Work-Related Violence Policy: A Process Evaluation

This study describes one employer's approach to evaluating employees' knowledge of a violence prevention policy and experience with work-related physical and non-physical violence. A cross-sectional design was used to collect data from a random sample of current and former employees of a Midwest health care organization via a specially designed mailed questionnaire and the employer's internal database. While 7% of employees reported experiencing physical violence in the workplace, almost half of all employees had experienced non-physical violence. Most employees were aware of the organization's violence policy; however, few reported violence or used organizational resources (e.g., employee health) following the violence. Employees experienced symptoms and productivity losses in association with both types of violence. Process evaluations are an effective means of evaluating whether violence policies are used as intended and can provide organizations with considerable information to make effective programmatic changes.

Reporting Violence to a Health Care Employer: A Cross-Sectional Study

The purpose of this cross-sectional study was to identify individual and employment characteristics associated with reporting workplace violence to an employer and to assess the relationship between reporting and characteristics of the violent event. Current and former employees of a Midwest health care organization responded to a specially designed mailed questionnaire. The researchers also used secondary data from the employer. Of those who experienced physical and non-physical violence at work, 57% and 40%, respectively, reported the events to their employer. Most reports were oral (86%). Women experienced more adverse symptoms, and reported violence more often than men did. Multivariate analyses by type of reporting (to supervisors or human resources personnel) were conducted for non-physical violence. Reporting work-related violence among health care workers was low and most reports were oral. Reporting varied by gender of the victim, the perpetrator, and the level of violence experienced.

Rethinking Compassion Fatigue Through the Lens of Professional Identity: The Case of Child-Protection Workers

Compassion fatigue is currently the dominant model in work-related stress studies that explain the consequences of caring for others on child-protection workers. Based on a deterministic approach, this model excludes the role of cognition a priori and a posteriori in the understanding of the impact of caregiving or providing social support. By integrating the notion of professional identity, this article adds a subjective perspective to the compassion fatigue model allowing for the consideration of positive outcomes and takes into account the influence of stress caused by accountability. Mainly, it is argued that meanings derived from identity and given to situations may protect or accelerate the development of compassion fatigue or compassion satisfaction. To arrive at this proposition, the notions of compassion fatigue and identity theory are first reviewed. These concepts are then articulated around four work-related stressors specific to child-protection work. In light of this exercise, it is argued that professional identity serves as a subjective interpretative framework that guides the understanding of work-related situations. Therefore, compassion fatigue is not only a simple reaction to external stimuli. It is influenced by meanings given to the situation. Furthermore, professional identity modulates the impact of compassion fatigue on psychological well-being. Practice, policy, and research implications in light of these findings are also discussed.

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The aim of this study is to understand violence directed against behaviour technicians in juvenile rehabilitation centres. The findings are based on a survey conducted among 586 educators working in one of ten youth centres across Quebec. In this article we will first assess the occurrence of violent acts. Then, we will examine individual and contextual factors that predict physical aggression. More than half (53.9 %) of the educators surveyed reported to have been physically assaulted at least once in the past year. Regarding individual factors, being affected by the exposure to aggressive behaviours and the frequency of psychological aggression increase the risk of victimization. With respect to situational factors, the age of the clientele and the legal basis for placement (i.e. civil or criminal) influence the occurrence of violent acts towards staff members. Our analyses also show that physical violence not only affects staff members but also the institution. The identification of predictors of violence can guide prevention programs in youth centres. Moreover, they can help target behaviour technicians who are at risk of being assaulted in order to prevent their victimization.

The antecedents of violence and aggression within psychiatric in-patient settings

OBJECTIVE

To systematically review the types and proportions of antecedents of violence and aggression within psychiatric in-patient settings.

METHOD

Empirical articles and reports with primary data pertaining to violence and aggression within adult psychiatric in-patient settings were retrieved. For each study, prospective antecedent data were extracted. The extracted antecedent data were thematically analysed, and all higher-level themes were meta-analysed using rate data.

RESULTS

Seventy-one studies met the inclusion criteria, from which 59 distinct antecedent themes were identified and organised into nine higher-level themes. The higher-level antecedent theme 'staff-patient interaction' was the most frequent type of antecedent overall, precipitating an estimated 39% of all violent/aggressive incidents. An examination of the staff-patient interaction themes revealed that limiting patients freedoms, by either placing some sort of restriction or denying a patient request, was the most frequent precursor of incidents, accounting for an estimated 25% of all antecedents. The higher-level themes 'patient behavioural cues' and 'no clear cause' also produced other large estimates and were attributed to 38% and 33% of incidents overall.

CONCLUSION

This review underscores the influence that staff have in making in-patient psychiatric wards safe and efficacious environments.

Risk factors for work-related assaults on nurses

BACKGROUND

Work-related homicides have been the subject of considerable study, but little is known about nonfatal violence and relevant risk factors.

METHODS

We surveyed 6300 Minnesota nurses who were selected randomly from the 1998 licensing database and determined their employment and occupational violence experience. In a nested case-control study, we examined environmental exposures and physical assault. Cases of assault in the previous 12 months and controls randomly selected from assault-free months were surveyed about prior-month exposures.

RESULTS

After adjustment by multiple logistic regression, incidence of physical assault was 13.2 per 100 persons per year (95% confidence interval = 12.2-14.3). Among 310 cases and 946 control subjects, odds ratios for assault were increased: in nursing homes or long-term care facilities (2.6; 1.9-3.6), emergency departments (4.2; 1.3-12.8), and psychiatric departments (2.0; 1.1-3.7); in environments not "bright as daylight" (2.2; 1.6-2.8); and for each additional hour of shift duration (1.05; 0.99-1.11). Risks were decreased when carrying cellular telephones or personal alarms (0.3; 0.2-0.7).

CONCLUSIONS

These results may guide in-depth investigation of ways protective and risk factors can control violence against nurses.