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Khedr RI, Mohamed OI, Sobh ZK. Medicolegal analysis of physical violence toward physicians in Egypt. Sci Rep 2024; 14:10911. [PMID: 38740880 DOI: 10.1038/s41598-024-60857-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2023] [Accepted: 04/29/2024] [Indexed: 05/16/2024] Open
Abstract
This study analyzed physical violence against physicians in Egypt from a medicolegal perspective. 88%, 42%, and 13.2% of participants were exposed to verbal, physical, and sexual violence. Concerning the tools of violence, 75.2% of attackers used their bodies. Blunt objects (29.5%), sharp instruments (7.6%), and firearm weapons (1.9%) were used. The commonest manners of attacks were pushing/pulling (44.8%), throwing objects (38.1%), and fists (30.5%). Stabbing (4.8%) and slashing (2.9%) with sharp instruments were also reported. Traumas were mainly directed towards upper limbs (43.8%), trunks (40%), and heads (28.6%). Considering immediate effects, simple injuries were reported that included contusions (22.9%), abrasions (16.2%), and cut wounds (1.9%). Serious injuries included firearm injuries (4.8%), internal organs injuries (3.8%), fractures (2.9%), and burns (1.9%). Most (90.5%) of injuries healed completely, whereas 7.6% and 1.9% left scars and residual infirmities, respectively. Only 14.3% of physicians proceeded to legal action. The current study reflects high aggression, which is disproportionate to legal actions taken by physicians. This medicolegal analysis could guide protective measures for healthcare providers in Egypt. In addition, a narrative review of studies from 15 countries pointed to violence against physicians as a worldwide problem that deserves future medicolegal analyses.
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Affiliation(s)
- Rasha Ismail Khedr
- Forensic Medicine and Clinical Toxicology Department, Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - Omneya Ibrahim Mohamed
- Forensic Medicine and Clinical Toxicology Department, Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - Zahraa Khalifa Sobh
- Forensic Medicine and Clinical Toxicology Department, Faculty of Medicine, Alexandria University, Alexandria, Egypt.
- Faculty of Medicine, Alexandria University, Champollion Street, Alexandria, 5372006, Egypt.
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AlHassan AK, AlSaqat RT, Al Sweleh FS. Sexual workplace violence in the health sector in Saudi Arabia: a cross sectional study. BMC Health Serv Res 2023; 23:1065. [PMID: 37798618 PMCID: PMC10557224 DOI: 10.1186/s12913-023-10080-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Accepted: 09/27/2023] [Indexed: 10/07/2023] Open
Abstract
BACKGROUND Sexual workplace violence occurs worldwide with increasing prevalence, causing psychological and physical injuries. However, only few reports from the Kingdom of Saudi Arabia have investigated the most involved health specialty and its association with other factors, such as working and sociodemographic conditions. The aim of this study was to determine the prevalence of workplace sexual violence over 12 months, from May 2018 to May 2019, circumstances related to the event, and consequences for the perpetrator and survivor and to identify associated factors among all healthcare workers (HCWs) in Saudi Arabia. METHODS This cross-sectional study included all HCWs registered with the Saudi Commission for Health Specialties who worked for > 1 year in the health sector (government or private) in Saudi Arabia until May 2019. A non-probability convenient sampling technique was used. A modified self-administered questionnaire sent via email was utilized to assess workplace violence. Descriptive statistics were used to report percentages and frequencies, while advanced statistics, such as bivariate analysis, were used to determine associations. Multivariate logistic binary regression analysis was used to assess the combined and individual associations between relevant predictors of exposure of HCWs to recent sexual violence at the workplace. RESULTS In total, 7,398 (male, 51.3%; female, 48.7%) HCWs were electively enrolled in the study (mean age 40 ± 8.62 years). Most were non-Saudi (60%). Overall, 3.9% were sexual violence survivors. Approximately 60.7%, 51.4%, 48.3%, and 65.9% of female workers, nurses, Saudi natives, and night shift workers (18:00 to 07:00), respectively, were significantly exposed to sexual violence. Furthermore, approximately 54.8% of those with direct physical contact with patients had a higher rate of exposure to sexual harassment (p = 0.001). CONCLUSIONS The prevalence of sexual violence is low but remains a risk to HCWs, especially those working night shifts and having direct physical contact with patients. Thus, more support, specific strategies, and policies are needed to reduce the rate of occurrence, protect HCWs, and prevent such events. The underreporting of cases may be skewing the magnitude of the problem; thus, more education and additional research in Saudi Arabia are needed regarding sexual violence experienced by HCWs.
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Affiliation(s)
- Aseel Khaled AlHassan
- King Khalid Hospital in AlKharj, Ministry of Health, P.O. BOX: 52166, Riyadh, Kingdom of Saudi Arabia.
| | - Reem Tarik AlSaqat
- Princess Nourah bint Abdulrahman University, Riyadh, Kingdom of Saudi Arabia
| | - Fahad Saleh Al Sweleh
- Dental University Hospital, King Saud medical city, King Saud University, Riyadh, Kingdom of Saudi Arabia
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Banga A, Mautong H, Alamoudi R, Faisal UH, Bhatt G, Amal T, Mendiratta A, Bollu B, Kutikuppala LVS, Lee J, Simadibrata DM, Huespe I, Khalid A, Rais MA, Adhikari R, Lakhani A, Garg P, Pattnaik H, Gandhi R, Pandit R, Ahmad F, Camacho-Leon G, Ciza N P, Barrios N, Meza K, Okonkwo S, Dhabuliwo A, Hamza H, Nemat A, Essar MY, Kampa A, Qasba RK, Sharma P, Dutt T, Vekaria P, Bansal V, Nawaz FA, Surani S, Kashyap R. ViSHWaS: Violence Study of Healthcare Workers and Systems-a global survey. BMJ Glob Health 2023; 8:e013101. [PMID: 37696546 PMCID: PMC10496720 DOI: 10.1136/bmjgh-2023-013101] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2023] [Accepted: 08/08/2023] [Indexed: 09/13/2023] Open
Abstract
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.
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Affiliation(s)
- Akshat Banga
- Department of Medicine, Sawai Man Singh Medical College and Hospital, Jaipur, India
| | - Hans Mautong
- Department of Medicine, Universidad de Especialidades Espíritu Santo, Samborondon, Ecuador
| | - Razan Alamoudi
- Department of Pharmaceutical Services, King Fahd Armed Forces Hospital, Jeddah, Makkah, Saudi Arabia
| | - Umme Habiba Faisal
- Department of Urology, All India Institute of Medical Sciences, Kalyani, India
| | - Gaurang Bhatt
- Department of Plastic Reconstructive and Burns Surgery, All India Institute of Medical Sciences, Rishikesh, India
| | - Tanya Amal
- Department of Medicine, Maulana Azad Medical College, New Delhi, India
| | - Ayushi Mendiratta
- Department of Internal medicine, Parkview Medical Center, Pueblo, Colorado, USA
| | - Bhaswanth Bollu
- Department of General medicine, Narayana Medical College and Hospital, Nellore, Andhra Pradesh, India
| | - L V Simhachalam Kutikuppala
- Department of General Surgery, Konaseema Institute of Medical Sciences and Research Foundation Hospital, Amalapuram, Andhra Pradesh, India
| | - Joanna Lee
- Department of Medicine, David Tvildiani Medical University, Tbilisi, Georgia
| | - Daniel Martin Simadibrata
- Department of Medicine, Universitas Indonesia, Depok, Indonesia
- Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Ivan Huespe
- Department of Intensive Care Medicine, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - Aisha Khalid
- Department of Gastroenterology, Postgraduate Medical Education, Harvard Medical School, Boston, Massachusetts, USA
| | | | - Ramesh Adhikari
- Department of Internal medicine, Franciscan Health Lafayette East, Lafayette, Indiana, USA
| | - Alisha Lakhani
- Department of Internal medicine, Shantabaa Medical College and General Hospital, Amreli, Gujarat, India
| | - Piyush Garg
- Department of Cardiology, Medanta The Medicity, Gurgaon, Haryana, India
| | - Harsha Pattnaik
- Department of Undergraduate Medicine, Lady Hardinge Medical College, New Delhi, Delhi, India
| | - Raghu Gandhi
- Department of Psychiatry, University of Minnesota, Minneapolis, Minnesota, USA
| | - Ramesh Pandit
- Department of Internal medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Faizan Ahmad
- Public Health Reference Laboratory Department, Khyber Medical University, Peshawar, Pakistan
| | - Genesis Camacho-Leon
- Division de estúdios para graduados, Universidad del Zulia, Maracaibo, Venezuela
| | - Pierre Ciza N
- Department of Psychiatry, Kampala International University, Kampala, Uganda
| | - Nimsi Barrios
- Department of Medicine, Universidad de San Carlos de Guatemala, Guatemala, Guatemala
| | - Kelly Meza
- Department of Internal medicine, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
| | - Susan Okonkwo
- Department of Family Health, Society for Family Health Nigeria, Abuja, Nigeria
| | - Amuza Dhabuliwo
- Department of Pediatrics, Kawempe National Refferal hospital, Kampala, Uganda
| | - Hafeez Hamza
- Department of Pharmacy, Girne American University, Girne, Cyprus
| | - Arash Nemat
- Microbiology Department, Kabul University of Medical Sciences Abu Ali Ibn Sina, Kabul, Afghanistan
| | | | - Anne Kampa
- Department of Development, Mayo Clinic, Rochester, Minnesota, USA
| | - Rakhtan K Qasba
- Department of Medicine, Green Life Medical College and Hospital, Dhanmondi, Bangladesh
| | - Pranjal Sharma
- Department of Nephrology, MercyOne Clinton, Clinton, Iowa, USA
| | - Taru Dutt
- Department of Psychiatry, Hennepin County Medical Center, Minneapolis, Minnesota, USA
| | - Pratikkumar Vekaria
- Department of Internal medicine, University of South Carolina School of Medicine, Columbia, South Carolina, USA
- Internal Medicine, Prisma Health Upstate, Greenville, South Carolina, USA
| | - Vikas Bansal
- Department of Anesthesiology and Critical Care Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Faisal A Nawaz
- Department of Psychiatry, Al Amal Psychiatric Hospital, Al Aweer, Dubai, UAE
| | - Salim Surani
- Department of Anesthesiology and Critical Care Medicine, Mayo Clinic, Rochester, Minnesota, USA
- Department of Pulmonary, and Critical Care & Sleep Medicine, Texas A&M University, College Station, Texas, USA
| | - Rahul Kashyap
- Department of Gastroenterology, Postgraduate Medical Education, Harvard Medical School, Boston, Massachusetts, USA
- Department of Research, WellSpan Health, York, Pennsylvania, USA
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Hu X, Conrad S, Dill M. Specialty Gender Composition and Prevalence of Physician Harassment. J Womens Health (Larchmt) 2022; 32:409-415. [PMID: 36576791 DOI: 10.1089/jwh.2022.0380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Background: Women physicians remain a minority in most medical specialties and are at higher risk of workplace harassment than men. This research examines the relationship between a medical specialty's gender composition and physicians' workplace harassment experience. Materials and Methods: We used the Association of American Medical Colleges' National Sample Survey of Physicians 2019 (n = 6000). Participants self-reported harassment experiences in the 12 months preceding the survey, including threats of physical harm, physical harm, offensive and sexist remarks, and unwanted sexual advances from patients and coworkers. We used data from the American Medical Association to determine medical specialties' gender composition. We used multiple logistic regression to assess the relationship between harassment experiences and specialty gender composition. Results: Women and men physicians reported threats and harm at similar rates. However, women reported offensive, sexist remarks and unwanted sexual advances more frequently. We found greater representation of women within a specialty is associated with a lower prevalence of harassment experienced by men and women physicians (e.g., threats of physical harm, odds ratio [OR] = 0.973 [women] and 0.984 [men], and unwanted sexual advances, OR = 0.976 [women] and 0.981 [men]). Also, as women's representation in a specialty increases, the gender gap in experiences of most types of harassment decreases. Conclusions: Greater representation of women within a medical specialty is associated with a safer environment for both men and women physicians and narrower gender gaps in harassment experience. Our findings support efforts to increase gender diversity across the specialties and illuminate the dire need for antiharassment solutions in specialties with low women's representation.
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Affiliation(s)
- Xiaochu Hu
- Workforce Studies, Association of American Medical Colleges, Washington, District of Columbia, USA
| | - Sarah Conrad
- Workforce Studies, Association of American Medical Colleges, Washington, District of Columbia, USA
| | - Michael Dill
- Workforce Studies, Association of American Medical Colleges, Washington, District of Columbia, USA
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Xu J, Cao Y, Wang Y, Qiao Q. Judicial judgment and media sensation of violence against medical staff in China: A fuzzy set qualitative comparative analysis (fsQCA). PLoS One 2021; 16:e0259014. [PMID: 34679107 PMCID: PMC8535389 DOI: 10.1371/journal.pone.0259014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Accepted: 10/11/2021] [Indexed: 11/26/2022] Open
Abstract
INTRODUCTION Violence against medical staff has been prevalent in China over the past two decades. Although Chinese authorities have released many laws and regulations to protect medical staff from violence since 2011, the legal approach alone is unlikely to resolve this complex issue. In particular, several cases of violence against medical staff in China have caused great media sensation. METHOD This paper proposes an integrated model that combines the environmental stimuli theory, broken windows theory, and rational choice theory. It adopts the fuzzy set qualitative comparative analysis (fsQCA) to untangle the causal relationship between violence against medical staff, media sensation, and judicial judgment. We examined reports of medical violence on media and news websites from January 1, 2010, to January 31, 2020, and selected 50 cases with detailed information for this study. RESULTS The results show that each condition is not sufficient for the absence of judicial judgment, but when combined, they are conducive to the outcome. The conditions of hospital level, medical cost, and media sensation play important roles. The providers, patients, and environmental factors are indicators of inadequate or lack of judicial judgment, which corresponds to previous expectations. CONCLUSIONS The integrated model greatly enriches the extant theories and literature, and also yields implications for preventing violence against medical staff in China. We suggest that sustainable and innovative healthcare reform should be initiated. For example, public hospitals should remain the cornerstone of national public health security. Medical staff in public hospitals must be regarded as "civil servants". Therefore, the current legal system should be improved. The media should objectively report events concerning medical staff and improve public healthcare knowledge.
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Affiliation(s)
- Jian Xu
- School of Media and Communication and China Institute for Urban Governance, Shanghai Jiao Tong University, Shanghai, China
| | - Yongrong Cao
- School of Media and Communication, Shanghai Jiao Tong University, Shanghai, China
| | - Yangyang Wang
- School of Media and Communication, Shanghai Jiao Tong University, Shanghai, China
| | - Qingquan Qiao
- China Institute for Urban Governance, Shanghai Jiao Tong University, Shanghai, China
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Dagnaw EH, Bayabil AW, Yimer TS, Nigussie TS. Working in labor and delivery unit increases the odds of work place violence in Amhara region referral hospitals: Cross-sectional study. PLoS One 2021; 16:e0254962. [PMID: 34669705 PMCID: PMC8528509 DOI: 10.1371/journal.pone.0254962] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Accepted: 07/07/2021] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Workplace violence is any act of negative behavior that causes, physically and psychologically harm to health professionals face in the workplace. The prevalence of workplace violence becomes a challenging occupational issue with increasing nature worldwide. In spite of the seriousness and the impact of the problem, little is known about its magnitude and determinants in the study area and even in Ethiopia. OBJECTIVE The study aimed to assess the magnitude of workplace violence and its associated factors among health care providers working for the last one year at Obstetrics and gynecology department in Amhara Regional State Referral Hospitals, Ethiopia 2019. METHODS Institutional based cross-sectional study was conducted from October 1st to 30th, 2019. 503 study participants were incorporated in the study. A pre-tested structured questionnaire was used to collect the data. Data were entered into EPI info version 7.2.3.1 and analyzed using SPSS version 23. Binary Logistic regression model was fitted to identify factors associated with workplace violence considering the association to be significant p- value <0.05. RESULT This study revealed that 44.5%of the health care providers had reported workplace violence (95% CI: 40.2-48.7). Of this majority of the Victims were experienced a verbal type of violence 200 (88.1%), followed by physical 14 (6.2%), sexual 11 (4.8%), and racial two (0.8%). Factors of workplace violence in this research with statically significant, were: working in labor ward (AOR = 7.4,95% CI: 2.9-18.7), Female sex of participant (AOR = 2.4, 95% CI:1.4-4), work experience less than 5 years(AOR 8.5, 95%CI:7.3-33.3) and numbers of staff less than5 in a shift (AOR = 5.3 95% CI:3.8-39.8) and 5-10 staff in a shift (AOR = 3.3, 95% CI:2.7-25). CONCLUSION AND RECOMMENDATIONS The prevalence of workplace violence among obstetrics and gynecology department health professionals in Amhara regional state referral hospitals was high. Developing an incident resolution protocol and legislations to encourage health professionals to prompt report violent acts and judicial punishment of perpetrators will be useful to combat workplace violence at obstetrics and gynecology department.
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Affiliation(s)
- Eyaya Habtie Dagnaw
- Department of Midwifery, College of Medicine and Health Sciences, Debre Tabore University, Debre Tabore, Ethiopia
- * E-mail:
| | - Abrham Walelign Bayabil
- Department of Midwifery, College of Medicine and Health Sciences, Debre Tabore University, Debre Tabore, Ethiopia
| | - Tigist seid Yimer
- Department of Midwifery, College of Medicine and Health Sciences, Debre Tabore University, Debre Tabore, Ethiopia
| | - Tewodros Seyoum Nigussie
- Department of Midwifery, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Doraiswamy S, Chaabna K, Jithesh A, Mamtani R, Cheema S. Physician burnout in the Eastern Mediterranean region: influence of gender and related factors - Systematic review and meta-analysis. J Glob Health 2021; 11:04043. [PMID: 34326993 PMCID: PMC8285757 DOI: 10.7189/jogh.11.04043] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Background While recent reviews highlight high burnout prevalence among physicians in the World Health Organization's (WHO) Eastern Mediterranean Region (EMR), there has been a limited exploration into the role of gender and related factors in this problem. Methods We conducted a systematic review and meta-analysis of studies on the prevalence of physician burnout and its relationship to gender, physician specialties, and age in the WHO's EMR based on the Cochrane Handbook for Systematic Reviews. We searched PubMed, Embase, PsycINFO, Google Scholar, and Al Manhal databases and synthesized the findings from the included studies. Results Among the 78 studies included, data was available from 16/22 (72.7%) countries and territories in the EMR covering a total of 16 016 physicians. The pooled prevalence of overall burnout among physicians in the region was estimated to be 24.5%. Among the sub-components of burnout, we estimated a high pooled prevalence of 44.26% for emotional exhaustion followed by 37.83% for depersonalization and 36.57% for low personal achievement. There was a statistically significant difference in the prevalence across the countries in the EMR and among the sub-categories of specialist medical practitioners. There was no statistically significant difference across the two genders at a regionally aggregated level. Conclusions The levels of physician burnout including the three sub-components in EMR are high by any standards. Based on our review of available studies, it is difficult to ascertain gender differences with certainty in burnout levels among physicians in the EMR nations. There is a need for better quality studies in this area.
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Affiliation(s)
| | - Karima Chaabna
- Institute for Population Health, Weill Cornell Medicine - Qatar
| | - Anupama Jithesh
- Institute for Population Health, Weill Cornell Medicine - Qatar
| | | | - Sohaila Cheema
- Institute for Population Health, Weill Cornell Medicine - Qatar
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Nøland ST, Taipale H, Mahmood JI, Tyssen R. Analysis of Career Stage, Gender, and Personality and Workplace Violence in a 20-Year Nationwide Cohort of Physicians in Norway. JAMA Netw Open 2021; 4:e2114749. [PMID: 34181010 PMCID: PMC8239948 DOI: 10.1001/jamanetworkopen.2021.14749] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
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.
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Affiliation(s)
| | | | - Javed Iqbal Mahmood
- Institute of Basic Medical Sciences, Department of Behavioural Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
- Emergency Addiction Services Consulting Team, Oslo University Hospital, Oslo, Norway
| | - Reidar Tyssen
- Institute of Basic Medical Sciences, Department of Behavioural Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
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Ma J, Chen X, Zheng Q, Zhang Y, Ming Z, Wang D, Wu H, Ye H, Zhou X, Xu Y, Li R, Sheng X, Fan F, Yang Z, Luo T, Lu Y, Deng Y, Yang F, Liu C, Liu C, Li X. Serious Workplace Violence Against Healthcare Providers in China Between 2004 and 2018. Front Public Health 2021; 8:574765. [PMID: 33520908 PMCID: PMC7841458 DOI: 10.3389/fpubh.2020.574765] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2020] [Accepted: 11/30/2020] [Indexed: 11/24/2022] Open
Abstract
Introduction: Workplace violence (WPV) against healthcare providers has severe consequences and is underreported worldwide. The aim of this study was to present the features, causes, and outcomes of serious WPV against healthcare providers in China. Method: We searched for serious WPV events reported online and analyzed information about time, location, people, methods, motivations, and outcomes related to the incident. Result: Serious WPV reported online in China (n = 379) were mainly physical (97%) and often involved the use of weapons (34.5%). Doctors were victims in most instances (81.1%). Serious WPV mostly happened in cities (90.2%), teaching hospitals (87.4%), and tertiary hospitals (67.9%) and frequently in Emergency Department (ED), Obstetrics and Gynecology Department (OB-GYN), and pediatric departments; it was most prevalent in the months of June, May, and February. Rates of serious WPV increased dramatically in 2014 and decreased after 2015, with death (12.8%), severe injury (6%), and hospitalization (24.2%) being the major outcomes. A law protecting healthcare providers implemented in 2015 may have helped curb the violence. Conclusion: Serious WPV in China may stem from poor patient-doctor relationships, overly stressed health providers in highly demanding hospitals, poorly educated/informed patients, insufficient legal protection, and poor communication. Furthering knowledge about WPV and working toward curtailing its presence in healthcare settings are crucial to increasing the safety and well-being of healthcare workers.
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Affiliation(s)
- Jing Ma
- Department of Child and Adolescent Psychiatry, School of Clinical Medicine, The Second People's Hospital of Hunan Province, Hunan University of Chinese Medicine, Changsha, China
| | - Xi Chen
- Department of Child and Adolescent Psychiatry, School of Clinical Medicine, The Second People's Hospital of Hunan Province, Hunan University of Chinese Medicine, Changsha, China
| | - Qiongjuan Zheng
- Department of Child and Adolescent Psychiatry, School of Clinical Medicine, The Second People's Hospital of Hunan Province, Hunan University of Chinese Medicine, Changsha, China
| | - Yun Zhang
- Medical College of Northwest University for Nationalities, Lanzhou, China
| | - Zhi Ming
- Department of Child and Adolescent Psychiatry, School of Clinical Medicine, The Second People's Hospital of Hunan Province, Hunan University of Chinese Medicine, Changsha, China
| | - Dongxin Wang
- Department of Child and Adolescent Psychiatry, School of Clinical Medicine, The Second People's Hospital of Hunan Province, Hunan University of Chinese Medicine, Changsha, China
| | - Hua Wu
- Furong Forensic Center of The Second People's Hospital of Hunan Province, Yuhua, China
| | - Haisen Ye
- Department of Child and Adolescent Psychiatry, School of Clinical Medicine, The Second People's Hospital of Hunan Province, Hunan University of Chinese Medicine, Changsha, China
| | - Xiaoxuan Zhou
- Department of Child and Adolescent Psychiatry, School of Clinical Medicine, The Second People's Hospital of Hunan Province, Hunan University of Chinese Medicine, Changsha, China
| | - Yunxuan Xu
- Department of Child and Adolescent Psychiatry, School of Clinical Medicine, The Second People's Hospital of Hunan Province, Hunan University of Chinese Medicine, Changsha, China
| | - Renjiao Li
- Department of Child and Adolescent Psychiatry, School of Clinical Medicine, The Second People's Hospital of Hunan Province, Hunan University of Chinese Medicine, Changsha, China
| | - Xia Sheng
- Department of Child and Adolescent Psychiatry, School of Clinical Medicine, The Second People's Hospital of Hunan Province, Hunan University of Chinese Medicine, Changsha, China
| | - Fangxiu Fan
- Department of Child and Adolescent Psychiatry, School of Clinical Medicine, The Second People's Hospital of Hunan Province, Hunan University of Chinese Medicine, Changsha, China
| | - Zuiwen Yang
- Department of Child and Adolescent Psychiatry, School of Clinical Medicine, The Second People's Hospital of Hunan Province, Hunan University of Chinese Medicine, Changsha, China
| | - Ting Luo
- Department of Child and Adolescent Psychiatry, School of Clinical Medicine, The Second People's Hospital of Hunan Province, Hunan University of Chinese Medicine, Changsha, China
| | - Yajun Lu
- Department of Child and Adolescent Psychiatry, School of Clinical Medicine, The Second People's Hospital of Hunan Province, Hunan University of Chinese Medicine, Changsha, China
| | - Ye Deng
- Department of Child and Adolescent Psychiatry, School of Clinical Medicine, The Second People's Hospital of Hunan Province, Hunan University of Chinese Medicine, Changsha, China
| | - Fen Yang
- Department of Child and Adolescent Psychiatry, School of Clinical Medicine, The Second People's Hospital of Hunan Province, Hunan University of Chinese Medicine, Changsha, China
| | - Chuntao Liu
- Department of Child and Adolescent Psychiatry, School of Clinical Medicine, The Second People's Hospital of Hunan Province, Hunan University of Chinese Medicine, Changsha, China
| | - Chunyu Liu
- Department of Psychiatry, Department of Neuroscience and Physiology, SUNY Upstate Medical University, Syracuse, NY, United States
| | - Xiaosong Li
- Hunan Provincial People's Hospital, Changsha, China
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Xu C, Sun Q. Great auricular nerve schwannoma in neck region: a case report with the risk of medical disputes. BMC Neurol 2019; 19:308. [PMID: 31787094 PMCID: PMC6886199 DOI: 10.1186/s12883-019-1532-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Accepted: 11/15/2019] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Great auricular nerve schwannoma is extremely rare. Herein, we reported the first case of schwannoma arising from great auricular nerve trunk. CASE PRESENTATION A 29 year-old female complained of a slowly-growing superfacial neck mass for 6 months. MRI revealed a high possibility of schwannoma. Although the patient underwent successfully surgical removal of the tumor, ipsilateral numbness of both auricle and peripheral skin developed due to traction of the nerve. Immunohistochemistry staining confirmed the diagnosis of schwannoma. And the patient has been followed regularly. CONCLUSION For superficial cervical tumors, the cervical plexus cutaneous nerve should be considered if MRI and other imaging findings suggest neurogenic tumors.
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Affiliation(s)
- Chunling Xu
- Department of Ophthalmology, The Second Hospital of Jilin University, Nanguan, Changchun, Jilin, 130041 People’s Republic of China
| | - Qingjia Sun
- Department of Otorhinolaryngology Head and Neck Surgery, The China-Japan Union Hospital of Jilin University, Xiantai Street 126, Changchun, 130033 China
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