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Cooper AL, Best MC, Read RA, Brown JA. Exploring work-related stressors experienced by mental health nurses: A qualitative descriptive study. J Psychiatr Ment Health Nurs 2024; 31:845-856. [PMID: 38462894 DOI: 10.1111/jpm.13038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Revised: 02/11/2024] [Accepted: 02/27/2024] [Indexed: 03/12/2024]
Abstract
INTRODUCTION The challenging work environments mental health nurses (MHNs) encounter can negatively impact their mental health, psychological well-being and physical health. While these impacts have been investigated in quantitative research, little is known about work-related stress from the perspective of MHNs. AIM To explore the stresses faced by nurses working in mental health settings and to gain an understanding of the underlying workplace context. METHOD A descriptive qualitative study with data collected via semi-structured individual telephone interviews conducted with n = 21 Western Australian MHNs. Data were analysed using reflexive thematic analysis. RESULTS A total of 85 codes were generated that led to the identification of 13 subthemes and 4 main themes: (1) mental health nursing context, (2) work environment stressors, (3) factors that alleviate stress and (4) the impact of workplace stress. DISCUSSION Many of the stressors MHNs were exposed to are modifiable, such as understaffing and poor skill mix. Modifiable stressors increased risk for MHNs, impeded patient care and exacerbated inherent stressors such as patient acuity and complexity. IMPLICATIONS FOR PRACTICE This study collected data that provide rich descriptions of the experiences of MHNs and identify modifiable work-related stressors that could be alleviated through effective leadership and management.
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Affiliation(s)
- Alannah L Cooper
- Centre for Wellbeing and Sustainable Practice, Royal Perth Bentley Group, Perth, Western Australia, Australia
| | - Megan C Best
- Faculty of Medicine and Health, Sydney Medical School, The University of Sydney, Camperdown, New South Wales, Australia
| | - Richard A Read
- Centre for Wellbeing and Sustainable Practice, Royal Perth Bentley Group, Perth, Western Australia, Australia
| | - Janie A Brown
- School of Nursing, Curtin University, Perth, Western Australia, Australia
- St John of God Midland Public and Private Hospital, Midland, Western Australia, Australia
- The Western Australian Group for Evidence Informed Healthcare Practice, Curtin University, Perth, Western Australia, Australia
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David E, Lifshitz M, Kraitenbrg K, Warshawski S. The Relationship Between Individual Social Responsibility and the Public's Intention to Act Violently Toward Nurses-A Cross-Sectional Study. J Clin Nurs 2024. [PMID: 39334538 DOI: 10.1111/jocn.17474] [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: 02/18/2024] [Revised: 05/07/2024] [Accepted: 09/13/2024] [Indexed: 09/30/2024]
Abstract
AIMS To explore (a) the associations between individual social responsibility and the public intention to use violence against nurses; and (b) the relationship between individual social responsibility, personal variables and the public's intention to employ violence against nurses. BACKGROUND Workplace violence against nurses is a significant widespread occupational health issue. To date, no reference has been found to the association between personality traits such as individual social responsibility and the public's intention to use violence against nurses. DESIGN AND METHODS A cross-sectional survey design with a convenience sample of 667 Israeli participants from among the public. A structured self-report questionnaire was distributed, including socioeconomic variables, individual social responsibility and responses to four vignettes describing incidents of violence directed at nurses. Multiple linear regressions were calculated for intention to employ violence, with demographic variables and individual social responsibility as independent variables. The STROBE checklist for cross-sectional studies was used for reporting. RESULTS Negative correlations were found between individual social responsibility and the intention to employ violence against nurses. Gender, having witnessed physical violence and individual social responsibility explained 19% of the variance in the intention to employ violence against nurses. Demographic variables and having witnessed verbal or physical violence were found to moderate the association between individual social responsibility and the intention to employ violence against nurses. CONCLUSIONS Witnessing a violent incident in a healthcare setting is a risk factor for the intention to employ violence against nurses. Our findings point to the role of individual social responsibility as one of the strategies to help reduce violent events. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE Educating and promoting values of social responsibility among the public can reduce incidents of violence in healthcare settings, thus contributing to the safety and quality of care provided. PATIENT OR PUBLIC CONTRIBUTION The public contributed via study participation.
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Affiliation(s)
- Efrat David
- Medical Intensive Care Unit, Hadassah University Medical Center, Jerusalem, Israel
| | - Mor Lifshitz
- The Raphael Cohen Pediatric Emergency Department, Sheba Medical Center, Ramat Gan, Israel
| | - Kim Kraitenbrg
- Surgical Trauma Department, Tel-Aviv Sourasky Medical Center-Ichilov Hospital, Tel Aviv-Yafo, Israel
| | - Sigalit Warshawski
- Nursing Department, The Stanley Steyer School of Health Professions, Faculty of Medicine, Tel-Aviv University, Tel Aviv-Yafo, Israel
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Meyer HA, Kiydal D, Siefert K, Clark E, Dondi AC, Abu-Alhaija DM, Davis KG, Gillespie GL. Workplace Violence and Worker Well-Being: A Preliminary Cross-Sectional Study. J Gerontol Nurs 2024:1-9. [PMID: 39312757 DOI: 10.3928/00989134-20240830-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/25/2024]
Abstract
PURPOSE To investigate the prevalence of workplace violence (WPV) in home health care and long-term care facilities (LTCFs) and explore the relationship between WPV and worker well-being. METHOD A cross-sectional survey was conducted with health care workers in an agency that provided care in homes or LTCFs. Six measures of worker well-being were collected: satisfaction with work and life, work-related rumination, work/family conflict, burnout, and turnover intention. Surveys also assessed type and frequency of WPV. RESULTS Seventeen participants completed surveys. Verbal abuse by patients was the most often experienced type of WPV. Employees who reported experiencing WPV had higher burnout and lower satisfaction with work and life. CONCLUSION WPV routinely occurs in home health care and LTCFs and appears to be related to worker well-being. Facility managers who can control WPV will likely impact the well-being of employees. [Journal of Gerontological Nursing, xx(x), xx-xx.].
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Benning L, Teepe GW, Kleinekort J, Thoma J, Röttger MC, Prunotto A, Gottlieb D, Klöppel S, Busch HJ, Hans FP. Workplace violence against healthcare workers in the emergency department - a 10-year retrospective single-center cohort study. Scand J Trauma Resusc Emerg Med 2024; 32:88. [PMID: 39285387 PMCID: PMC11403778 DOI: 10.1186/s13049-024-01250-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2024] [Accepted: 08/17/2024] [Indexed: 09/22/2024] Open
Abstract
BACKGROUND Medical staff are regularly confronted with workplace violence (WPV), which poses a threat to the safety of both staff and patients. Structured de-escalation training (DET) for Emergency Department (ED) staff has been shown to positively affect the reporting of WPV incidents and possibly reduce its impact. This study aimed to describe the development of incidence rates, causes, means, targets, locations, responses, and the time of WPV events. Additionally, it explored the effect of the staff trained in DET on the objective and subjective severity of the respective WPV events. METHODS In a retrospective, single-center cohort study, we analyzed ten years of WPV events using the data of Staff Observation Aggression Scale-Revised (SOAS-R) score (ranging from 0 to 22) in a tertiary ED from 2014 to 2023. The events were documented by ED staff and stored in the electronic health record (EHR). RESULTS Between 2014 and 2023, 160 staff members recorded 859 incidents, noting an average perceived severity of 5.78 (SD = 2.65) and SOAS-R score of 11.18 (SD = 4.21). Trends showed a non-significant rise in incident rates per 10,000 patients over time. The WPV events were most frequently reported by nursing staff, and the cause of the aggression was most often not discernible (n = 353, 54.56%). In total, n = 273 (31.78%) of the WPV events were categorized as severe, and the most frequent target of the aggressive behavior was the staff. WPV events occurred most frequently in the traumatology section and the detoxification rooms. While the majority of events could be addressed with verbal interventions, more forceful interventions were performed significantly more often for higher severity WPV events. More WPV events occurred during off-hours and were of a significantly higher objective and subjective severity. Overall, the presence of staff with completed DET led to significantly higher SOAS-R scores and higher perceived severity. CONCLUSION The findings underline the relevance of WPV events in the high-risk environment of an ED. The analyzed data suggest that DET significantly fostered the awareness of WPV. While most events can be addressed with verbal interventions, WPV remains a concern that needs to be addressed through organizational measures and further research.
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Affiliation(s)
- Leo Benning
- University Emergency Center, Medical Center-University of Freiburg, Freiburg, Germany
| | - Gisbert W Teepe
- University Hospital of Old Age Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Jan Kleinekort
- University Emergency Center, Medical Center-University of Freiburg, Freiburg, Germany
| | - Jorun Thoma
- Medical Center, University of Freiburg, CNO Office, Freiburg, Germany
| | | | - Andrea Prunotto
- Data Integration Center, University Medical Center Freiburg, Albert-Ludwigs-University Freiburg, Freiburg, Germany
| | - Dominik Gottlieb
- University Emergency Center, Medical Center-University of Freiburg, Freiburg, Germany
| | - Stefan Klöppel
- University Hospital of Old Age Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Hans-Jörg Busch
- University Emergency Center, Medical Center-University of Freiburg, Freiburg, Germany
| | - Felix P Hans
- University Emergency Center, Medical Center-University of Freiburg, Freiburg, Germany.
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Friese CR, Medvec BR, Marriott DJ, Khadr L, Wade MG, Riba M, Titler MG. Nurse-reported workplace violent events: Results from a repeated statewide survey. Nurs Outlook 2024; 72:102265. [PMID: 39208685 DOI: 10.1016/j.outlook.2024.102265] [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: 04/05/2024] [Revised: 07/22/2024] [Accepted: 07/28/2024] [Indexed: 09/04/2024]
Abstract
BACKGROUND Workplace violence significantly affects registered nurses, contributing to burnout and intention to leave. METHODS The Michigan Nurses Study conducted surveys in 2022 and 2023, examining the prevalence of verbal, physical, and sexual violence, and coworker bullying. Personal and workplace factors associated with reporting any violent event were examined using multivariable logistic regression. RESULTS There was a decline in overall workplace violence from 50.2% to 43.4%, despite a rise in sexual harassment from 9.9% to 11.8%. Over half of the events were patient-sourced. Underreporting remained a problem. Factors associated with increased likelihood of reporting any violent event included younger age, employment in acute care and long-term care settings, unfavorable practice environments, less confidence in management, inadequate support for workplace stress, and understaffing on the past shift. CONCLUSION Despite a decrease in reported violent events, incidents remain common. Improvements in working conditions, management of understaffing, and support systems are crucial to mitigate workplace violence against nurses.
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Affiliation(s)
- Christopher R Friese
- Center for Improving Patient and Population Health, School of Nursing, University of Michigan, Ann Arbor, MI; Department of Health Management and Policy, School of Public Health, University of Michigan, Ann Arbor, MI.
| | - Barbara R Medvec
- Center for Improving Patient and Population Health, School of Nursing, University of Michigan, Ann Arbor, MI
| | - Deanna J Marriott
- Center for Improving Patient and Population Health, School of Nursing, University of Michigan, Ann Arbor, MI; Applied Biostatistics Laboratory, School of Nursing, University of Michigan, Ann Arbor, MI
| | - Lara Khadr
- Applied Biostatistics Laboratory, School of Nursing, University of Michigan, Ann Arbor, MI
| | | | - Melissa Riba
- Center for Health and Research Transformation, Ann Arbor, MI
| | - Marita G Titler
- Center for Improving Patient and Population Health, School of Nursing, University of Michigan, Ann Arbor, MI
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Babkair KA, Altirkistani BA, Baljoon JM, Almehmadi AA, Atiah AL, Alsadan SA, Moamena ME. The prevalence of physical and verbal violence among emergency medicine physicians in military hospitals vs non-military hospitals, Jeddah, Saudi Arabia: multi-center cross-sectional study. BMC Emerg Med 2024; 24:129. [PMID: 39075365 PMCID: PMC11288119 DOI: 10.1186/s12873-024-01049-z] [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: 12/25/2023] [Accepted: 07/12/2024] [Indexed: 07/31/2024] Open
Abstract
INTRODUCTION In healthcare settings, physical and verbal attacks are commonly encountered in the workplace among healthcare providers. Patients and patients' relatives and friends have been reported to be the perpetrators of workplace violence. Among all healthcare settings, emergency department (ED) have been designated as high-risk settings for violence, where more than one-quarter of emergency physicians reported that they were victims of physical assault. This study aimed to report the prevalence of workplace violence against emergency medicine physicians in military and non-military hospitals in Jeddah city. METHODOLOGY A cross-sectional design has been used in this study. An electronic questionnaire was developed through the Google Form Platform and it included demographic data, the occurrence of verbal or physical violence in the workplace to participants, how many times they experienced this violence, the time of incidents, the location either inside or outside the hospital, whether the perpetrators were mostly patients, patient families, or friends, and whether they reported any violence or not. Categorical variables were used to describe frequencies and percentages, while descriptive statistics such as mean and 95% Confidence Interval (95% CI) were used to summarize the scale variables. P < 0.05 was considered for statistically significant differences. RESULTS Among the 100 participants, 76 experienced either physical or verbal violence, or both. The remaining 24 did not experience any sort of violence. 83% of the physicians who have been physically violated were working in non-military hospitals. Of the 72 participants who had experienced verbal violence, 51 (70.8%) were working in a non-military hospital, while 21 (29.2%) were in a military hospital. The most common reason for not reporting was that the participants felt that reporting the violence incidence was useless. Moreover, 92% of participants chose "Train healthcare workers to deal with violent attacks" as a suggested helpful factor in decreasing the number of work-related violence. In addition, "Education of the public" and "Raising awareness of healthcare workers" were chosen as helpful factors as well by 91% and 90% of participants, respectively. CONCLUSION This revealed that physicians in non-military hospitals experience higher levels of violence compared to their military counterparts. However, it is concerning that instances of violence are substantially under-reported across both military and non-military healthcare facilities.
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Affiliation(s)
- Kholoud Abdullah Babkair
- Department of Emergency Medicine, Ministry of the National Guard - Health Affairs, Jeddah, Saudi Arabia
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
- King Abdullah International Medical Research Center, Jeddah, Saudi Arabia
| | - Bsaim Abdulsalam Altirkistani
- Department of Emergency Medicine, Ministry of the National Guard - Health Affairs, Jeddah, Saudi Arabia.
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia.
- King Abdullah International Medical Research Center, Jeddah, Saudi Arabia.
| | - Jamil Mostafa Baljoon
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
- King Abdullah International Medical Research Center, Jeddah, Saudi Arabia
| | - Abdulrahman Adnan Almehmadi
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
- King Abdullah International Medical Research Center, Jeddah, Saudi Arabia
| | - Ahmad Loay Atiah
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
- King Abdullah International Medical Research Center, Jeddah, Saudi Arabia
| | - Sultan Abdullah Alsadan
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
- King Abdullah International Medical Research Center, Jeddah, Saudi Arabia
| | - Montasir Esam Moamena
- Department of Emergency Medicine, Ministry of the National Guard - Health Affairs, Jeddah, Saudi Arabia
- King Abdullah International Medical Research Center, Jeddah, Saudi Arabia
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Dziruni TB, Hutchinson AM, Keppich-Arnold S, Bucknall T. A realist evaluation protocol: assessing the effectiveness of a rapid response team model for mental state deterioration in acute hospitals. FRONTIERS IN HEALTH SERVICES 2024; 4:1400060. [PMID: 39076771 PMCID: PMC11284174 DOI: 10.3389/frhs.2024.1400060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/13/2024] [Accepted: 07/01/2024] [Indexed: 07/31/2024]
Abstract
Background Mental state deterioration poses significant challenges in healthcare, impacting patients and providers. Symptoms like confusion and agitation can lead to prolonged hospital stays, increased costs, and the use of restrictive interventions. Despite its prevalence, there's a lack of consensus on effective practices for managing mental state deterioration in acute hospital settings. To address this gap, a rapid response team model has been proposed as a potential intervention, aiming to provide early identification and targeted interventions. Methods Based on realist evaluation steps, first, initial program theories are formulated to understand the logic behind the intervention. Second, literature synthesis identifies empirical evidence on contexts, mechanisms, and outcomes elements, refining initial theories. During the third step, data will be collected using qualitative methods such as field observations and interviews, as well as quantitative methods such as surveys of the staff, audits of electronic medical records, and analysis of incident records of mental state deterioration. Analysing this data informs configurations of contexts, mechanisms, and outcomes. In the fifth step, the configurations are synthesised, presenting refined, evidence-informed program theories. Conclusion This study addresses the knowledge gap by evaluating the rapid response model's effectiveness in managing mental state deterioration in acute hospital settings. Realist principles guide the exploration of causal mechanisms and their interaction with specific implementation contexts. The objective is to identify what works, for whom, and under what circumstances, aiming to manage deterioration, reduce restrictive interventions, and enhance the experience for patients and staff by implementing a proactive model of care. The findings contribute to evidence-based approaches for managing mental state deterioration in hospital settings, informing policy and practice in this crucial area of healthcare.
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Affiliation(s)
- Tendayi Bruce Dziruni
- School of Nursing and Midwifery, Deakin University, Geelong, VIC, Australia
- Alfred Health, Melbourne, VIC, Australia
- Centre for Quality and Patient Safety Research, Institute for Health Transformation, Deakin University, Geelong, VIC, Australia
| | - Alison M. Hutchinson
- School of Nursing and Midwifery, Deakin University, Geelong, VIC, Australia
- Centre for Quality and Patient Safety Research, Institute for Health Transformation, Deakin University, Geelong, VIC, Australia
- Barwon Health, Geelong, VIC, Australia
| | - Sandra Keppich-Arnold
- School of Nursing and Midwifery, Deakin University, Geelong, VIC, Australia
- Alfred Health, Melbourne, VIC, Australia
| | - Tracey Bucknall
- School of Nursing and Midwifery, Deakin University, Geelong, VIC, Australia
- Alfred Health, Melbourne, VIC, Australia
- Centre for Quality and Patient Safety Research, Institute for Health Transformation, Deakin University, Geelong, VIC, Australia
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Lin E, Malhas M, Bratsalis E, Thomson K, Hargreaves F, Donner K, Baig H, Boateng R, Swain R, Benadict MB, Busch L. Behavioral skills training for teaching safety skills to mental health service providers compared to training-as-usual: a pragmatic randomized control trial. BMC Health Serv Res 2024; 24:639. [PMID: 38760754 PMCID: PMC11102142 DOI: 10.1186/s12913-024-10994-1] [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: 09/06/2023] [Accepted: 04/16/2024] [Indexed: 05/19/2024] Open
Abstract
BACKGROUND Violence in the healthcare workplace has been a global concern for over two decades, with a high prevalence of violence towards healthcare workers reported. Workplace violence has become a healthcare quality indicator and embedded in quality improvement initiatives of many healthcare organizations. The Centre for Addiction and Mental Health (CAMH), Canada's largest mental health hospital, provides all clinical staff with mandated staff safety training for self-protection and team-control skills. These skills are to be used as a last resort when a patient is at imminent risk of harm to self or others. The purpose of this study is to compare the effectiveness of two training methods of this mandated staff safety training for workplace violence in a large psychiatric hospital setting. METHODS Using a pragmatic randomized control trial design, this study compares two approaches to teaching safety skills CAMH's training-as-usual (TAU) using the 3D approach (description, demonstration and doing) and behavioural skills training (BST), from the field of applied behaviour analysis, using instruction, modeling, practice and feedback loop. Staff were assessed on three outcome measures (competency, mastery and confidence), across three time points: before training (baseline), immediately after training (post-training) and one month later (follow-up). This study was registered with the ISRCTN registry on 06/09/2023 (ISRCTN18133140). RESULTS With a sample size of 99 new staff, results indicate that BST was significantly better than TAU in improving observed performance of self-protection and team-control skills. Both methods were associated with improved skills and confidence. However, there was a decrease in skill performance levels at the one-month follow-up for both methods, with BST remaining higher than TAU scores across all three time points. The impact of training improved staff confidence in both training methods and remained high across all three time points. CONCLUSIONS The study findings suggest that BST is more effective than TAU in improving safety skills among healthcare workers. However, the retention of skills over time remains a concern, and therefore a single training session without on-the-job-feedback or booster sessions based on objective assessments of skill may not be sufficient. Further research is needed to confirm and expand upon these findings in different settings.
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Affiliation(s)
- Elizabeth Lin
- Department of Education, Centre for Addiction and Mental Health, Toronto, ON, Canada.
| | - Mais Malhas
- Department of Education, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Emmanuel Bratsalis
- Department of Education, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Kendra Thomson
- Department of Education, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Applied Disability Studies, Brock University, St. Catharines, ON, Canada
| | - Fabienne Hargreaves
- Department of Education, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Kayle Donner
- Department of Education, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Heba Baig
- Department of Education, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Rhonda Boateng
- Department of Education, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Rajlaxmi Swain
- Department of Education, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Mary Benisha Benadict
- Department of Education, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Louis Busch
- Department of Education, Centre for Addiction and Mental Health, Toronto, ON, Canada
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Lickiewicz J, Lorenz LS, Kolb B. Photovoice in Aggression Management Training for Medical and Nursing Students-A Pilot Study. Healthcare (Basel) 2024; 12:873. [PMID: 38727430 PMCID: PMC11083180 DOI: 10.3390/healthcare12090873] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2024] [Revised: 04/20/2024] [Accepted: 04/22/2024] [Indexed: 05/13/2024] Open
Abstract
Aggression towards medical staff in the healthcare workplace is a common global concern. Measures to mitigate consequences of patient aggression include training through Aggression Management Programs (AMPs), which have been shown to increase students' self-efficacy and self-confidence. To encourage better engagement with a 30 h required AMP training, the study piloted an adapted photovoice activity with 58 students of medicine and nursing. Each student took one to three photos depicting their perceptions, feelings, and experiences of patient aggression in the workplace and discussed them in a course session. Their photos showed types of aggression in psychiatric settings, and their consequences for patients and students. Photo strategies included showing 'actors' or toy figures in aggressive encounters; tools to control aggression in psychiatric settings (e.g., mechanical restraints and syringes); and symbolic photos showing violence to the heart (emotional impact). Adding photovoice elements to the established AMP training appeared to contribute to student reflection on their individual perspectives on patient aggression in the workplace and help students to link their subjective experiences and theoretical learning. In future, incorporating pre-test and post-test questionnaires measuring empathy, attitudes, or critical thinking could help to decipher any changes in AMP effectiveness due to the use of a self-directed photovoice activity.
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Affiliation(s)
- Jakub Lickiewicz
- Department of Health Psychology, Jagiellonian University Medical College, 31-501 Krakow, Poland
| | - Laura S. Lorenz
- Heller School for Social Policy and Management, Brandeis University, Waltham, MA 02453, USA;
| | - Bettina Kolb
- Department of Sociology, University of Vienna, 1090 Vienna, Austria;
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Ponce B, Gruenberger E, McGwin G, Samora J, Patt J. Workplace Violence in Orthopaedic Surgery: A Survey of Academy of Orthopaedic Surgeons Membership. J Am Acad Orthop Surg 2024; 32:e359-e367. [PMID: 38442420 DOI: 10.5435/jaaos-d-23-00596] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Accepted: 01/11/2024] [Indexed: 03/07/2024] Open
Abstract
INTRODUCTION Workplace violence (WPV) in US health care is increasing, and many workers are likely to experience WPV during their careers. This study aims to assess the scope of WPV in orthopaedics. METHODS A 20-item survey adopted from the World Health Organization's 'Workplace Violence in the Health Sector Country Case Studies Research Instruments Survey Questionnaire' was sent to Academy of Orthopaedic Surgeons members, including residents and fellows. Deidentified responses were collected electronically over a 1-month period and assessed. RESULTS Overall, 1,125 Academy of Orthopaedic Surgeons members participated (5% response rate). Most respondents were male (86%) and identified with the majority ethnic group (80%). WPV of any type was reported by 77.1%. Verbal abuse was the most common type (71.6%), and patients were the most common perpetrators. WPV was most prevalent among traumatologists, tumor surgeons, female surgeons, and those with 0 to 15 years in practice. Female surgeons reported more WPV events per practice year (2.25 versus 0.65, P < 0.01) and increased likelihood of physical threats and physical assaults from coworkers ( P = 0.004). DISCUSSION WPV in orthopaedic surgery is largely perpetrated by patients and directed toward traumatologists, tumor surgeons, female surgeons, and less experienced surgeons. These data can be used to address safety measures in the workplace.
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Affiliation(s)
- Brent Ponce
- From the Hughston Clinic and Foundation, Columbus, GA (Ponce and Gruenberger), Department of Epidemiology, Birmingham, University of Alabama Birmingham, School of Public Health, AB (McGwin) Nationwide Children's Hospital, Columbus, OH (Samora) Atrium Health Levine Cancer Institute, Charlotte, NC (Patt)
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Kynoch K, Liu XL, Cabilan CJ, Ramis MA. Educational programs and interventions for health care staff to prevent and manage aggressive behaviors in acute hospitals: a systematic review. JBI Evid Synth 2024; 22:560-606. [PMID: 37851359 DOI: 10.11124/jbies-22-00409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2023]
Abstract
OBJECTIVE The objective of this review was to determine the effect of educational programs that have been implemented in acute health care settings to manage or prevent aggressive behaviors toward staff perpetrated by patients, families, or visitors. INTRODUCTION Health care staff working within acute-level and tertiary-level hospitals are at high risk of exposure to aggressive behaviors by patients, their family, or visitors. Negative staff and organizational impacts reported in the literature include individual psychological or emotional distress and severe harm, increased absenteeism, high staff turnover, and awarded compensation. Reports of this kind of occupational violence are increasing globally; therefore, strategies to address prevention and management are needed to mitigate the risk of harm to staff and the wider hospital service. Various educational activities have been implemented to address the issue, but the overall effect of these is unclear. INCLUSION CRITERIA Experimental and quasi-experimental studies were considered for inclusion if they reported on an educational program or intervention for staff working within an acute hospital setting and aimed at managing or preventing occupational violence perpetrated by patients, family, or visitors. Reports of programs implemented to address occupational violence, whether verbal or physical, were included. Studies were excluded if they reported on upward violence or bullying, patients in psychiatric or dementia facilities, or pediatric patients, due to the specific care needs of these cohorts. METHODS The following databases were searched: PubMed (PubMed Central), CINAHL (EBSCOhost), PsycINFO (EBSCOhost), Embase, ERIC (ProQuest), Cochrane Central Register of Controlled Trials (Cochrane Library), and Scopus. ProQuest Dissertations and Theses was searched for unpublished studies. To obtain a wider perspective of the issue, studies published in Chinese were also searched in WanFang Database, China National Knowledge Infrastructure, and Chongqing VIP. A date filter of 2008-2023 was applied in a deliberate effort to expand from previous work. No language filters were applied. The review was conducted in accordance with JBI methodology for systematic reviews of effectiveness, and reported as per the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. RESULTS The search process retrieved 4681 citations. A total of 32 studies representing 3246 health staff were included in the review. The studies were either before-and-after or pre-test/post-test study designs. Methodological quality of studies varied, with the main issues being absence of CIs within statistical analysis, limited detail on participant selection or attrition/non-response, and underreporting of confounding factors. Educational programs varied in content and duration. Content delivery across the studies also varied, with several didactic, role-play, debriefing, group work, and simulation exercises reported. While studies reported some improvement in self-reported confidence levels, results were mixed for other outcomes. Determining overall effect of included studies was challenging due to heterogeneity within and across studies with regard to intervention types, populations, measurement tools, and outcomes. CONCLUSIONS This review is unable to determine which workplace educational programs had an effect on staff outcomes or on the number of occupational violence incidents. In the future, educators and researchers could use the findings of this review to guide the design of educational programs and employ measures that are comparable to their settings. REVIEW REGISTRATION PROSPERO CRD42020190538. SUPPLEMENTAL DIGITAL CONTENT A Chinese-language version of the abstract of this review is available [ http://links.lww.com/SRX/A33 ].
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Affiliation(s)
- Kathryn Kynoch
- Mater Health, Brisbane, QLD, Australia
- Queensland Centre for Evidence Based Nursing and Midwifery: A JBI Centre of Excellence, Brisbane, QLD, Australia
- Queensland University of Technology (QUT), School of Nursing, Brisbane, QLD, Australia
| | - Xian-Liang Liu
- School of Nursing and Health Studies, Hong Kong Metropolitan University, Homantin, Kowloon, Hong Kong, China
- Charles Darwin Centre for Evidence-Based Practice: A JBI Affiliated Group, Brisbane, QLD, Australia
| | - C J Cabilan
- Queensland Centre for Evidence Based Nursing and Midwifery: A JBI Centre of Excellence, Brisbane, QLD, Australia
- Princess Alexandra Hospital Emergency Department, Brisbane, QLD, Australia
- School of Nursing, Midwifery and Social Work, Faculty of Health and Behavioural Sciences, The University of Queensland, Brisbane, QLD, Australia
| | - Mary-Anne Ramis
- Mater Health, Brisbane, QLD, Australia
- Queensland Centre for Evidence Based Nursing and Midwifery: A JBI Centre of Excellence, Brisbane, QLD, Australia
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Kynoch K, Liu XL, Cabilan CJ, Ramis MA. Managing workplace violence against health care workers: education alone is not enough. JBI Evid Synth 2024; 22:515-517. [PMID: 38600645 DOI: 10.11124/jbies-24-00104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/12/2024]
Affiliation(s)
- Kathryn Kynoch
- Mater Health, Brisbane, QLD, Australia
- Queensland Centre for Evidence Based Nursing and Midwifery: A JBI Centre of Excellence, Brisbane, QLD, Australia
- Queensland University of Technology (QUT), School of Nursing, Brisbane, QLD, Australia
| | - Xian-Liang Liu
- School of Nursing and Health Studies, Hong Kong Metropolitan University, Homantin, Kowloon, Hong Kong, China
| | - C J Cabilan
- Occupational Violence Prevention and Management, Work Health and Safety, Canberra Health Services, ACT, Australia
| | - Mary-Anne Ramis
- Mater Health, Brisbane, QLD, Australia
- Queensland Centre for Evidence Based Nursing and Midwifery: A JBI Centre of Excellence, Brisbane, QLD, Australia
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Yenealem DG, Mengistu AM. Fear of violence and working department influences physical aggression level among nurses in northwest Ethiopia government health facilities. Heliyon 2024; 10:e27536. [PMID: 38509935 PMCID: PMC10951522 DOI: 10.1016/j.heliyon.2024.e27536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Revised: 07/05/2023] [Accepted: 03/01/2024] [Indexed: 03/22/2024] Open
Abstract
Purpose Violence is recognized as an extreme expression of aggressive behavior and physical violence is most recognized type among victims. Patients always come to the hospitals looking for a cure, remedy, or assurance; however, incompatibility of demand and service often results in violent incidents that become statuesque in health facilities. This study aims to investigate physical violence and associated factors among nurses in health facilities in Gondar town, Ethiopia. Method The study was an institutional-based cross-sectional study among nurses in Gondar town from April to May 2017. Data were collected using a pretested modified version of the standard [ILO/ICN/WHO/PSI] questionnaire by trained data collectors among 339 nurses across health facilities. Multivariable logistic regression analysis with 95% confidence interval (CI) was used to identify the factors significantly associated with physical violence at p-value ≤0.05. Result Over one fourth (28.9%) [95% CI: (24.8, 33.9)] of nurses were victims of violence in the past 12 months. Level of verbal abuse (AOR = 2.35; 95%CI, 1.26-4.40), working in emergency (AOR = 4.58; 95%CI, 1.47-14.30) and inpatient (AOR = 3.33; 95%CI, 1.15-9.66)departments; having moderate (AOR = 0.41; 95%CI, 0.18-0.90),high (AOR = 0.41; 95%CI, 0.18-0.90), optimal (AOR = 0.41; 95%CI, 0.18-0.90) level of concern of violence were significantly associated with physical violence. Conclusion This study underlines findings nurses are at high-risk of physical violence and it is ranked second highest only to psychiatric and trauma facilities in Gondar town. Exposure to verbal abuse, working in emergency and inpatient departments and perceived level of concern are the precursors of experiencing physical violence. Therefore, investing time and capital in training like restraining and de-escalation, structural measures that deter the assailants are important.
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Affiliation(s)
- Dawit Getachew Yenealem
- Department of Environmental and Occupational Health and Safety, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Avier Mesfin Mengistu
- Hygiene and Sanitation Office, Gondar University Comprehensive Specialized Hospital, University of Gondar, Gondar, Ethiopia
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Xiao Y, Chen TT, Zhu SY, Li CY, Zong L. Factors associated with workplace violence against Chinese healthcare workers: an online cross-sectional survey. Front Public Health 2024; 12:1295975. [PMID: 38550327 PMCID: PMC10977601 DOI: 10.3389/fpubh.2024.1295975] [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: 09/17/2023] [Accepted: 03/06/2024] [Indexed: 04/02/2024] Open
Abstract
Objectives Workplace violence (WPV) against healthcare workers (HCWs) has reached significant levels globally, impeding the quality and accessibility of healthcare systems. However, there is limited available knowledge regarding the determinants linked with WPV among HCWs and the discrepancies observed across various levels of hospitals in China. The objective of the present research was to investigate the factors linked to WPV and job satisfaction among HCWs in China. Methods A self-developed questionnaire based on WeChat was employed to collect data. The questionnaire consisted of demographic information as well as occupational factors. To measure WPV, the Chinese version of the Workplace Violence Scale was utilized. Career satisfaction was assessed through two questions regarding career choices. The collected data was analyzed using descriptive analyses, chi-square tests, and multivariate logistic regressions. Results A total of 3,781 valid questionnaires (1,029 doctors and 2,752 nurses) were collected. Among all participants, 2,201 (58.2%) reported experiencing at least one form of WPV in the past year, with emotional abuse being the most frequent occurrence (49.7%), followed by threats (27.9%). The multivariate logistic regression analysis revealed several risk factors associated with WPV, including male gender, shift work, senior professional title, bachelor's degree education, employment in secondary-level hospitals, and working over 50 h per week (p < 0.05). Career satisfaction among HCWs who experienced high levels of WPV was low, with only 11.2% remaining confident in their profession, and a mere 2.0% supporting their children pursuing careers in healthcare. Conclusion WPV poses a significant challenge within the Chinese healthcare system. Efforts should be made to address the identified risk factors and promote a safe and satisfying working environment for HCWs.
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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
| | - Ting-ting Chen
- Nursing Department, West China Hospital of Sichuan University, Chengdu, China
| | - Shao-yi Zhu
- Department of Psychiatry, Shantou University Mental Health Center, Shantou, China
| | - Chun-ya Li
- Psychosomatic Medical Center, The Fourth People’s Hospital of Chengdu, Chengdu, China
| | - Ling Zong
- Department of Judicial Expertise, Zhongshan Third People’s Hospital, Zhongshan, China
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Elom P, Agu A, Unah A, Azuogu B, Ituma B, Okah O, Okocha Y, Ugwunweze J, Ossai E, Igwe D. Prevalence and factors associated with workplace violence in a tertiary healthcare facility in Nigeria. Niger Med J 2024; 65:173-184. [PMID: 39005550 PMCID: PMC11240196 DOI: 10.60787/nmj-v65i2-336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/16/2024] Open
Abstract
Background Healthcare workers globally are at an increased risk of workplace violence. Adverse effects such as physical injury, reduced quality of care to patients and lower productivity with associated costs to employers occur. Non-reporting hinders the implementation of effective prevention. This study aimed to assess the prevalence, reasons for non-reporting of workplace violence, and knowledge of prevention prior to designing intervention strategies in the study location where there is a paucity of research on this issue. Methodology This cross-sectional study was conducted at a Teaching Hospital in Abakaliki, Ebonyi State, for 4 weeks in 2020 among 205 employees. The hospital was stratified into Clinical, Nursing Services, Pharmacy, Laboratory, and administrative divisions; proportionate allocation and random sampling were used to select the allocated samples. A structured questionnaire was used to collect data. Descriptive statistics determined the measures of central tendencies and dispersion, while bivariate analysis of the variables was done using Pearson's Chi-Square test. Statistical significance was set at p ≤ 0.05 with a confidence level of 95%. Results The mean age of the participants was 39.1 ± 7.8 years. The prevalence of workplace violence was 70%. The most common reason for non-reporting was complexities and time-consuming reporting procedures (26.5%) followed by fear of reprisal on career (22.4%). The proportion of respondents with good knowledge of workplace violence prevention strategies was high (69.8%). Gender (p = 0.03), work setting (p = 0.006), previous workplace violence training (p = 0.005) and knowledge of workplace violence preventive strategies (p = 0.04) had statistically significant associations with experience of workplace violence. Conclusion The high prevalence of workplace violence suggests a need for a workplace violence prevention program which should include a simple process of reporting and training. The improved awareness from previous training may account for the significant association with workplace violence.
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Affiliation(s)
- Peter Elom
- Department of Community Medicine, Ebonyi State University, Abakaliki, Nigeria
| | - Adaoha Agu
- African Institute for Health Policy and Health Systems, Ebonyi State University, Abakaliki, Nigeria
| | - Alfred Unah
- Department of Community Medicine, Alex Ekwueme Federal University Teaching Hospital, Abakaliki, Ebonyi State, Nigeria
| | - Benedict Azuogu
- Department of Community Medicine, Alex Ekwueme Federal University Teaching Hospital, Abakaliki, Ebonyi State, Nigeria
| | - Bernard Ituma
- Department of Community Medicine, Alex Ekwueme Federal University Teaching Hospital, Abakaliki, Ebonyi State, Nigeria
- Department of Community Medicine, University of Nigeria Teaching Hospital, Ituku Ozalla, Enugu State, Nigeria
| | - Onyinyechi Okah
- Department of Community Medicine, Alex Ekwueme Federal University Teaching Hospital, Abakaliki, Ebonyi State, Nigeria
- Department of Community Medicine, University of Nigeria Teaching Hospital, Ituku Ozalla, Enugu State, Nigeria
| | - Yusuf Okocha
- Department of Community Medicine, Alex Ekwueme Federal University Teaching Hospital, Abakaliki, Ebonyi State, Nigeria
- Department of Community Medicine, University of Nigeria Teaching Hospital, Ituku Ozalla, Enugu State, Nigeria
| | - Jacintha Ugwunweze
- Department of Community Medicine, Alex Ekwueme Federal University Teaching Hospital, Abakaliki, Ebonyi State, Nigeria
| | - Edmund Ossai
- Department of Community Medicine, Alex Ekwueme Federal University Teaching Hospital, Abakaliki, Ebonyi State, Nigeria
| | - Dorothy Igwe
- Department of Community Medicine, Alex Ekwueme Federal University Teaching Hospital, Abakaliki, Ebonyi State, Nigeria
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Hu Y, Huang J, Zhao D, Zhang C, Xia J, Lu XM. Effect of safety and security equipment on patient and visitor violence towards nurses in multiple public hospitals of China during the COVID-19 pandemic: a retrospective, difference-in-difference analysis. BMJ Open 2024; 14:e078598. [PMID: 38296297 PMCID: PMC10831433 DOI: 10.1136/bmjopen-2023-078598] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2023] [Accepted: 01/17/2024] [Indexed: 02/03/2024] Open
Abstract
OBJECTIVES This study aimed to analyse whether safety and security equipment decreased patient and visitor violence (PVV) towards nurses in the COVID-19 period and quantify to what extent safety and security equipment affects PVV. DESIGN Controlled before and after study and difference-in-difference (DID) analysis. SETTING A large hospital medical group, consisting of three public tertiary teaching hospitals, namely, Xinjiekou Branch, Huilongguan Branch and Xinlongze Branch of Beijing Jishuitan Hospital, located in the west and north parts of Beijing, China. PARTICIPANTS A panel of nine departments recruited using two-step sampling method, administered online surveys in 2021 and 2022. A total of 632 eligible nurses participated in the survey in 2021 and 725 eligible nurses in 2022. MEASURES We assessed impacts of the safety and security equipment on the PVV. The policy had been enacted in June 2020, and the corresponding measures were established after mid-December 2020, and therefore, we use a DID design to evaluate changes in nurses' PVV incidence. Departments are classified as either department installed or non installed, and nurses are classified based on their department. RESULTS Within the treatment group, the incidence of physical PVV significantly decreased from 13.8% in 2020 to 2.0% in 2021. In the control group, the incidence of physical PVV increased from 0.6% in 2020 to 2.7% in 2021. The application of the safety and security equipment decreased the incidence of physical PVV by 13.93% (95% CI: -23.52% to -4.34%). In contrast, no difference was observed between the treatment and control groups for the incidence of psychological PVV (6.23%, 95% CI: -11.56% to 24.02%) and overall PVV (0.88, 95% CI: -20.90% to 22.66%). CONCLUSION The safety and security equipment reduced the incidence of physical PVV towards nurses. For hospital managers in public hospitals, longer-term strategies roadmap for PVV prevention measures are needed to create a more supportive work environment in employees.
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Affiliation(s)
- Yanzhen Hu
- Department of Nursing, Beijing Jishuitan Hospital, Capital Medical University, Beijing, Beijing, China
| | - Ju Huang
- Institute of Medical Information, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Dan Zhao
- Department of Nursing, Beijing Jishuitan Hospital, Capital Medical University, Beijing, Beijing, China
| | - Cheng Zhang
- Institute of Medical Information, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Jinghua Xia
- Department of Nursing, Beijing Jishuitan Hospital, Capital Medical University, Beijing, Beijing, China
| | - Xue-Mei Lu
- Department of Nursing, Beijing Jishuitan Hospital, Capital Medical University, Beijing, Beijing, China
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Zhou X, Liu Y, Zhang X, Wang C, Liu S, Jiang Y. Global prevalence of restless legs syndrome among hemodialysis patients: A systematic review and meta-analysis. Brain Behav 2024; 14:e3378. [PMID: 38376019 PMCID: PMC10784193 DOI: 10.1002/brb3.3378] [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: 10/18/2023] [Revised: 12/18/2023] [Accepted: 12/19/2023] [Indexed: 02/21/2024] Open
Abstract
OBJECTIVES Restless legs syndrome (RLS) is a common complaint in patients undergoing hemodialysis (HD). Despite the fact that the estimated prevalence of RLS among HD patients is widely reported, these results varied significantly in the relevant literature. Due to this limitation, the aim of this study was to determine the global prevalence of RLS among HD patients. METHODS This systematic review was conducted and reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses 2020 statement. We searched the electronic databases: Cochrane Library, PubMed, Embase, Web of Science, Scopus, Cumulative Index to Nursing and Allied Health Literature, China Knowledge Resource Integrated Database, Wanfang Database, Chinese Biomedical Database, and Weipu Database. A random effects model was employed to calculate pooled prevalence rates. RESULTS The global pooled prevalence of RLS in HD patients was 27.2% (95% CI: 24.8-29.7). Stratified analyses demonstrated that included studies with sample size <100 had the highest pooled prevalence of RLS. The prevalence of RLS using clinical interviews and questionnaires was 28.7% (95% CI: 25.2-32.2) and 25.9% (95% CI: 22.8-29.1), respectively. RLS prevalence is higher in females (29.7%, 95% CI: 26.2-33.2) HD patients than in males (23.5%, 95% CI: 20.9-26.0), and the African region has the highest prevalence in the world when the diagnostic criteria were restricted to the 2003 version of International RLS Study Group criteria, the prevalence of RLS was highest (28.9%, 95% CI: 25.9-31.9). CONCLUSION Our results revealed a high RLS prevalence in HD patients worldwide. However, the prevalence of RLS among HD patients varied significantly based on sample size, data collection method, gender, diagnostic criteria, and geographical region.
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Affiliation(s)
- Xu‐Hua Zhou
- Evidence‐Based Nursing Center, West China HospitalSichuan University/West China School of Nursing, Sichuan UniversityChengduSichuanP. R. China
| | - Yuan Liu
- Evidence‐Based Nursing Center, West China HospitalSichuan University/West China School of Nursing, Sichuan UniversityChengduSichuanP. R. China
| | - Xin‐Rui Zhang
- Evidence‐Based Nursing Center, West China HospitalSichuan University/West China School of Nursing, Sichuan UniversityChengduSichuanP. R. China
| | - Cong Wang
- Evidence‐Based Nursing Center, West China HospitalSichuan University/West China School of Nursing, Sichuan UniversityChengduSichuanP. R. China
| | - Shan‐Shan Liu
- Evidence‐Based Nursing Center, West China HospitalSichuan University/West China School of Nursing, Sichuan UniversityChengduSichuanP. R. China
| | - Yan Jiang
- Nursing Department, West China HospitalSichuan University/West China School of NursingSichuan UniversityChengduSichuanP. R. China
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Rehan ST, Shan M, Shuja SH, Khan Z, Hussain HU, Ochani RK, Shaikh A, Ratnani I, Nashwan AJ, Surani S. Workplace violence against healthcare workers in Pakistan; call for action, if not now, then when? A systematic review. Glob Health Action 2023; 16:2273623. [PMID: 37938187 PMCID: PMC10653705 DOI: 10.1080/16549716.2023.2273623] [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: 05/03/2023] [Accepted: 10/17/2023] [Indexed: 11/09/2023] Open
Abstract
BACKGROUND Workplace violence (WPV) is a global problem that affects healthcare workers' physical and mental health and impairs work performance. Pakistan's healthcare system is not immune to WPV, which the World Health Organization recognises as an occupational hazard. OBJECTIVES The primary objective of this systematic review is to determine the prevalence of physical, verbal, or other forms of WPV in healthcare workers in Pakistan. Secondary objectives include identifying the associated risk factors and perpetrators of WPV. METHODS A systematic review of six electronic databases was conducted through August 2022. Studies were included if they met the following criteria: 1) healthcare workers (HCWs), including physicians, nurses, and paramedic staff working in the private or public sector of Pakistan; 2) exposure to physical, verbal, or any type of violence. Data were extracted and analysed for the prevalence of WPV, types of violence, associated risk factors, and perpetrators of violence. RESULTS Twenty-four studies including 16,070 HCWs were included in this review. Verbal violence was the most common form of violence levied, with its highest prevalence (100%) reported in Islamabad and lowest verbal violence prevalence (25%) in Karachi. Verbal abuse was preponderant against female HCWs, while physical abuse was directed more towards males. The most common perpetrators were patient attendants, followed by the patients. CONCLUSION Our review determines a 25-100% prevalence of WPV against HCWs in Pakistani medical setups. This occupational hazard needs the attention of relevant authorities in the country to put protective enforcement policies in place. Large-scale surveys should be conducted to better gauge the current plight of HCWs in the nation.
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Affiliation(s)
- Syeda Tayyaba Rehan
- Department of Medicine, Dow University of Health Sciences, Karachi, Pakistan
| | - Mishal Shan
- Department of Pediatrics, Dr. Ruth KM Pfau Civil Hospital, Karachi, Pakistan
| | - Syed Hasan Shuja
- Department of Medicine, Dow University of Health Sciences, Karachi, Pakistan
| | - Zayeema Khan
- Department of Medicine, Dow University of Health Sciences, Karachi, Pakistan
| | - Hassan Ul Hussain
- Department of Medicine, Dow University of Health Sciences, Karachi, Pakistan
| | - Rohan Kumar Ochani
- Department of Medicine, Dow University of Health Sciences, Karachi, Pakistan
| | - Asim Shaikh
- Department of Medicine, The Aga Khan University, Karachi, Pakistan
| | - Iqbal Ratnani
- Department of Anesthesiology and Critical Care, Methodist DeBakey Heart & Vascular Center, Houston Methodist Hospital, Houston, TX, USA
| | | | - Salim Surani
- Adjunct Clinical Professor, Texas A&M University, Corpus Christi, TX, USA
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Acquaye AGO, Hull SC. Ethics of identity concordance requests in patient-clinician encounters. J Natl Med Assoc 2023; 115:539-544. [PMID: 37880065 DOI: 10.1016/j.jnma.2023.09.004] [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: 06/05/2023] [Revised: 08/10/2023] [Accepted: 09/26/2023] [Indexed: 10/27/2023]
Abstract
Systemic injustice has resulted in significant baseline inequality amongst populations according to gradients of privilege. What is the ethical approach to situations wherein equity may require differential treatment to correct for baseline disadvantages as a necessary means to its attainment? We explore this concept through the issue of patient requests for clinician identity concordance, when patients request a clinician who matches their race, ethnicity, or gender. Firstly, we discuss ethical grounds for refusing requests by exploring the balance between patient autonomy, a physician's obligation to not abandon one's patients, and the right of a clinician to be free from violence of any form. Next, we explore the ethics surrounding conditional acceptance through the frames of intent and clinical outcomes. We note the legacy of trauma experienced by marginalized patients at the hands of medicine and the abundance of data suggesting that identity concordance can mitigate disparities.
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Affiliation(s)
- Amber G O Acquaye
- Yale School of Medicine, 703 Whitney Ave, New Haven, Connecticut 06511 United States.
| | - Sarah C Hull
- Section of Cardiovascular Medicine, Yale School of Medicine, 15 York Street, PO Box 208017, New Haven, CT 06520-8017 United States; Program for Biomedical Ethics, Yale School of Medicine, 15 York Street, PO Box 208017, New Haven, CT 06520-8017 United States
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Ose SO, Lohmann-Lafrenz S, Kaspersen SL, Berthelsen H, Marchand GH. Registered nurses' exposure to workplace aggression in Norway: 12-month prevalence rates, perpetrators, and current turnover intention. BMC Health Serv Res 2023; 23:1272. [PMID: 37974173 PMCID: PMC10655393 DOI: 10.1186/s12913-023-10306-z] [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: 05/09/2023] [Accepted: 11/09/2023] [Indexed: 11/19/2023] Open
Abstract
BACKGROUND Identifying occupational health hazards among Registered Nurses (RNs) and other health personnel and implementing effective preventive measures are crucial to the long-term sustainability of health services. The objectives of this study were (1) to assess the 12-month prevalence rates of exposure to workplace aggression, including physical violence, threats of violence, sexual harassment, and bullying; (2) to identify whether the perpetrators were colleagues, managers, subordinates, or patients and their relatives; (3) to determine whether previous exposure to these hazards was associated with RNs' current turnover intention; and (4) to frame workplace aggression from an occupational health and safety perspective. METHODS The third version of the Copenhagen Psychosocial Questionnaire (COPSOQ III) was used to assess RNs' exposure to workplace aggression and turnover intention. A national sample of 8,800 RNs in Norway, representative of the entire population of registered nurses in terms of gender and geography, was analysed. Binary and ordinal logistic regression analyses were conducted, and odds for exposure and intention to leave are presented, with and without controls for RNs' gender, age, and the type of health service they work in. RESULTS The 12-month prevalence rates for exposure were 17.0% for physical violence, 32.5% for threats of violence, 12.6% for sexual harassment, and 10.5% for bullying. In total, 42.6% of the RNs had experienced at least one of these types of exposure during the past 12 months, and exposure to more than one of these hazards was common. Most perpetrators who committed physical acts and sexual harassment were patients, while bullying was usually committed by colleagues. There was a strong statistical association between exposure to all types of workplace aggression and RNs' intention to leave. The strongest association was for bullying, which greatly increased the odds of looking for work elsewhere. CONCLUSIONS Efforts to prevent exposure to workplace aggression should be emphasised to retain health personnel and to secure the supply of skilled healthcare workers. The results indicate a need for improvements. To ensure the sustainability of health services, labour and health authorities should join forces to develop effective workplace measures to strengthen prevention, mitigation, and preparedness regarding incidents of workplace aggression in health services and the response and recovery regarding incidents that could not be prevented.
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Affiliation(s)
| | | | | | - Hanne Berthelsen
- Centre for WorkLife and Evaluation Studies, Malmö University, Malmö, Sweden
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Abbiati M, Golay P, De Maria LF, Palix J. Measuring the Severity of Objective and Subjective Patient-to-Staff Violence in Psychogeriatric and Adult Psychiatric Wards: A Retrospective Study of Four Swiss Hospitals. Issues Ment Health Nurs 2023; 44:1142-1149. [PMID: 37699065 DOI: 10.1080/01612840.2023.2246560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/14/2023]
Abstract
Measurement of patient-to-staff violence (PSV) is essential for the institution to prevent negative outcomes and provide effective interventions. Although there are several approaches to doing this in psychiatry, little is known about how well they adapt to different types of wards. The role of gender and age also needs further investigation. The present study aimed to examine and compare characteristics that contribute to the objective and subjective measurement of the severity of PSV in adult (AP) and geriatric (PG) psychiatric wards. Results show that 70% of the reported violence over 30 months (N = 589) was PSV, mostly perpetrated by male patients against nurses. Objective severity ratings were higher in PG than in AP wards, and conversely, subjective ratings were higher in AP than in PG wards. The findings support the systematic measurement of PSV in psychiatric wards and highlight the need for targeted interventions to address the risks associated with minimizing violence.
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Affiliation(s)
- Milena Abbiati
- Legal Psychiatry and Psychology Research Unit, Institute of Legal Psychiatry, Lausanne University Hospital, Switzerland
| | - Philippe Golay
- Community Psychiatry Unit, Department of Psychiatry, Lausanne University Hospital and University of Lausanne, Switzerland
- General Psychiatry Unit, Treatment and Early Intervention in Psychosis Program (TIPP-Lausanne), Lausanne University Hospital and University of Lausanne, Switzerland
- Institute of Psychology, University of Lausanne, Switzerland
| | - Lora Flor De Maria
- Legal Psychiatry and Psychology Research Unit, Institute of Legal Psychiatry, Lausanne University Hospital, Switzerland
| | - Julie Palix
- Legal Psychiatry and Psychology Research Unit, Institute of Legal Psychiatry, Lausanne University Hospital, Switzerland
- Institute of Psychology, University of Lausanne, Switzerland
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Nelson S, Leslie K, McCormick A, Gonsalves J, Baumann A, Thiessen NJ, Schiller C. Workplace Violence Against Nurses in Canada: A Legal Analysis. Policy Polit Nurs Pract 2023; 24:239-254. [PMID: 37403491 PMCID: PMC10563371 DOI: 10.1177/15271544231182583] [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] [Indexed: 07/06/2023]
Abstract
Workplace violence against nurses is a significant global occupational health problem, with incidents of violence increasing in frequency since the COVID-19 pandemic began. In this article, we provide a review of recent legislative amendments meant to bolster workplace safety in health care in Canada, analyze legal cases where nurses were the victims of violence, and discuss what these legal reforms and decisions reveal about how nurses' work is treated within the Canadian legal system. Under criminal law, the limited number of cases we could find with oral or written sentencing decisions show that, historically, the fact a victim was a nurse was not always considered an aggravating factor on sentencing. Recent legislative amendments make this a specified aggravating factor and it is important to track the impact of these amendments when judges exercise their discretion in sentencing. Under employment law, it appears that, despite the government's efforts to increase the deterrence factor under legislation with significantly increased fines for employers who fail to protect their employees from injury, courts remain reluctant to impose such sanctions. In these cases, it is also important to track the impact of harsher penalties. We conclude that combating the widespread normalization of workplace violence in health care, and specifically against nurses, is acutely needed to help ensure that these ongoing legal reforms aimed at improving the safety of health workers are effective.
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Affiliation(s)
- Sioban Nelson
- Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON Canada
| | - Kathleen Leslie
- Faculty of Health Disciplines, Athabasca University, Athabasca, AB Canada
| | - Aleah McCormick
- Faculty of Health Disciplines, Athabasca University, Athabasca, AB Canada
| | | | - Andrea Baumann
- Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON Canada
| | | | - Catharine Schiller
- School of Nursing, University of Northern British Columbia, Prince George, BC Canada
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Yusoff HM, Ahmad H, Ismail H, Reffin N, Chan D, Kusnin F, Bahari N, Baharudin H, Aris A, Shen HZ, Rahman MA. Contemporary evidence of workplace violence against the primary healthcare workforce worldwide: a systematic review. HUMAN RESOURCES FOR HEALTH 2023; 21:82. [PMID: 37833727 PMCID: PMC10576303 DOI: 10.1186/s12960-023-00868-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Accepted: 10/02/2023] [Indexed: 10/15/2023]
Abstract
Violence against healthcare workers recently became a growing public health concern and has been intensively investigated, particularly in the tertiary setting. Nevertheless, little is known of workplace violence against healthcare workers in the primary setting. Given the nature of primary healthcare, which delivers essential healthcare services to the community, many primary healthcare workers are vulnerable to violent events. Since the Alma-Ata Declaration of 1978, the number of epidemiological studies on workplace violence against primary healthcare workers has increased globally. Nevertheless, a comprehensive review summarising the significant results from previous studies has not been published. Thus, this systematic review was conducted to collect and analyse recent evidence from previous workplace violence studies in primary healthcare settings. Eligible articles published in 2013-2023 were searched from the Web of Science, Scopus, and PubMed literature databases. Of 23 included studies, 16 were quantitative, four were qualitative, and three were mixed method. The extracted information was analysed and grouped into four main themes: prevalence and typology, predisposing factors, implications, and coping mechanisms or preventive measures. The prevalence of violence ranged from 45.6% to 90%. The most commonly reported form of violence was verbal abuse (46.9-90.3%), while the least commonly reported was sexual assault (2-17%). Most primary healthcare workers were at higher risk of patient- and family-perpetrated violence (Type II). Three sub-themes of predisposing factors were identified: individual factors (victims' and perpetrators' characteristics), community or geographical factors, and workplace factors. There were considerable negative consequences of violence on both the victims and organisations. Under-reporting remained the key issue, which was mainly due to the negative perception of the effectiveness of existing workplace policies for managing violence. Workplace violence is a complex issue that indicates a need for more serious consideration of a resolution on par with that in other healthcare settings. Several research gaps and limitations require additional rigorous analytical and interventional research. Information pertaining to violent events must be comprehensively collected to delineate the complete scope of the issue and formulate prevention strategies based on potentially modifiable risk factors to minimise the negative implications caused by workplace violence.
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Affiliation(s)
- Hanizah Mohd Yusoff
- Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia, Cheras, 56000, Kuala Lumpur, Malaysia
| | - Hanis Ahmad
- Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia, Cheras, 56000, Kuala Lumpur, Malaysia.
| | - Halim Ismail
- Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia, Cheras, 56000, Kuala Lumpur, Malaysia
| | - Naiemy Reffin
- Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia, Cheras, 56000, Kuala Lumpur, Malaysia
| | - David Chan
- Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia, Cheras, 56000, Kuala Lumpur, Malaysia
| | - Faridah Kusnin
- The State of Selangor Health Department, Tingkat 9, 10-11, Wisma 16 Sunway Mas, Lot 1, Jalan Persiaran Kayangan, 40100, Shah Alam, Selangor, Malaysia
| | - Nazaruddin Bahari
- The State of Selangor Health Department, Tingkat 9, 10-11, Wisma 16 Sunway Mas, Lot 1, Jalan Persiaran Kayangan, 40100, Shah Alam, Selangor, Malaysia
| | - Hafiz Baharudin
- Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia, Cheras, 56000, Kuala Lumpur, Malaysia
| | - Azila Aris
- Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia, Cheras, 56000, Kuala Lumpur, Malaysia
| | - Huam Zhe Shen
- Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia, Cheras, 56000, Kuala Lumpur, Malaysia
| | - Maisarah Abdul Rahman
- Anaesthesiology Department, Hospital Queen Elizabeth II, Lorong Bersatu Off Jalan Damai, 88300, Kota Kinabalu, Sabah, Malaysia
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24
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la Cruz JPSD, Genis-Mendoza AD, López-Narváez ML, González-Castro TB, Juárez-Rojop IE, Tovilla-Zárate CA, Nicolini H. Aggression against Nursing Personnel during the First Wave of COVID-19 Pandemic: An Internet-Based Survey. NURSING REPORTS 2023; 13:1388-1398. [PMID: 37873823 PMCID: PMC10594505 DOI: 10.3390/nursrep13040116] [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: 06/19/2023] [Revised: 08/18/2023] [Accepted: 10/03/2023] [Indexed: 10/25/2023] Open
Abstract
(1) Background: health care workers, particularly nurses, have been regularly assaulted during the COVID-19 pandemic. Purpose: to evaluate the prevalence and location of assaults against nursing personnel in Latin America, and to determine predictor factors for aggression against nurses. (2) Methods: A cross-sectional online survey was answered by 374 nurses working in health care during the COVID-19 pandemic. The aggression against nurses was estimated using the Victimization Scale. (3) Results: A total of 288 nurses were included in this study. The victimization scale showed that 52.1% of nurses have suffered aggression by the general population during the COVID-19 pandemic. Males were more likely to be attacked than females (p < 0.05). Additionally, males were attacked more frequently on public transport (x2 = 6.72, p = 0.01). The home neighborhood and markets were other locations with a higher risk of being assaulted (OR: 3.39, CI: 1.53-7.50). (4) Conclusions: Our results indicate that nurses in Latin America who work during the COVID-19 pandemic and social isolation have been frequently assaulted by the general public. Males are more frequently attacked than females and the main places of aggression are public transportation, their home neighborhood and supermarkets. Implications for nursing practice: it is necessary to create and implement protocols and guidelines to support nursing personnel during the COVID-19 pandemic. This study was retrospectively registered at the Juarez Autonomous University of Tabasco (103/CIPDACS/2020) on the (08/2020).
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Affiliation(s)
- Juan Pablo Sánchez-de la Cruz
- División Académica Multidisciplinaria de Comalcalco, Universidad Juárez Autónoma de Tabasco, Comalcalco 86650, Mexico; (J.P.S.-d.l.C.); (M.L.L.-N.)
| | - Alma Delia Genis-Mendoza
- Servicio de Atención Psiquiátrica, Hospital Psiquiátrico Infantil Dr. Juan N. Navarro, Mexico City 14080, Mexico;
| | - María Lilia López-Narváez
- División Académica Multidisciplinaria de Comalcalco, Universidad Juárez Autónoma de Tabasco, Comalcalco 86650, Mexico; (J.P.S.-d.l.C.); (M.L.L.-N.)
| | - Thelma Beatriz González-Castro
- División Académica Multidisciplinaria de Jalpa de Méndez, Universidad Juárez Autónoma de Tabasco, Jalpa de Méndez 86250, Mexico;
| | - Isela Esther Juárez-Rojop
- División Académica de Ciencias de la Salud, Universidad Juárez Autónoma de Tabasco, Villahermosa 86100, Mexico;
| | - Carlos Alfonso Tovilla-Zárate
- División Académica Multidisciplinaria de Comalcalco, Universidad Juárez Autónoma de Tabasco, Comalcalco 86650, Mexico; (J.P.S.-d.l.C.); (M.L.L.-N.)
| | - Humberto Nicolini
- Laboratorio de Genómica de Enfermedades Psiquiátricas y Neurodegenerativas, Instituto Nacional de Medicina Genómica, Mexico City 14610, Mexico
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López-Ros P, López-López R, Pina D, Puente-López E. User violence prevention and intervention measures to minimize and prevent aggression towards health care workers: A systematic review. Heliyon 2023; 9:e19495. [PMID: 37809629 PMCID: PMC10558594 DOI: 10.1016/j.heliyon.2023.e19495] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Revised: 08/22/2023] [Accepted: 08/24/2023] [Indexed: 10/10/2023] Open
Abstract
Workplace violence in the health care setting is a social problem of great interest both at the health care level and in research in recent decades. The most common type of violence is the one coming from the user towards the professional. Although the bibliography includes multiple preventive actions focused on working with professionals, there are hardly any studies that explore and collect actions aimed at the user. The aim of this study is to analyze the results of the literature to provide an overview of the current evidence. Specifically, it aims to describe the various user-directed strategies or interventions aimed at reducing workplace violence experienced by professionals within the healthcare sector. A systematic review was performed following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), methodology of publications published up to December 2022 in the main databases. Studies that met the previously established eligibility criteria were identified. A peer review of the risk of bias was performed and the data were extracted from a previously elaborated template. The search yielded 5231 articles of which 11 were finally included in the review. Of these, 3 had a quantitative design, 7 had a qualitative design and one had a combined design. Of these, 38 measures or actions aimed at the user were compiled, grouped into four blocks according to the attitudinal objective pursued: Improvement of communication and creation of links, involvement of the user in joint decisions with the staff, informing and training the user, and other independent proposals. This study makes it possible to explore actions aimed at users with the objective of reducing violence towards health professionals. It collects and makes available to the scientific community a set of measures aimed at making a change of attitude in the perpetrator themselves, with the involvement of the perpetrator in the health system. This set of collected measures provides researchers with a basis to be taken into account for the implementation of future prevention plans according to the new multicomponent prevention models and with the involvement of the perpetrator themselves.
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Affiliation(s)
- Paloma López-Ros
- Department of Behavioral Sciences and Health, University Miguel Hernández, Elche, Spain
| | - Reyes López-López
- Applied Psychology Service (SEPA), University of Murcia, Murcia, Spain
| | - David Pina
- Applied Psychology Service (SEPA), University of Murcia, Murcia, Spain
- Department of Socio-Sanitary Sciences, University of Murcia, Murcia, Spain
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26
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Sanders J, Thomas L, Kerr T, Benita T, Abela K, Ulrich B. Interventions to prevent and mitigate workplace violence: Teaming up for a safer environment. Nurs Manag (Harrow) 2023; 54:20-30. [PMID: 37527648 DOI: 10.1097/nmg.0000000000000040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/03/2023]
Affiliation(s)
- Jennifer Sanders
- Jennifer Sanders is associate chief nurse executive and vice president at Texas Children's Hospital in Houston, Tex. Lisa Thomas is a nontenured instructional assistant professor of nursing at Cizik School of Nursing in Houston, Tex. Tarra Kerr is an assistant vice president at Texas Children's Hospital in Houston, Tex. Tiffany Benita is the clinical manager at Memorial Hermann Cancer Center Northeast in Humble, Tex. Karla Abela is an assistant professor, research at Cizik School of Nursing in Houston, Tex. Beth Ulrich is a professor of nursing at The University of Texas Medical Branch School of Nursing in Galveston, Tex
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27
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Sari H, Yildiz İ, Çağla Baloğlu S, Özel M, Tekalp R. The frequency of workplace violence against healthcare workers and affecting factors. PLoS One 2023; 18:e0289363. [PMID: 37506128 PMCID: PMC10381052 DOI: 10.1371/journal.pone.0289363] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Accepted: 07/17/2023] [Indexed: 07/30/2023] Open
Abstract
BACKGROUND Workplace violence has become a global issue, especially among healthcare workers. This study aimed to determine the influencing factors and legal processes of workplace violence incidents, as well as the frequency of workplace violence in a tertiary hospital. METHODS This observational, descriptive, retrospective frequency study was conducted between January 2020 and March 2022. This study examined the workplace violence records of 135 healthcare professionals at a tertiary hospital's Patient Rights and Employee Safety and Law departments. Factors affecting workplace violence were categorized as noncompliance with the procedure, communication, and dissatisfaction. RESULTS Workplace violence frequency was observed in the cumulative total of 10821 healthcare workers at 1.2%. In terms of workplace violence types, 71.9% were verbal and 28.1% were physical. In terms of exposure to workplace violence, doctors accounted for 62.3%, nurses for 20%, and medical secretaries for 7.4%. Most cases were observed in outpatient clinics (34.8%), followed by emergency departments (25.9%). Among the main reasons for workplace violence against healthcare workers, non-compliance with procedures (49.6%), communication (27.4%), and dissatisfaction (23.1%) were identified. Legal aid was provided to all notifications of workplace violence. 37.1% were not prosecuted, 55.5% were under investigation, 4.4% were accepted indictments, and 3.0% were punished by a judicial fine. CONCLUSION This study can provide significant contributions to the formulation of workplace violence prevention policies and programs by analyzing white-code notifications for workplace violence frequency and preventable factors. Healthcare workers may have underreported workplace violence events due to the length of the proceedings and the perceived lack of protection from legal regulations.
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Affiliation(s)
- Hıdır Sari
- Dicle University Faculty of Medicine, Department of Public Health, Diyarbakır, Turkey
| | - İsmail Yildiz
- Dicle University Faculty of Medicine, Department of Biostatistics and Medical Informatics, Diyarbakır, Turkey
| | | | - Mehmet Özel
- Department of Emergency Medicine, Diyarbakır Gazi Yasargil Training and Research Hospital, University of Health Sciences, Diyarbakır, Turkey
| | - Ronay Tekalp
- Dicle University, Office of Legal Affairs, Diyarbakır, Turkey
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28
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Alhassan AK, Alsaqat RT, Al Sweleh FS. Physical workplace violence in the health sector in Saudi Arabia. Medicine (Baltimore) 2023; 102:e34094. [PMID: 37478266 PMCID: PMC10662896 DOI: 10.1097/md.0000000000034094] [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: 01/18/2023] [Accepted: 06/02/2023] [Indexed: 07/23/2023] Open
Abstract
Physical workplace violence (WPV) occurs worldwide, causing psychological and physical injuries. However, reports from Saudi Arabia investigating which specialty is the most exposed are scarce. This study aimed to determine the prevalence and circumstances related to physical WPV among all healthcare providers in Saudi Arabia in 12 months, as well as the consequences for both attackers and targets of physical WPV. This cross-sectional study included all healthcare providers registered with the Saudi Commission for Health Specialties who had worked for more than 1 year in the health sector in Saudi Arabia until May 2019. Researchers distributed the questionnaire to the participants via email. Descriptive statistics were used to describe the basic features of the data. Correlations between the categorically measured variables were explored using a chi-square test of independence. Overall, 7398 healthcare workers (HCWs) voluntarily participated in the study, 51.3% being men and 48.7% being women. The mean age was 40 ± 8.62 years), and most participants were of non-Saudi origin. Overall, 9.3% HCWs had encountered physical violence. Male HCWs, pharmacists, nurses, and HCWs of non-Saudi origin were significantly more exposed to physical violence. Furthermore, those with direct physical contact with patients and those working with male patients only were more exposed to physical violence. Physical WPV is an important issue faced by HCWs, particularly those who work night shifts or have direct contact with patients. Results showed that more support, specific strategies and policies to reduce violence occurrence, and protection for healthcare providers are required.
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Affiliation(s)
- Aseel Khaled Alhassan
- Department of Dentistry, King Khalid Hospital in AlKharj, Ministry of Health, Alkharj, Saudi Arabia
| | - Reem Tarik Alsaqat
- Department of Dentistry, Restorative Division, Princes Noura University, Riyadh, Saudi Arabia
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29
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Mohd Hatta FH, Samsudin EZ, Aimran N, Ismail Z. Development and Validation of Questionnaires to Assess Workplace Violence Risk Factors (QAWRF): A Tripartite Perspective of Worksite-Specific Determinants in Healthcare Settings. Risk Manag Healthc Policy 2023; 16:1229-1240. [PMID: 37431510 PMCID: PMC10329825 DOI: 10.2147/rmhp.s411335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Accepted: 06/02/2023] [Indexed: 07/12/2023] Open
Abstract
Introduction Workplace violence (WPV) incidences are prevalent in healthcare, and existing WPV interventions have only moderate evidence for effectiveness. This study aimed to develop and validate an instrument to assess worksite-specific WPV risk factors in healthcare settings based on a tripartite perspective of key stakeholders to facilitate improved interventions. Methods Three questionnaires were developed to get the responses from healthcare administrators, workers, and clients, representing the three components of Questionnaires to Assess Workplace Violence Risk Factors (QAWRF). The domains of the questionnaires were developed based on The Chappell and Di Martino's Interactive Model of Workplace Violence, and the items were generated from 28 studies identified from a systematic review of the literature. Six experts, 36 raters, and 90 respondents were recruited to assess the content validity, face validity, and usability and reliability of the QAWRF respectively. Item and Scale Level Content Validity Index, Item and Scale Level Face Validity Index, and Cronbach's alpha values were determined for QAWRF-administrator, QAWRF-worker, and QAWRF-client. Results The psychometric indices for QAWRF are satisfactory. Conclusion QAWRF holds good content validity, face validity, and reliability, and findings from QAWRF can contribute towards worksite-specific interventions that are expected to be resource efficient and more effective than general WPV interventions.
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Affiliation(s)
- Faizul Haris Mohd Hatta
- Department of Public Health Medicine, Faculty of Medicine, Universiti Teknologi MARA, Selangor, Malaysia
| | - Ely Zarina Samsudin
- Department of Public Health Medicine, Faculty of Medicine, Universiti Teknologi MARA, Selangor, Malaysia
| | - Nazim Aimran
- College of Computing, Informatics, and Media, Universiti Teknologi MARA, Shah Alam, Selangor, Malaysia
| | - Zaliha Ismail
- Department of Public Health Medicine, Faculty of Medicine, Universiti Teknologi MARA, Selangor, Malaysia
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30
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Dou J, Liu H, Ma Y, Wu YY, Tao XB. Prevalence of post-dialysis fatigue: a systematic review and meta-analysis. BMJ Open 2023; 13:e064174. [PMID: 37311633 DOI: 10.1136/bmjopen-2022-064174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/15/2023] Open
Abstract
OBJECTIVES The purpose of this study was to synthesise data on the prevalence of post-dialysis fatigue (PDF) among haemodialysis (HD) patients. DESIGN Systematic review and meta-analysis. DATA SOURCES China National Knowledge Infrastructure, Wanfang, Chinese Biological Medical Database, PubMed, EMBASE and Web of Science were searched from their inception to 1 April 2022. ELIGIBILITY CRITERIA We selected patients who must receive HD treatment for at least 3 months. Cross-sectional or cohort studies published in Chinese or English were eligible for inclusion. The main search terms used in the abstract were: "renal dialysis", "hemodialysis" and "post-dialysis", in combination with the word "fatigue". DATA EXTRACTION AND SYNTHESIS Two investigators independently performed data extraction and quality assessment. Data were pooled to estimate the overall prevalence of PDF among HD patients using the random-effects model. Cochran's Q and I2 statistics were adopted to evaluate heterogeneity. RESULT A total of 12 studies were included, with 2152 HD patients, of which 1215 were defined as having PDF. The overall prevalence of PDF in HD patients was 61.0% (95% CI: 53.6% to 68.3%, p<0.001, I2=90.0%). Subgroup analysis failed to explain the source of heterogeneity, but univariable meta-regression showed that a mean age of ≥50 years might be the source of heterogeneity. Egger's test revealed no publication bias among the studies (p=0.144). CONCLUSIONS PDF is highly prevalent among HD patients.
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Affiliation(s)
- Junkai Dou
- School of Nursing, Anhui University of Traditional Chinese Medicine-East Campus, Hefei, China
| | - Huan Liu
- Department of Nephrology, The First Affiliated Hospital of Wannan Medical College, Wuhu, China
| | - Yuan Ma
- School of Nursing, Wannan Medical College, Wuhu, China
| | - Ying-Ying Wu
- School of Nursing, Wannan Medical College, Wuhu, China
| | - Xiu-Bin Tao
- Department of Nursing, The First Affiliated Hospital of Wannan Medical College, Wuhu, China
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31
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Fryburg DA. Kindness Isn't Just about Being Nice: The Value Proposition of Kindness as Viewed through the Lens of Incivility in the Healthcare Workplace. Behav Sci (Basel) 2023; 13:457. [PMID: 37366709 DOI: 10.3390/bs13060457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 05/21/2023] [Accepted: 05/26/2023] [Indexed: 06/28/2023] Open
Abstract
The healthcare workplace is a high-stress environment. All stakeholders, including patients and providers, display evidence of that stress. High stress has several effects. Even acutely, stress can negatively affect cognitive function, worsening diagnostic acumen, decision-making, and problem-solving. It decreases helpfulness. As stress increases, it can progress to burnout and more severe mental health consequences, including depression and suicide. One of the consequences (and causes) of stress is incivility. Both patients and staff can manifest these unkind behaviors, which in turn have been shown to cause medical errors. The human cost of errors is enormous, reflected in thousands of lives impacted every year. The economic cost is also enormous, costing at least several billion dollars annually. The warrant for promoting kindness, therefore, is enormous. Kindness creates positive interpersonal connections, which, in turn, buffers stress and fosters resilience. Kindness, therefore, is not just a nice thing to do: it is critically important in the workplace. Ways to promote kindness, including leadership modeling positive behaviors as well as the deterrence of negative behaviors, are essential. A new approach using kindness media is described. It uplifts patients and staff, decreases irritation and stress, and increases happiness, calmness, and feeling connected to others.
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32
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Zhang S, Zhao Z, Zhang H, Zhu Y, Xi Z, Xiang K. Workplace violence against healthcare workers during the COVID-19 pandemic: a systematic review and meta-analysis. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2023:10.1007/s11356-023-27317-2. [PMID: 37209334 DOI: 10.1007/s11356-023-27317-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Accepted: 04/26/2023] [Indexed: 05/22/2023]
Abstract
Workplace violence (WPV) is a prevalent phenomenon, especially in the healthcare setting. WPV against healthcare workers (HCWs) has increased during the COVID-19 epidemic. This meta-analysis determined the prevalence and risk factors of WPV. A database search was conducted across six databases in May 2022, which was updated in October 2022. WPV prevalence among HCWs was the main outcome. Data were stratified by WPV/HCW type, pandemic period (early, mid, late), and medical specialty. WPV risk factors were the secondary outcome. All analyses were conducted through STATA. Newcastle Ottawa Scale evaluated the quality. Sensitivity analysis identified effect estimate changes. A total of 38 studies (63,672 HCWs) were analyzed. The prevalence of WPV of any kind (43%), physical (9%), verbal (48%), and emotional (26%) was high. From mid-pandemic to late-pandemic, WPV (40-47%), physical violence (12-23%), and verbal violence (45-58%) increased. Nurses had more than double the rate of physical violence (13% vs. 5%) than physicians, while WPV and verbal violence were equal. Gender, profession, and COVID-19 timing did not affect WPV, physical, or verbal violence risk. COVID-19 HCWs were more likely to be physically assaulted (logOR = 0.54; 95% CI: 0.10: 0.97). Most healthcare employees suffer verbal violence, followed by emotional, bullying, sexual harassment, and physical assault. Pandemic-related workplace violence increased. Nurses were twice as violent as doctors. COVID-19 healthcare employees had a higher risk of physical and workplace violence.
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Affiliation(s)
- Shuisheng Zhang
- Department of Geriatrics, Jilin Academy of Chinese Medical Sciences, No. 1745, Gongnongda Road, Changchun, 130012, Jilin, China
| | - Zhen Zhao
- Department of Geriatrics, Jilin Academy of Chinese Medical Sciences, No. 1745, Gongnongda Road, Changchun, 130012, Jilin, China
| | - Huan Zhang
- Nursing Department, Changchun Children's Hospital, Changchun, 130061, Jilin, China
| | - Yanhua Zhu
- Department of Geriatrics, Jilin Academy of Chinese Medical Sciences, No. 1745, Gongnongda Road, Changchun, 130012, Jilin, China
| | - Zhongyuan Xi
- Department of Pulmonary Disease, Jilin Academy of Chinese Medical Sciences, Changchun, 130012, Jilin, China
| | - Ke Xiang
- Department of Geriatrics, Jilin Academy of Chinese Medical Sciences, No. 1745, Gongnongda Road, Changchun, 130012, Jilin, China.
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Brune S, Killam L, Camargo-Plazas P. Caring Knowledge as a Strategy to Mitigate Violence against Nurses: A Discussion Paper. Issues Ment Health Nurs 2023; 44:437-452. [PMID: 37167098 DOI: 10.1080/01612840.2023.2205502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
Violence against nurses is a disturbing trend in healthcare that has reached epidemic proportions globally. These violent incidents can result in physical and psychological injury, exacerbating already elevated levels of stress and burnout among nurses, further contributing to absenteeism, turnover, and intent to leave the profession. To ensure the physical and mental well-being of nurses and patients, attention to the development of strategies to reduce violence against nurses must be a priority. Caring knowledge-rooted in the philosophy of care-is a potential strategy for mitigating violence against nurses in healthcare settings. We present what caring knowledge is, analyze its barriers to implementation at the health system and education levels and explore potential solutions to navigate those barriers. We conclude how the application of models of caring knowledge to the nurse-patient relationship has the potential to generate improved patient safety and increased satisfaction for both nurses and patients.
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Affiliation(s)
- Sara Brune
- School of Nursing, Queen's University, Kingston, Ontario, Canada
- Nursing (BSN) Program, University of the Fraser Valley, Chilliwack, British Columbia, Canada
| | - Laura Killam
- School of Nursing, Queen's University, Kingston, Ontario, Canada
- School of Health Sciences and Emergency Services, Cambrian College, Sudbury, Ontario, Canada
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Spencer C, Sitarz J, Fouse J, DeSanto K. Nurses' rationale for underreporting of patient and visitor perpetrated workplace violence: a systematic review. BMC Nurs 2023; 22:134. [PMID: 37088834 PMCID: PMC10122798 DOI: 10.1186/s12912-023-01226-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2022] [Accepted: 02/28/2023] [Indexed: 04/25/2023] Open
Abstract
BACKGROUND Patient and visitor perpetrated workplace violence (WPV) is a problem within healthcare and is known to be underreported by nurses and other healthcare workers. However, there are multiple and diverse reasons identified in the literature as to why nurses do not report. This systematic review aimed to investigate nurses' reasons and rationale related to underreporting of violence that occurs in the workplace. METHODS Following PRISMA guidelines for systematic review reporting, studies conducted between 2011 and early 2022 were identified from MEDLINE, CINAHL, APA PsychInfo, and Psychological and Behavioral Sciences Collection via EBSCOHost. Quantitative studies related to patient and visitor perpetrated violence containing explanations, reasons, or rationale related to underreporting were included. RESULTS After quality appraisals, 19 studies representing 16 countries were included. The resulting categories identified nursing, management, and organizational factors. The most prominent nursing factors included nurses' fear of consequences after reporting, nurses' perceptions, and their lack of knowledge about the reporting process. Common management factors which contributed to nursing underreporting included lack of visible changes after reporting, non-supportive culture in which to report, and the lack of penalties for perpetrators. Organizational factors included the lack of policies/procedures/training for WPV, as well as a lack of an efficient and user-friendly reporting system. Supportive interventions from management, organizations, and community sources were summarized to provide insight to improve nurse reporting of WPV events. CONCLUSION Underreporting of WPV is a complex and multi-faceted problem. An investigation into the rationale for underreporting a workplace violent event illustrates nurses, management, and organizations contribute to the problem. Clear and actionable interventions such as educational support for staff and the development of a clear and concise reporting processes are recommended to encourage staff reporting and to help address WPV in healthcare.
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Affiliation(s)
| | - Jamie Sitarz
- UCHealth Cancer Center, Highlands Ranch, CO, USA
| | - June Fouse
- University of Colorado Hospital, Aurora, CO, USA
| | - Kristen DeSanto
- University of Colorado Anschutz Medical Campus, Strauss Health Sciences Library, Aurora, CO, USA
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Recsky C, Moynihan M, Maranghi G, Smith OM, PausJenssen E, Sanon PN, Provost SM, Hamilton CB. Evidence-Based Approaches to Mitigate Workplace Violence From Patients and Visitors in Emergency Departments: A Rapid Review. J Emerg Nurs 2023:S0099-1767(23)00059-4. [PMID: 37074250 DOI: 10.1016/j.jen.2023.03.002] [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: 01/31/2023] [Revised: 03/11/2023] [Accepted: 03/19/2023] [Indexed: 04/20/2023]
Abstract
INTRODUCTION This is a rapid review of the published evidence on the effectiveness of interventions for mitigating workplace violence against staff in hospital emergency departments. Focused on the specific needs of an urban emergency department in Canada, this project sought to address the question, "What interventions have evidence regarding effectiveness for addressing workplace patient/visitor violence toward staff in the emergency department?" METHODS Following Cochrane Rapid Review methods, 5 electronic databases (MEDLINE via PubMed, Cochrane CENTRAL, Embase, PsycINFO, CINAHL) and Google Scholar were searched in April 2022 for intervention studies to reduce or mitigate workplace violence against staff in hospital emergency departments. Critical appraisal was conducted using Joanna Briggs Institute tools. Key study findings were synthesized narratively. RESULTS Twenty-four studies (21 individual studies, 3 reviews) were included in this rapid review. A variety of strategies for reducing and mitigating workplace violence were identified and categorized as single or multicomponent interventions. Although most studies reported positive outcomes on workplace violence, the articles offered limited descriptions of the interventions and/or lacked robust data to demonstrate effectiveness. Insights from across the studies offer knowledge users information to support the development of comprehensive strategies to reduce workplace violence. DISCUSSION Despite a large body of literature on workplace violence, there is little guidance on effective strategies to mitigate workplace violence in emergency departments. Evidence suggests that multicomponent approaches targeting staff, patients/visitors, and the emergency department environment are essential to addressing and mitigating workplace violence. More research is needed that provides robust evidence on effective violence prevention interventions.
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Reducing Violence in Riyadh’s Emergency Departments: The Critical Role of Healthcare Providers. Healthcare (Basel) 2023; 11:healthcare11060823. [PMID: 36981480 PMCID: PMC10048218 DOI: 10.3390/healthcare11060823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Revised: 03/05/2023] [Accepted: 03/09/2023] [Indexed: 03/16/2023] Open
Abstract
Emergency department staff are at high risk of experiencing violence and aggression from patients and visitors, which can have negative impacts on healthcare providers in the ED. The aim of this study was to explore the role of healthcare providers in addressing local violence in Riyadh EDs and investigate their preparedness for managing violent incidents. We used a descriptive, correlational design with survey methodology to collect data from a convenience sample of nurses, ED technicians, physicians, and advanced practice providers in Riyadh city’s EDs. To examine the associations, we used an analysis of variance (ANOVA) for unadjusted relationships and an analysis of covariance (ANCOVA) for adjusted associations. Measures included a demographic survey, and clinicians responded to an online survey. A total of 206 ED staff participated in the questionnaire, and 59% reported experiencing physical violence during an ED shift, with 61% of incidents being caused by relatives. Additionally, 32% of the participants witnessed workplace violence. Our findings revealed that male healthcare workers, physicians, and those working in the governmental sector were at the highest risk of experiencing violence. We also found a statistically significant association between the rate of patients seen in the ED and the frequency of assault (physical or verbal) in the ED. Our results suggest that the rate of workplace violence in Riyadh EDs is high, and more efforts are needed to protect the health and well-being of healthcare providers. Senior management should take a position against ED domestic violence and reinforce managerial and healthcare provider resources by adopting policies and procedures that protect healthcare workers’ safety. This study provides valuable insights into the nature and prevalence of violence in Riyadh EDs and highlights the critical role of healthcare providers in reducing violence in EDs.
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Tosswill H, Cabilan CJ, Learmont B, Taurima K. A descriptive study on the use of restrictive interventions for potentially or actually violent patients in the emergency department. Australas Emerg Care 2023; 26:7-12. [PMID: 35882619 DOI: 10.1016/j.auec.2022.07.001] [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: 03/28/2022] [Revised: 07/03/2022] [Accepted: 07/03/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND Restrictive interventions (chemical, physical, or mechanical restraints) to manage patients who are potentially or actually violent in the emergency department (ED) can be harmful and costly. Non-restrictive interventions are advocated; but this must be preceded with an understanding of patient characteristics that influence their use. A study was conducted to describe the use of restrictive interventions and ascribe it with patient characteristics in the ED. METHODS Records from October 2020 to March 2021 in the occupational violence database were used to analyse patient characteristics and restrictive interventions. Logistic regression was used to establish influencing factors of restrictive interventions adjusting for clinically relevant confounders. RESULTS Of the N = 1276 potentially or actually violent patients, 70 % received restrictive interventions. Chemical restraint was common, with 1 in 2 patients receiving either oral medication or intramuscular injection. Probability of restrictive interventions were higher in patients who were intoxicated [(adjusted odds ratio (aOR) 3.48, 95 % confidence interval (CI) 1.675-7.21)], had high triage score (aOR 2.084, 95 % CI 1.094-3.96), and were in the ED involuntarily (aOR 1.494, 95 % CI 1.105-2.020). CONCLUSION The results reveal the need for multifaceted approaches that limit the presentations of, and minimise restrictive interventions among, potentially or actually violent patients.
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Affiliation(s)
- Hayden Tosswill
- The University of Queensland, Faculty of Medicine, Brisbane, Australia
| | - C J Cabilan
- Princess Alexandra Hospital Emergency Department, Brisbane, Australia.
| | - Ben Learmont
- Princess Alexandra Hospital Emergency Department, Brisbane, Australia
| | - Karen Taurima
- Princess Alexandra Hospital Emergency Department, Brisbane, Australia
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Naegle MA, Kelly LA, Embree JL, Valentine N, Sharp D, Grinspun D, Hines-Martin VP, Crawford CL, Rosa WE. American Academy of Nursing consensus recommendations to advance system level change for nurse well-being. Nurs Outlook 2023; 71:101917. [PMID: 36736029 PMCID: PMC9889942 DOI: 10.1016/j.outlook.2023.101917] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2022] [Revised: 12/08/2022] [Accepted: 12/31/2022] [Indexed: 02/04/2023]
Abstract
The COVID-19 pandemic has required close examination of workforce-related stressors that over decades have contributed to widespread burnout, negative health outcomes, including mental health outcomes, and the loss of the well-educated professionals who are the future of the nursing profession. In the United States and globally, evidence points to factors known to diminish well-being, including inequities, issues of minority status, persistent discrimination, and demanding work environments. The American Academy of Nursing (AAN), dedicated to organizational excellence, nursing leadership and evidence-based policy, develops statements reflecting its mission and those of its nursing affiliates and corporate member, The American Nurses Association. Within nursing, despite the efforts of its members toward advancement, professional fulfillment is often constrained by the systems in which nurses practice and workplace factors over which they have little control. Action by key organizations to initiate changes at systems levels in workplace safety, to increase professional mobility, and propel policies that increase access to health care resources could improve nurse well-being. This paper proposes recommendations from the AAN Expert Panels on Building Health Care System Excellence, Psychiatric Mental Health and Substance Use, and Global Health Expert Panels for the American Academy of Nursing to leverage related policy in the arenas of government and professional/healthcare organizations. Transforming health care work environments and advancing nurse well-being and equity can be accomplished through key, innovative policy changes. These will be achieved through collaboration among associations, organizations, nonprofit groups, and with the public and the media.
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Affiliation(s)
- Madeline A Naegle
- Psychiatric Mental Health and Substance Use Expert Panel, New York, NY.
| | - Lesly A Kelly
- Building Health Care Systems Excellence Expert Panel
| | | | | | - Daryl Sharp
- Psychiatric Mental Health and Substance Use Expert Panel, New York, NY
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Hvidhjelm J, Berring LL, Whittington R, Woods P, Bak J, Almvik R. Short-term risk assessment in the long term: A scoping review and meta-analysis of the Brøset Violence Checklist. J Psychiatr Ment Health Nurs 2023. [PMID: 36718598 DOI: 10.1111/jpm.12905] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 12/17/2022] [Accepted: 01/22/2023] [Indexed: 02/01/2023]
Abstract
INTRODUCTION Existing literature on the Brøset Violence Checklist (BVC) is examined in the context of usability, implementation and validity to provide evidence-based recommendations on its application and identify opportunities for future development. AIM/QUESTION To identify current knowledge on the BVC and guide clinicians and researchers toward the next steps in using this tool in clinical practice to prevent violence in healthcare settings. METHOD A scoping review approach with a meta-analysis supplement was adopted to broadly identify and map available evidence on the BVC and provide specific estimates of predictive validity in different contexts. RESULTS Sixty-two studies conducted in 23 countries addressed the implementation of the BVC across various settings. Many studies adapted the original BVC, and the clinical utility was noted as an important feature. A meta-analysis of the original BVC format estimated a pooled area under the curve at 0.83 (95% CI 0.78-0.87) in a subset of 15 studies. DISCUSSION The BVC combines high predictive validity and good clinical utility across a wide range of settings and cultures. It should continue to be incorporated into routine practice in mental health services focused on preventing violence and coercion. IMPLICATIONS FOR PRACTICE Development of collaborative approaches with service users involved in assessing their own risk of future violence.
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Affiliation(s)
- Jacob Hvidhjelm
- Clinical Mental Health and Nursing Research Unit, Mental Health Center, Sct Hans, Copenhagen University Hospital - Mental Health Services CPH, Copenhagen, Denmark
| | - Lene Lauge Berring
- Psychiatric Research Unit, Centre for Relation & De-escalation, Mental Health Services, Region Zealand, Denmark.,Institute of Regional Health Research, University of Southern Denmark, Odense, Denmark
| | - Richard Whittington
- Centre for Research & Education in Security, Prisons and Forensic Psychiatry, St. Olav's University Hospital, Trondheim, Norway.,Department of Mental Health, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Phil Woods
- College of Nursing, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Jesper Bak
- Clinical Mental Health and Nursing Research Unit, Mental Health Center, Sct Hans, Copenhagen University Hospital - Mental Health Services CPH, Copenhagen, Denmark
| | - Roger Almvik
- Centre for Research & Education in Security, Prisons and Forensic Psychiatry, St. Olav's University Hospital, Trondheim, Norway.,Department of Mental Health, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
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Spencer C, Loehr K, Byrd A. Patient and Family Perpetrated Cyber-Incivility and Cyber-Aggression Within Healthcare: A Cross-Sectional Descriptive Study. SAGE Open Nurs 2023; 9:23779608231158970. [PMID: 36923238 PMCID: PMC10009025 DOI: 10.1177/23779608231158970] [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: 08/08/2022] [Accepted: 02/03/2023] [Indexed: 03/12/2023] Open
Abstract
Introduction Verbal violence may manifest in written form as cyber incivility within patient portal communications. As a form of digital technology, patient portal messages create a physical and emotional distance leading the sender to be disinhibited and disassociated from the recipient nurse. Written patient portal messages may contain uncivil language deemed verbally violent when the content escalates beyond professional standards. When these messages are encountered as part of patient care, they may lead to nurses' psychological distress. Although cyber-incivility has been studied within social media and business, little is known about cyber-incivility within healthcare. Objectives The purpose of the study was to define cyber-incivility as it manifests within healthcare compared to business, determine sender demographics, and quantify the impact on nurses. Methods A cross-sectional descriptive study was conducted to analyze portal communications. Nurses forwarded aggressive messages to leadership and quantified their level of distress after receiving the message. Sender demographics were tracked, and content was analyzed using Braun and Clarke's Thematic Analysis. Results Of the 31 included messages, senders were of varying ages, genders, and marital statuses. Messages rarely related to medications and rarely contained expletives. The most distressing messages were ad hominem, demanding, accusatory, or contained threats. These messages illustrated how healthcare cyber-incivility manifested and deviated from appropriate professional standards to become a form of verbal workplace violence. Message content also identified antecedents; related to unmet expectations, patient accountability, or difficulty navigating healthcare. Conclusions Written incivil/uncivil/aggressive patient portal messages contained personal attacks and professionally degrading content, which were distressing to nurses. A healthcare-specific framework was created and provided context to understand the difficult and aggressive messages nurses received while providing digital patient care. Awareness of cyber-incivility within healthcare allows for better support of nurses who are exposed to this form of workplace violence and is foundational to future intervention development.
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Affiliation(s)
| | | | - Abby Byrd
- Children's Hospital Colorado, Aurora, CO, USA
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Wijkander M, Farrants K, Magnusson Hanson LL. Exposure to work-related violence and/or threats of violence as a predictor of certified sickness absence due to mental disorders: a prospective cohort study of 16,339 Swedish men and women in paid work. Int Arch Occup Environ Health 2023; 96:225-236. [PMID: 36070001 PMCID: PMC9905169 DOI: 10.1007/s00420-022-01917-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Accepted: 08/21/2022] [Indexed: 11/25/2022]
Abstract
OBJECTIVES The aim of this prospective cohort study was to investigate if exposure to work-related violence and/or threats of violence predict certified sickness absence due to mental disorders. METHODS Information on work-related exposure to violence and/or threats of violence were derived from the biannual Swedish Longitudinal Occupational Survey of Health (SLOSH) study 2012-2016, including individuals in paid work across Sweden and from different occupations/sectors (n = 16,339). Certified sickness absence due to mental disorders were ascertained from register data from the Swedish Social Insurance Agency. Odds ratios of certified sickness absence due to mental disorders according to exposure to work-related violence were estimated using multiple logistic regression. Several potential confounding variables, such as demographic and socio-economic factors, age, sex, cohabitation, children living at home, socio-economic status, educational level, as well as other types of psychosocial work environmental factors, were adjusted for in the analyses. RESULTS In the total study sample, 9% reported exposure to violence and/or threats of violence and the prevalence of sickness absence due to mental disorders was 5%. Exposure to work-related violence and/or threats of violence was associated prospectively with certified sickness absence due to mental disorders (odds ratio 1.46, 95% confidence interval 1.17-1.82, p < 0.01). Analysis of possible interaction showed no difference in association when comparing women to men and different age groups. CONCLUSIONS Exposure to work-related violence and/or threats of violence appear to increase the odds of certified sickness absence due to mental disorders. Preventive measures aiming to lower the risk of exposure is thus of great importance.
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Affiliation(s)
- Maria Wijkander
- Stress Research Institute, Department of Psychology, Stockholm University, 10691, Stockholm, Sweden
| | - Kristin Farrants
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden
| | - Linda L Magnusson Hanson
- Stress Research Institute, Department of Psychology, Stockholm University, 10691, Stockholm, Sweden.
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Vyas S, Saini RS, Semwal J, Sharma N, Chaturvedi M, Ansari MWF. Are Health Caregivers safe from workplace violence? A cross sectional study on workplace safety from Tertiary Care Hospital of Uttarakhand. INDIAN JOURNAL OF COMMUNITY HEALTH 2022. [DOI: 10.47203/ijch.2022.v34i04.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Background: The prevalence of workplace violence in the healthcare sector is a problem that is frequently ignored and underreported. The performance of healthcare workers who have been the target of violence may suffer, which may have a negative effect on patient satisfaction and health. Aims & Objectives: The purpose of the current study was to determine the prevalence of workplace violence (WPV), risk factors for violence against healthcare workers, and their experiences regarding the same. Methodology: It was a cross-sectional study conducted on 157 hospital staff at Tertiary Care Medical College of Uttarakhand. Data was gathered using a semi-structured, self-administered questionnaire that was modified from the ILO, ICN, WHO, and PSI. Data were analyzed using SPSS software (version 20). Results: Factors like age, gender, job profile, lesser work experience, night shifts, and fewer staff on duty were found to have a positive association with workplace violence. It was observed that the majority of incidents took place in the ward, and the patient’s relatives were the attacker in most of the cases. It was also seen that the majority of Hospital staff did not get bothered by the incident except by staying super alert while dealing with other patients or their relatives. Conclusion: The study concludes that while caring for patients, Hospital staff are at risk of being victims of aggressive and violent situations. To reduce this problem, strategies like training staff in order to handle such incidents in the future should be brought into practice. Laws should be made stricter & assaulting staff on duty should be made a cognizable offense with serious consequences & heavy penalties. Also, the young budding MBBS students should be trained by incorporating these strategies, laws & policies in the CBME curriculum
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Mavragani A, Malhas M, Bratsalis E, Thomson K, Boateng R, Hargreaves F, Baig H, Benadict MB, Busch L. Behavioral Skills Training for Teaching Safety Skills to Mental Health Clinicians: Protocol for a Pragmatic Randomized Control Trial. JMIR Res Protoc 2022; 11:e39672. [PMID: 36515979 PMCID: PMC9798261 DOI: 10.2196/39672] [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: 05/18/2022] [Revised: 11/01/2022] [Accepted: 11/18/2022] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Workplace violence is an increasingly significant topic, particularly for staff working in mental health settings. The Centre for Addiction and Mental Health (CAMH), Canada's largest mental health hospital, considers workplace safety a high priority and consequently has mandated staff safety training. For clinical staff, key components of this training are self-protection and team-control skills, which are a last resort when an individual is at an imminent risk of harm to self or others and other interventions are ineffective (eg, verbal de-escalation). For the past 20 years, CAMH's training-as-usual (TAU) has been based on a 3D approach (description, demonstration, and doing), but without any competency-based assessment. Recent staff reports indicate that the acquisition and retention of these skills may be problematic and that staff are not always confident in their ability to effectively address workplace violence. The current literature lacks studies that evaluate how staff are trained to acquire these physical skills and consequently provides no recommendations or best practice guidelines. To address these gaps described by the staff and in the literature, we have used an evidence-based approach from the field of applied behavior analysis known as behavioral skills training (BST), which requires trainees to actively execute targeted skills through instruction, modeling, practice, and feedback loop. As part of this method, competency checklists of skills are used with direct observation to determine successful mastery. OBJECTIVE Our objectives are to evaluate the effectiveness of BST versus TAU in terms of staff confidence; their competence in self-protection and team-control physical skills; their level of mastery (predefined as 80% competence) in these skills; and their confidence, competency, and mastery at 1 month posttraining. METHODS We are using a pragmatic randomized controlled trial design. New staff registering for their mandatory safety training are randomly assigned to sessions which are, in turn, randomly assigned to either the BST or TAU conditions. Attendees are informed and consented into the study at the beginning of training. Differences between those consenting and those not consenting in terms of role and department are tracked to flag potential biases. RESULTS This study was internally funded and commenced in January 2021 after receiving ethics approval. As of May 2022, data collection is complete; half of the baseline, posttraining, and 1-month videotapes have been rated, and three-fourths of the interrater reliability checks have been completed. The analysis is expected to begin in late summer 2022 with results submitted for publication by fall 2022. CONCLUSIONS The findings from this study are expected to contribute to both the medical education literature as well as to the field of applied behavioral analysis where randomized controlled trial designs are rare. More practically, the results are also expected to inform the continuing development of our institutional staff safety training program. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/39672.
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Affiliation(s)
| | - Mais Malhas
- Department of Education, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Emmanuel Bratsalis
- Department of Education, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Kendra Thomson
- Department of Applied Disability Studies, Brock University, St. Catherines, ON, Canada
| | - Rhonda Boateng
- Department of Education, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Fabienne Hargreaves
- Department of Education, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Heba Baig
- Department of Education, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Mary Benisha Benadict
- Department of Education, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Louis Busch
- Department of Education, Centre for Addiction and Mental Health, Toronto, ON, Canada
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Young J, Fawcett K, Gillman L. Evaluation of an immersive simulation programme for mental health clinicians to address aggression, violence, and clinical deterioration. Int J Ment Health Nurs 2022; 31:1417-1426. [PMID: 35815952 DOI: 10.1111/inm.13040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/23/2022] [Indexed: 11/28/2022]
Abstract
This study investigated the effectiveness of high-fidelity immersive simulation education to support inter-professional hospital clinical staff in recognizing and responding to aggression, violence, and clinical deterioration of patients admitted with mental health issues. Increased incidents of aggression and violence have been reported in many clinical hospital settings, especially in mental health wards. Patients experiencing severe psychological distress/agitation can result in the escalation of physiological symptoms such as chest pain, difficulty breathing, traumatic injury, etc. Mental health staff do receive aggression prevention training and medical emergency team training. However, there is added complexity when dealing with a mental health patient who is exhibiting aggressive, violent behaviour while also experiencing a medical or psychological emergency. Therefore, mental health staff needed a combined training programme that enhanced their delivery of recovery focussed care, de-escalation, and medical emergency crisis resource management skills. This study used a prospective quasi experimental research design with repeated measures. Hospital clinical staff were immersed in two mental health emergency response and clinical deterioration scenarios and debriefing sessions. Self-efficacy was evaluated using a 10-item validated tool which addressed non-technical skills of Leadership, Management, Communication, and Teamwork. The sample consisted of 122 clinical staff, with the majority from mental health wards (52%; n = 63) who were nurses (68%; n = 83). Mean self-efficacy scores increased significantly across the three time points (F = 11.555; df = 2; P = 0.000). Post hoc pairwise comparisons showed that self-efficacy scores increased between pretest (mean 62.9; n = 122) and posttest 1 (mean 83.2; n = 122) and follow up, 3 months later (posttest 2; mean 81.9; n = 24). Between pre- and posttest 1, significant improvements in self-efficacy were observed for both the Leadership/Management domain (t = 8.2; df 119; P < 0.000; 95% CI 13.3-21.7) and the Communication/Teamwork domain (t = 8.0; df 119; P < 0.000; 95% CI 11.1-18.4). Immersive simulation with high fidelity education was found to be effective in improving hospital nursing and medical staffs' confidence, when responding to incidents of aggression/violence and clinical deterioration of a mental health patient.
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Affiliation(s)
- Jeanne Young
- Royal Perth Bentley Group (RPBG) Organisational Learning and Development, Perth, Australia
| | - Kylie Fawcett
- Royal Perth Bentley Group (RPBG) Organisational Learning and Development, Perth, Australia
| | - Lucia Gillman
- Royal Perth Bentley Group (RPBG) Organisational Learning and Development, Perth, Australia
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Assil AO, Salem AA, Mokhtar OA, Taha OH, Ramadan AM, Mansour AHR, Awad AAE, El-Hossainy AA, Khattab AA, Salem AM, Dalaab AEA, Azab SMS. Workplace violence at emergency departments, Ain Shams University Hospitals, Cairo, Egypt. BMC Health Serv Res 2022; 22:1437. [PMID: 36443795 PMCID: PMC9706819 DOI: 10.1186/s12913-022-08867-6] [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: 09/15/2022] [Accepted: 11/21/2022] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND The present study aimed to determine the prevalence and forms of workplace violence (WPV) at the emergency departments (EDs) of Ain Shams University Hospitals (ASUH), Cairo and identify risk factors for WPV. METHODS A cross-sectional study was conducted at the EDs of ASUH comprising attending physicians and nurses using a self-administered structured questionnaire. Interviews were conducted with patients and relatives attending these departments to explore attitudes toward WPV against healthcare workers. RESULTS The present study comprised 108 healthcare professionals working in EDs. Verbal violence was the most common type of WPV (86.1%), followed by sexual (48.1%) and physical violence (34.3%). Patient relatives were the most common perpetrator of all types of violence. A lack of facilities was the most common risk factor for violence (82.4%), followed by overcrowding (50.9%) and patient culture (47.2%). On the other hand, approximately 78% of interviewed patients and relatives agreed that the occurrence of violence at EDs was due to several triggering factors, including improper manner of communication by healthcare workers (63.2%), lack of facilities (32.4%), waiting time (22.1%), and unmet expectations (22.1%). CONCLUSION WPV represents a significant issue in EDs with violent behavior against healthcare workers widely accepted by attending patients.
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Affiliation(s)
- Altaf O Assil
- Department of Forensic Medicine and Toxicology, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
| | | | | | | | | | | | | | | | | | | | | | - Sonya M S Azab
- Department of Forensic Medicine and Toxicology, Faculty of Medicine, Ain Shams University, Cairo, Egypt
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Vidal-Alves MJ, Pina D, Ruiz-Hernández JA, Puente-López E, Paniagua D, Martínez-Jarreta B. (Un)Broken: Lateral violence among hospital nurses, user violence, burnout, and general health: A structural equation modeling analysis. Front Med (Lausanne) 2022; 9:1045574. [PMID: 36507501 PMCID: PMC9729731 DOI: 10.3389/fmed.2022.1045574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Accepted: 11/11/2022] [Indexed: 11/25/2022] Open
Abstract
Introduction Workplace violence is a social problem yet to be solved. Although it is present in virtually all work environments, its prevalence in healthcare settings stands out, being perceived as something inherent to the job. Most studies in this context have focused on user violence against professionals. However, it has been observed that violence among colleagues in these types of jobs is a risk factor for the health of workers and has rarely been studied as a whole. Among the main consequences of exposure to violence reported in the literature, burnout syndrome, depression, anxiety, or somatic problems have been among the most studied. On the one hand, some authors claim that being exposed to workplace violence can increase the associated physical and psychological pathology and lead to a picture congruent with burnout. On the other hand, it has been hypothesized that violence is associated with burnout, which can trigger physical and psychological symptoms. Taking into account this background, the aim of this study is to explore workplace violence in health personnel, symptomatology, and burnout syndrome through mediation models that allow us to know the interrelationships between the variables. Methods A cross-sectional design with a double descriptive-associative strategy was used. The sample was composed of 950 nursing professionals from public hospitals. The scales of physical and non-physical violence from users to professionals HABS-U, personal, social, and occupational violence among co-workers using the Health Aggressive Behavior Scale - Co-workers and Superiors (HABS-CS) scale, the burnout scale Maslach Burnout Inventory - General Survey (MBI-GS) which evaluates professional exhaustion, efficacy and cynicism, and the factors referring to depression, anxiety, somatization, and dysfunction of the GHQ-28 scale were applied. In order to calculate the models, workplace violence was used as a predictor of symptomatology, using the burnout variables as mediators. Regression coefficients with and without mediation model, direct and standardized estimates were obtained. For statistical power, Bootstrap analysis was used to calculate direct mediation effects. Results After controlling the mediation effects of burnout and cynicism, physical and non-physical user violence toward healthcare personnel were significant predictors of the GHQ-28 scores. These same results were obtained when assessing the relationship between social, occupational, and personal violence among co-workers and GHQ-28 scores. Conclusion Our results contribute to increase the evidence about the effects of violence on the health of professionals and to advance in the characterization of the possible consequent psychological damage. Regardless of the type of violence experienced, exposure to violence can lead to anxious, depressive or somatization symptoms, among others. Violence is also a predictor of burnout syndrome, which in turn accentuates the rest of the consequences studied. Despite the limitations of the proposed model, these results serve to highlight the complexity of the situation experienced by healthcare professionals. Moreover, it serves as a basis for proposing intervention/prevention programs to raise awareness and protect professionals from these risks. To this end, self-care tools should be proposed with which professionals take care of their own health through the management of violent situations and/or the improvement of occupational health.
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Affiliation(s)
- Maria Joao Vidal-Alves
- Department of Socio-Sanitary Sciences, University of Murcia, Murcia, Spain,Department of Community Medicine, Information and Health Decision Sciences, School of Medicine, University of Porto, Porto, Portugal,EPIUnit – Institute of Public Health, University of Porto, Porto, Portugal,Laboratory for Integrative and Translational Research in Population Health (ITR), University of Porto, Porto, Portugal
| | - David Pina
- Department of Socio-Sanitary Sciences, University of Murcia, Murcia, Spain,*Correspondence: David Pina,
| | | | - Esteban Puente-López
- Facultad de Derecho, Universidad Internacional de la Rioja (UNIR), Logroño, Spain
| | - David Paniagua
- Department of Psychobiology and Methodology in Behavioral Sciences, Faculty of Psychology, Complutense University of Madrid, Madrid, Spain
| | - Begoña Martínez-Jarreta
- Department of Pathological Anatomy, Forensic and Legal Medicine and Toxicology, University of Zaragoza, Zaragoza, Spain
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Özdamar Ünal G, İşcan G, Ünal O. The occurrence and consequences of violence against healthcare workers in Turkey: before and during the COVID-19 pandemic. Fam Pract 2022; 39:1001-1008. [PMID: 35395085 PMCID: PMC9383775 DOI: 10.1093/fampra/cmac024] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Before and throughout the COVID-19 pandemic, healthcare workers (HCWs) were victims of workplace violence (WPV). There are no reliable statistics on the occurrence and consequences of WPV against HCWs in Turkey throughout the pandemic period. OBJECTIVE We investigated the rates of WPV against HCWs in Turkey in the pre-pandemic and pandemic periods, variables associated with WPV, and the relationship between these variables and job satisfaction and burnout. METHODS A structured online questionnaire was disseminated through social media channels to HCWs in various healthcare settings. All the respondents also completed the Maslach Burnout Inventory (MBI) and Job Satisfaction Scale. Based on the data obtained, we determined the frequency, causes, and consequences of WPV against HCWs before and during the pandemic. RESULTS There were 701 completed questionnaires. 68.2% of participants were female, and 65.6% of them were doctors. The rate of WPV was 54.1% and 24.3% before and during the pandemic, respectively. Verbal abuse was the most common kind of WPV. Female HCWs were more likely to be physically assaulted than their male counterparts, especially those working in COVID-19 units. The majority of HCWs who were exposed to the violence at least once did not report WPV. HCWs exposed to WPV during the pandemic reported more emotional exhaustion and depersonalization and a lower perceived level of personal achievement. CONCLUSION HCWs were exposed to significant levels of violence both before and during the pandemic. Preventing WPV against HCWs and removing barriers to reporting abuse is crucial.
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Affiliation(s)
- Gülin Özdamar Ünal
- Department of Psychiatry, Faculty of Medicine, University of Süleyman Demirel, Çünür East Campus, Isparta 32200, Turkey
| | - Gökçe İşcan
- Department of Family Medicine, Faculty of Medicine, University of Süleyman Demirel, Çünür East Campus, Isparta 32200, Turkey
| | - Onur Ünal
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, University of Süleyman Demirel, Çünür East Campus, Isparta 32200, Turkey
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48
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Moore N, Ahmadpour N, Brown M, Poronnik P, Davids J. Designing virtual reality experiences to supplement clinician Code Black education. Simul Healthc 2022. [DOI: 10.54531/dnzc8446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
- Nathan Moore
- 1Digital Health Solutions, Western Sydney Local Health District, North Parramatta, Australia
| | - Naseem Ahmadpour
- 2Affective Interactions Lab, School of Architecture, Design and Planning, University of Sydney, Sydney, Australia
| | - Martin Brown
- 3FMH Media Lab, Education Innovation, School of Medical Sciences, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - Philip Poronnik
- 3FMH Media Lab, Education Innovation, School of Medical Sciences, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - Jennifer Davids
- 4Research and Education Network, Western Sydney Local Health District, Westmead, Australia
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Sun T, Yin HY, Zhang SE, Huang XH, Liu B. Current Status of Intergroup Threats Perceived by Chinese Physicians and Its Association with Organizational Psychology, Behavior, and Well-Being during the COVID-19 Pandemic: A Cross-Sectional Survey. Healthcare (Basel) 2022; 10:healthcare10101972. [PMID: 36292418 PMCID: PMC9602264 DOI: 10.3390/healthcare10101972] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Revised: 10/05/2022] [Accepted: 10/06/2022] [Indexed: 11/04/2022] Open
Abstract
(1) Background: Chinese physicians have encountered serious physical and verbal attacks in recent decades due to poor patient−physician relationships, leading to a broad spectrum of negative consequences. This study aims to assess the status of intergroup threats perceived by physicians and explore its association with organizational psychology, behavior, and well-being during the COVID-19 pandemic. (2) Methods: We conducted a cross-sectional online survey with physicians from November to December 2020 in three provinces: Heilongjiang Province, Henan Province, and Zhejiang Province, in China. A total of 604 physicians were recruited to complete an anonymous questionnaire. There were 423 valid questionnaires. (3) Results: We developed a 25-item intergroup threat scale with four dimensions: interest damage, performance impairment, value derogation, and unjust sentiment. Internal consistency reliability analyses showed that the four dimensions and overall scale exhibited high internal consistency (0.756−0.947). Additionally, the average scores for physicians’ perceived overall intergroup threat, interest damage, performance impairment, value derogation, and unjust sentiment were 4.35 ± 0.51, 4.24 ± 0.73, 4.33 ± 0.58, 4.22 ± 0.65, and 4.53 ± 0.55, respectively. Moreover, this study shows that the intergroup threats perceived positively by physicians were associated with psychological stress (β = 0.270, p < 0.01), emotional exhaustion (β = 0.351, p < 0.01), turnover intention (β = 0.268, p < 0.01), and defensive medical behavior (β = 0.224, p < 0.01), and were negatively associated with job satisfaction (β = −0.194, p < 0.01) and subjective well-being (β = −0.245, p < 0.01). (4) Conclusions: The newly developed scale in this study is a reliable tool for measuring intergroup threats perceived by Chinese physicians. Physicians in China were suffering high-level intergroup threats during the anti-COVID-19 pandemic, which has a significant impact on damage to organizational psychology, behavior, and well-being. Intergroup threats perceived by physicians not only enlarged the risk of emotional exhaustion and psychological stress but also threatened organizational well-being. Moreover, greater intergroup threats were associated with a lower job satisfaction, more frequent defensive medical behavior, and a higher turnover intention for physicians. The results of this study suggest that essential intervention and governance measures should be considered to protect physicians’ well-being and benefits in China, which are urgently needed.
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Affiliation(s)
- Tao Sun
- Department of Health Policy and Management, School of Public Health, Hangzhou Normal University, Hangzhou 311121, China
| | - Hong-yan Yin
- Department of Humanities and Social Sciences, Harbin Medical University (Daqing), Daqing 163319, China
| | - Shu-e Zhang
- Department of Health Management, School of Health Management, Harbin Medical University, Harbin 150081, China
| | - Xian-hong Huang
- Department of Health Policy and Management, School of Public Health, Hangzhou Normal University, Hangzhou 311121, China
| | - Bei Liu
- Department of Laboratorial Science and Technology &Vaccine Research Center, School of Public Health, Peking University, Beijing 100191, China
- Correspondence:
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García-Zamora S, Pulido L, Miranda-Arboleda AF, García DE, Pérez G, Priotti M, Chango DX, Antoniolli M, Zaidel EJ, Lopez-Santi R, Vazquez G, Nuñez-Mendez R, Cabral LT, Sosa-Liprandi Á, Liblik K, Baranchuk A. Aggression, Micro-aggression, and Abuse Against Health Care Providers During the COVID-19 Pandemic. A Latin American Survey. Curr Probl Cardiol 2022; 47:101296. [PMID: 35779676 PMCID: PMC9239921 DOI: 10.1016/j.cpcardiol.2022.101296] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2022] [Accepted: 06/17/2022] [Indexed: 11/29/2022]
Abstract
The COVID-19 pandemic has had tremendous consequences globally. Notably, increasing complaints of verbal and physical violence against health care providers have been reported. A cross-sectional electronic survey was conducted between January 11 and February 28, 2022 to delineate the violent behavior against front-line health professionals in Latin America. A total of 3544 participants from 19 countries were included. There were 58.5% women, 70.8% were physicians, 16% were nurses, and 13.2% were other health team members. About 54.8% reported acts of abuse: 95.6% verbal abuse, 11.1% physical abuse, and 19.9% other types. Nearly half of those who reported abuse experienced psychosomatic symptoms after the event, 56.2% considered changing their care tasks, and 33.6% considered quitting their profession. In a logistic regression model, nurses (odds ratio (OR) 1.90, P < 0.001), doctors (OR 2.11, P < 0.001), and administrative staff (OR 3.53, P = 0.005) experienced more abuse than other health workers. Women more frequently reported abuse (OR 1.56, P < 0.001), as well as those who worked directly with COVID-19 patients (OR 3.66, P < 0.001). A lower probability of abuse was observed at older ages (OR 0.95, P < 0.001). There has been a high prevalence of abuse against health personnel in Latin America during the COVID-19 pandemic. Those caring for COVID-19 patients, younger staff, and women were found to be at elevated risk. It is imperative to develop strategies to mitigate these acts and their repercussions on the patient-provider relationship and outcomes.
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Affiliation(s)
| | - Laura Pulido
- Asociación Argentina de Medicina Respiratoria (AAMR), Buenos Aires, Argentina
| | - Andrés Felipe Miranda-Arboleda
- Division of Cardiology, Queen's University, Kingston, Ontario, Canada; Cardiology Department, Pablo Tobón Uribe Hospital, Medellín, Colombia
| | - Darío Eduardo García
- Hospital de Alta Complejidad en Red "El Cruce", Buenos Aires, Argentina; Federación Latinoamericana de Medicina de Emergencias (FLAME), Buenos Aires
| | - Gonzalo Pérez
- Division of Cardiology, Clínica Olivos, Buenos Aires, Argentina
| | - Mauricio Priotti
- Cardiology Department, Delta Clinic, Rosario, Santa Fe, Argentina
| | - Diego X Chango
- Cardiology and Advanced Cardiac Imaging Division, Hospital Universitario del Río, Cuenca, Azuay, Ecuador
| | | | - Ezequiel José Zaidel
- Cardiology Department, Sanatorio Güemes, Ciudad Autónoma de Buenos Aires, Argentina
| | - Ricardo Lopez-Santi
- Division of Cardiology, Hospital Italiano de La Plata, Buenos Aires, Argentina
| | - Gustavo Vazquez
- Department of Psychiatry, Queen's University, Kingston, Ontario, Canada
| | - Rodrigo Nuñez-Mendez
- Asociación de Residentes y Fellows de Cardiología de México A. C. (ARCAME), México
| | - Luz Teresa Cabral
- Cardiology Department, Hospital Nacional de Itaguá, Itaguá, Paraguay
| | - Álvaro Sosa-Liprandi
- Cardiology Department, Sanatorio Güemes, Ciudad Autónoma de Buenos Aires, Argentina
| | - Kiera Liblik
- Department of Medicine, Queen's University, Kingston, Ontario, Canada
| | - Adrian Baranchuk
- Division of Cardiology, Queen's University, Kingston, Ontario, Canada.
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