarce data are available on its impact on turnover intention among psychiatrists, and the possible mechanisms between WPV and turnover intention have not been explored in China. METHODS A cross-sectional survey was conducted among psychiatrists in 41 tertiary psychiatric hospitals from 29 provinces and autonomous regions in China. A stress-strain-outcome (SSO) model was adopted to examine the effects of WPV on mental health and turnover intention. The association and mediation by burnout and stress were examined by multivariate logistic regression (MLR) and generalized structure equation modeling (GSEM). RESULTS We invited 6,986 psychiatrists to participate, and 4,520 completed the survey (64.7% response rate). The prevalence of verbal and physical violence against psychiatrist in China was 78.0 and 30.7%, respectively. MLR analysis showed that psychiatrists who experienced verbal violence (OR = 1.15, 95% CI = 1.10-1.21) and physical violence (OR = 1.15, 95% CI = 1.07-1.24) were more likely to report turnover intention. GSEM analysis showed that burnout (β = 4.00, p < 0.001) and stress (β = 1.15, p < 0.001) mediated the association between verbal violence and turnover intention; similarly, burnout (β = 4.92, p < 0.001) and stress (β = 1.80, p < 0.001) also mediated the association between physical violence and turnover intention. CONCLUSIONS Experience of WPV is a significant contributor to turnover intention among psychiatrists. Mental health status, such as burnout and stress level significantly mediated the association. Policy makers and hospital administrators need to be aware of this association. Action is needed to promote mental health among the psychiatrists to improve morale and workforce sustainability.
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Affiliation(s)
- Yanhua Chen
- Vanke School of Public Health, Tsinghua University, Beijing, China.,School of Medicine, Tsinghua University, Beijing, China
| | - Peicheng Wang
- School of Medicine, Tsinghua University, Beijing, China
| | - Lina Zhao
- Institute for Hospital Management, Tsinghua University, Beijing, China
| | - Yanrong He
- Vanke School of Public Health, Tsinghua University, Beijing, China
| | - Nuoya Chen
- Health Related Activity Recognition System Based on IoT Project, University of Macerata, Macerata, Italy
| | - Huanzhong Liu
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei, China.,Anhui Psychiatric Center, Anhui Medical University, Hefei, China
| | - Yuanli Liu
- School of Health Policy and Management, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Tingfang Liu
- Institute for Hospital Management, Tsinghua University, Beijing, China
| | - Yi-Lang Tang
- Mental Health Service Line, Atlanta VA Medical Center, Decatur, GA, United States.,Addiction Psychiatry Fellowship Program, Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, GA, United States
| | - Feng Jiang
- School of International and Public Affairs, Shanghai Jiao Tong University, Shanghai, China.,Institute of Healthy Yangtze River Delta, Shanghai Jiao Tong University, Shanghai, China
| | - Jiming Zhu
- Vanke School of Public Health, Tsinghua University, Beijing, China.,Institute for Healthy China, Tsinghua University, Beijing, China
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11
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Davies SM, Sriskandarajah S, Staneva AS, Boulton HCM, Roberts C, Shaw SH, Silverio SA. Factors influencing ‘burn‐out’ in newly qualified counsellors and psychotherapists: A cross‐cultural, critical review of the literature. COUNSELLING & PSYCHOTHERAPY RESEARCH 2021. [DOI: 10.1002/capr.12485] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Affiliation(s)
- Siân M. Davies
- School of Psychology Liverpool John Moores University Liverpool UK
- Centre for Women's Mental Health The University of Manchester Manchester UK
- Department of Psychological Sciences University of Liverpool Liverpool UK
| | | | | | | | - Chelsey Roberts
- Therapist and Independent Researcher Tucson USA
- Elizabeth Garrett Anderson Institute for Women's Health University College London London UK
| | | | - Sergio A. Silverio
- Department of Psychological Sciences University of Liverpool Liverpool UK
- Elizabeth Garrett Anderson Institute for Women's Health University College London London UK
- School of Life Course Sciences King’s College London London UK
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Civilotti C, Berlanda S, Iozzino L. Hospital-Based Healthcare Workers Victims of Workplace Violence in Italy: A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:5860. [PMID: 34072551 PMCID: PMC8198045 DOI: 10.3390/ijerph18115860] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 05/26/2021] [Accepted: 05/27/2021] [Indexed: 12/18/2022]
Abstract
The aim of this scoping review is to synthesize the available evidence on the prevalence rates of healthcare workers being victims of violence perpetrated by patients and visitors in Italy. PubMed, Scopus, Web of Science and CINAHL were systematically searched from their inception to April 2021. Two authors independently assessed 1182 studies. All the scientific papers written in English or in Italian reporting primary quantitative and/or qualitative data on the prevalence of aggression or sexual harassment perpetrated by patients or visitors toward healthcare workers in Italy were included. Thirty-two papers were included in the review. The data extracted were summarized in a narrative synthesis organized in the following six thematic domains: (1). Methodology and study design; (2). Description of violent behavior; (3). Characteristics of health care staff involved in workplace violence (WPV); (4). Prevalence and form of WPV; (5). Context of WPV; and (6). Characteristics of violent patients and their relatives and/or visitors. The proportion of studies on WPV differed greatly across Italian regions, wards and professional roles of the healthcare workers. In general, the prevalence of WPV against healthcare workers in Italy is high, especially in psychiatric and emergency departments and among nurses and physicians, but further studies are needed in order to gather systematic evidence of this phenomenon. In Italy, and worldwide, there is an urgent need for governments, policy-makers and health institutions to prevent, monitor and manage WPV towards healthcare professionals.
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Affiliation(s)
- Cristina Civilotti
- Department of Psychology, Università di Torino, Via Verdi 10, 10124 Torino, Italy;
| | - Sabrina Berlanda
- Department of Human Sciences, University of Verona, Lungadige Porta Vittoria, 17, 37129 Verona, Italy;
| | - Laura Iozzino
- Psychiatric Epidemiology and Evaluation Unit, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Via Pilastroni 4, 25125 Brescia, Italy
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Eisele F, Flammer E, Steinert T. Incidents of aggression in German psychiatric hospitals: Is there an increase? PLoS One 2021; 16:e0245090. [PMID: 33400702 PMCID: PMC7785246 DOI: 10.1371/journal.pone.0245090] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Accepted: 12/22/2020] [Indexed: 11/18/2022] Open
Abstract
INTRODUCTION In a meta-analysis of international studies, 17% of admitted patients in psychiatric hospitals had exhibited violent behavior toward others. Reported data from studies in Germany were considerably lower until recent years. However, studies examining only single hospitals, as well as the quality of the data itself, have raised questions as to the validity of these findings. Indeed, a debate currently exists as to whether there has, in fact, been an increase of violent incidents in German mental institutions. METHODS In a group of 10 hospitals serving about half the population of the Federal State of Baden-Wuerttemberg with 11 million inhabitants, the Staff Observation Aggression Scale-Revised (SOAS-R) was introduced into patients' electronic charts as part of routine documentation. Data recording was strongly supported by staff councils and unions. A completed data set is now available for the year 2019. For one hospital, data are available since 2006. Due to some doubts with respect to fully covering self-directed aggression, we restricted the analysis to aggression toward others and toward objects. RESULTS In 2019, 17,599 aggressive incidents were recorded in 64,367 admissions (1,660 staying forensic psychiatric inpatients included). 5,084 (7.90%) of the admitted cases showed aggressive behavior toward others. Variation between hospitals was low to modest (SD = 1.50). The mean SOAS-R score was 11.8 (SD between hospitals 1.20%). 23% of the incidents resulted in bodily harm. The percentage of patients showing violent behavior was highest among patients with organic disorders (ICD-10 F0) and lowest among patients with addictive or affective disorders (F1, F3, F4). Forensic psychiatry had the highest proportion of cases with aggressive behavior (20.54%), but the number of incidents per bed was lower than in general adult psychiatry and child and adolescent psychiatry (indicating a lower risk for staff). In the hospital with longer-term recordings available, an increase could be observed since 2010, with considerable variation between years. CONCLUSIONS This is the most robust estimate of the frequency of violent incidents in German psychiatric hospitals thus far. The incidence is about half of what has been reported internationally, probably due to sample selection bias in previous studies and a relatively high number of hospital beds in Germany. Available data suggest an increase of violent incidents over the last ten years; however, it is unclear to which extent this is due to increased reporting.
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Affiliation(s)
- Frank Eisele
- Centers for Psychiatry Suedwuerttemberg, Ravensburg, Germany
| | - Erich Flammer
- Clinic for Psychiatry and Psychotherapy I, Ulm University, Ulm, Germany
| | - Tilman Steinert
- Clinic for Psychiatry and Psychotherapy I, Ulm University, Ulm, Germany
- * E-mail:
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Affiliation(s)
- David Adler
- Department of Psychiatry, Tufts Medical Center, Boston. Send correspondence to Dr. Adler
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