Prevalence and associated factors of sexual, psychological, and physical violence among Physical Therapists in their clinical role in Spain: A national web-based cross-sectional survey

OBJECTIVES

To determine the extent of career-long and 12-month exposure to sexual, physical and psychological/verbal violence committed by patients or their companions among physical therapists in Spain. Additionally, to identify the factors associated with such exposure.

METHODS

This study employed an observational cross-sectional approach. Initially, a questionnaire was developed and validated using a convenience sample. Subsequently, it was distributed via e-mail to all physical therapists registered in Spain in the first quarter of 2022. Individual risk models were created for each type of violence experienced within the past 12 months.

RESULTS

The prevalence of violence encountered by physical therapists throughout their careers were 47.9% for sexual violence, 42.7% for psychological/verbal abuse, and 17.6 % for physical abuse. Lower values were observed within the last 12 months (13.4%, 15.8% and 5.2%, respectively). Statistical risk modeling for each type of violence experienced in the past 12 months indicated that the common precipitating factor for all forms of violence was working with patients with cognitive impairment. Working part-time appeared to be a protective factor. Other factors, such as the practitioners' gender, practice setting, or clinic location showed variations among the diverse types of violence.

CONCLUSIONS

The exposure to type II workplace violence within the last 12 months among physical therapists in Spain (Europe) is not so high as in some other world regions. Various individual, clinical, and professional/organizational risk factors have been identified in connection with type II workplace violence. Further research is warranted to compare the violence experienced once the COVID pandemic has subsided.

Non-violent communication as a technology in interpersonal relationships in health work: a scoping review

BACKGROUND

Working in healthcare environments is highly stressful for most professionals and can trigger problems in interpersonal relationships that can result in horizontal violence. In order to prevent violence and improve the working environment, some strategies can be implemented to provide well-being for all those involved, whether directly or indirectly in health care, such as non-violent communication. The aim of this study was to map and synthesize the available scientific evidence on the use of Nonviolent Communication as a technology for a culture of peace in interpersonal relationships in healthcare.

METHODS

This is a scoping review carried out in the National Library of Medicine (PubMed), Cumulative Index to Nursing and Allied Health Literature (CINAHL), Web of Science, Excerpa Medica DataBASE (Embase), PsycINFO - APA/ PsycNET (American Psychological Association) and Latin American and Caribbean Health Sciences Literature (LILACS) databases between March and August 2023. The eligibility criteria used were studies that addressed the topic of NVC in the area of health, published in Portuguese, Spanish or English, with no time restrictions.

RESULTS

53 studies were found in the databases. Two additional studies were extracted from of primary research. In the first exclusion phase, 16 texts were removed due to being duplicated. 39 articles were potentially relevant, and full-texts were reviewed for eligibility along with the inclusion and exclusion criteria Thus, seven studies were included in this review, published in English (five) and Portuguese (two), two of which were carried out in Brazil, one in the United States of America, one in South Korea, one in France, one in Canada and one in Thailand. In terms of the type of study/publication, two studies were reflections, one was a review, one was a mixed study, one was an experience report and two were experimental. The studies were predominantly of high and moderate methodological quality (85.7%). The total number of participants in the studies was 185. The studies showed that NVC is a technology that has made it possible to improve interpersonal relationships between health professionals. Training programs or educational intervention projects on the subject are useful for familiarizing professionals with the subject and demonstrating situations in which the technique can be included.

CONCLUSION

The global scientific literature indicates that Nonviolent Communication is a significant resource for improving interpersonal relationships in healthcare work. This approach can be adopted as a strategy by managers and decision-makers, both to resolve conflicts and to prevent aggressive situations between health professionals, especially when it comes to moral or psychological aspects.

Prevalence of workplace violence in Chinese obstetric nurses under the new situation and its correlation with violence prevention knowledge-attitude-practice and climate perception: a cross-sectional study

BACKGROUND

Workplace violence severely impacts individual nurses. With the three-child opening policy of China and the impact of the COVID-19 epidemic in the recently years, obstetric nurses face the double attack of heavy workload and staffing shortage. This study aimed to evaluate the current situation of workplace violence among Chinese obstetric nurses under the new situation, assess the level of violence prevention knowledge-attitude-practice and climate perception in Chinese obstetric nurses and explore the correlation between workplace violence and the level of violence prevention knowledge-attitude-practice and climate perception.

METHODS

A cross-sectional survey on the workplace violence for Chinese obstetric nurses was conducted from August to February 2023. All the questionnaires came from 10 provinces and 3 autonomous regions in China. The basic characteristics of obstetric nurse's workplace violence, workplace violence prevention knowledge-attitude-practice scale and workplace violence climate perception scale were collected.

RESULTS

Totally, 522 Chinese obstetric nurses were included. 55.0% of obstetric nurses (287) had experienced workplace violence in the past 12 months, including verbal assault (40.4%), physical assault (34.1%), and sexual assault (31.0%). The overall level of obstetric nurses' workplace violence prevention knowledge-attitude-practice and climate perception of workplace violence was low. Multiple linear regression analysis showed that the violence prevention knowledge dimension significantly influenced obstetric nurses' workplace violence (B = -0.278, P < .001), attitude dimension (B = -0.241, P < .001), behavior dimension (B = -0.216, P < .001) and the violence climate perception's organizational management (B = -0.177, P < .001), organizational training (B = -0.175, P < .001), organizational support (B = -0.143, p < .001) and the violence handling (B = -0.165, P < .001).

CONCLUSION

The incidence of workplace violence among obstetric nurses in the new situation is high. However, the overall violence prevention knowledge-attitude-practice and climate perception levels are low. Therefore, nursing managers should take targeted measures according to the relevant influencing factors and the characteristics of obstetrics to improve the level of obstetric nurses' violence prevention knowledge-attitude-practice and climate perception to reduce workplace violence among obstetric nurses.

The effectiveness of a workplace violence prevention strategy based on situational prevention theory for nurses in managing violent situations: a quasi-experimental study

BACKGROUND

Workplace violence (WPV) poses a significant occupational hazard for nurses. The efficacy of current education and training programs in mitigating WPV incidence among nurses remains uncertain, possibly due to insufficient consideration of clinical contexts and nurses' specific needs. Therefore, this study developed a WPV prevention strategy based on the actual requirements of clinical nurses and situational prevention theory and aimed to explore its application effects.

METHODS

Under the guidance of situational prevention theory, a WPV prevention strategy for nurses was constructed through literature review, semi-structured interviews and focus group discussion. This study adopted a self-controlled research design, and trained 130 nurses selected from a comprehensive tertiary grade A hospital in Suzhou in this WPV prevention strategy. Data were collected through structured questionnaires, including the revised WPV questionnaire, WPV severity grading scale, and hospital WPV coping resources scale. The WPV incidence, severity, and WPV coping resource scores of nurses were collected before the intervention, as well as at 3 months, 6 months, and 9 months after training.

RESULTS

The WPV prevention strategy comprised 11 prevention plans based on 11 high-risk situational elements of WPV. Each prevention plan included the WPV prevention flowchart, treatment principle, and communication strategy. The strategy demonstrated excellent feasibility and practicality. Following the intervention, the overall incidence of WPV among nurses significantly decreased from 63.85% (baseline) to 46.15% (9 months after training) (P < 0.05). After the training, the severity of psychological violence (Wald χ² = 20.066, P < 0.001) and physical violence (Wald χ² = 9.100, P = 0.028) reported by nurses decreased compared to the baseline (P < 0.05). Moreover, the overall WPV coping resource score significantly increased from [66.50 (57.00, 77.25) points] (baseline) to [80.00 (68.00, 97.25) points] (9 months after training) (P < 0.05).

CONCLUSIONS

The described WPV prevention strategy, grounded in situational prevention theory and tailored to the needs of clinical nurses, effectively reduced WPV incidence, mitigated its severity, and enhanced nurses' WPV coping resources. This approach offered new avenues for nurses in the prevention of WPV.

National Development and Implementation of a Democratized Disruptive Behavior Reporting System in Health Care

INTRODUCTION

Workplace disruptive behavior/ violence (WDBV) is underreported in health care. This study evaluated a 7-year implementation of the Disruptive Behavior Reporting System (DBRS), the most robust consolidated WDBV reporting system developed in the United States within the Veterans Health Administration (VHA).

METHODS

After implementation of the system, implementation success was measured in real time by number of reports, types of staff entering reports, time to review the reports and time between when the incident occurred and report entry.

RESULTS

Over the seven years since implementation, there has been a significant increase in reporting within DBRS with more than 50,000 reports in fiscal year (FY) 2021 up from 0 to 2014. Types of staff reporting increased to 67 from 54. The median number of days to review events in FY19 Q2 was 4.79 days and the report latency has almost completely disappeared.

DISCUSSION

DBRS was designed to democratize reporting so staff can report WDBV anytime and anywhere playing a large role in the successful implementation. The increase in total number of reported events is an indication of the success of the system as it captures data historically lost due to underreporting.

CONCLUSION

DBRS development and implementation showcases how information systems can empower front-line personnel to voice behavioral safety concerns.

Support mechanisms that enable emergency nurses to cope with aggression and violence: Perspectives from New Zealand nurses

BACKGROUND

Although efforts to reduce aggression and violence in emergency departments are important, it is also critical to minimise harm and support staff where this occurs. This research describes support mechanisms emergency nurses value when they experience occupational aggression and violence.

METHODS

A mixed-methods design including thematic analysis of six interviews and descriptive analysis of fifty-one surveys, with experienced emergency nurse participants and respondents from a single large urban emergency department.

RESULTS

Four key themes summarised coping with aggression and violence: Minimising exacerbating factors (mental health, lack of understanding of zero tolerance in practice, and wait times); Support before violence (use of huddles and having experienced nurses on each shift); Support during violence (education including restraint, self-defence, de-escalation and legalities); and Support after violence (debriefing, incident reporting and a sense of 'toughness') CONCLUSION: Emergency nurses need preparation and support to competently manage complex mental health presentations, understand legal rights, communicate effectively with patients, families and colleagues and access event debriefing. Security staff are valued team members but also need adequate resourcing and preparation.

Workplace violence against health care workers during the COVID-19 Pandemic: A systematic review and meta-analysis

INTRODUCTION

During the COVID-19 pandemic, Health Care Workers (HCWs) have been at the frontline against the disease and have direct contact with patients and their companions, so they are exposed to all sorts of Workplace Violence (WPV). The aim of this study was to investigate the prevalence of WPV against HCWs during the COVID-19 pandemic.

METHOD

This study was conducted according to the PRISMA guideline, and its protocol was registered at the PROSPERO under the code of CRD42021285558. Articles were obtained from data resources such as Scopus, PubMed, Web of Science, Science Direct, Google Scholar, and Embase. A literature search was conducted from the beginning of 2020 to the end of December 2021. Meta-analysis was conducted using the Random effects model, and the I² index was used to check the heterogeneity.

RESULTS

In this study, 1,054 articles were initially obtained during the primary search, of which 13 were finally entered in the meta-analysis. According to the results of the meta-analysis, the prevalence of physical and verbal WPV were 10.75% (95% CI: 8.20-13.30, I² = 97.8%, P = 0 < 001) and 45.87% (95% CI: 36.8-54.93, I² = 99.6%, P = 0 < 001), respectively. The overall prevalence of WPV was obtained, 45.80% (95% CI: 34.65-56.94, I² = 99.8%, P = 0 < 001) were reported.

CONCLUSION

The results of the present study showed that the prevalence of WPV against HCWs was relatively high during the COVID-19 pandemic; nevertheless, it was lower compared to the area prior to the pandemic. Therefore, HCWs need essential training to reduce stress and increase resilience. Also, considering organizational interventions (including policies to ensure that HCWs report WPV to their supervisors, increasing staffing per patient, and installing systems for HCWs to call for immediate assistance) can increase the resilience HCWs.

Nurses' rationale for underreporting of patient and visitor perpetrated workplace violence: a systematic review

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.

Analysis of some Demographic and Psy-chosocial Factors that Influence in the Perception of the Workplace Violence

Objective

The objective of this study is to evaluate the impact of psychosocial risks based on the demographic variables of sex, age, and seniority, on the perception of workplace violence in a group of workers from Spanish companies.

Methods

a total of 22 Spanish companies were analysed between 2016 and 2018 with a total sample of 26741 people using the FPSICO 3.1 psychosocial assessment method and divided into demographic groups of sex, age, and seniority for subsequent comparison of means and regression analysis.

Results

The results confirm the relationship between psychosocial risks and the perception of workplace violence. The analyses by demographic variables position the group of men as the group with the highest perception of workplace violence, except for discrimination, where it was higher in the group of women. The results confirm that the perception of workplace violence increases significantly with age and seniority in the company.

Conclusions

workplace violence is one of the most worrying risk factors today and it is necessary to better understand what risk factors can favour its appearance or its differentiated behaviour according to sex, age, or seniority. This can allow us to develop planned strategies to control this risk and focus on specific demographic groups.

Electronic Reporting of Workplace Violence Incidents: Improving the Usability, and Optimizing Healthcare Workers' Cognitive Workload, and Performance

A majority of healthcare workers (HCWs) experience workplace violence (WPV) but most WPV events go unreported. Underreporting of WPV is well documented in the literature as a barrier to identifying underlying causes and to evaluating the effectiveness of WPV interventions. Previous studies suggest that WPV reporting data is fragmentary, unreliable, and inconsistent. Also, WPV reporting systems are suboptimally designed making it difficult for healthcare workers to report WPV incidents. This study aims to assess the usability of an electronic WPV report in a large academic medical center and the perceived cognitive workload (CWL) and performance of HCWs associated with reporting WPV events. Findings from this study suggest that our institutional WPV report has suboptimal perceived usability and suboptimal perceived cognitive workload. Further, participants with training reported lower error rates in comparison to participants without training on performance.

A causal model of thriving at work in Chinese nurses

AIM

To develop and test the first causal model of thriving at work in Chinese nurses.

BACKGROUND

Nurses' ability to thrive at their work is critical to retain qualified nurses and meet the needs of a constantly changing health environment. However, this is a poorly researched area.

INTRODUCTION

Thriving at work refers to the feeling of vitality and learning at work, which are evidenced to be solidly associated with nurses' development. Only a few factors have been explored regarding the effects of thriving at work.

METHODS

A cross-sectional study was undertaken using stratified random sampling. This involved 565 nurses from five general hospitals in Dali city, Yunnan Province, People's Republic of China. Data were collected from April to September 2019 using seven instruments. The model was constructed and tested using the Analysis of Moment Structure program and reported using the STROBE checklist.

RESULTS

All model variables provided direct and indirect effects to the outcome. The final model fitted the empirical data with acceptable indices.

DISCUSSION

Predicting variables of workplace mindfulness, authentic leadership, workplace violence, organizational justice and years of experience were found to affect thriving at work directly and indirectly. Psychological capital and perceived organizational support mediated the effects between predicting variables to the outcome.

CONCLUSION AND IMPLICATIONS FOR NURSING AND HEALTH POLICY

Recommendations for nursing and health leaders are provided to improve nurses' thriving at work by building fair, supportive, and safe working environments, improving head nurses' authentic leadership and cultivating nurses' mindfulness. Policies need to be promulgated to improve and regulate the nurse-patient ratio and to eliminate violence against Chinese nurses.

Assessment of occupational violence towards pharmacists at practice settings in Nigeria

Background:

Occupational Violence is prevalent among healthcare workers, including pharmacists, and poses a big threat to their job satisfaction, safety, and social wellbeing.

Objective:

This study seeks to assess the incidents and factors associated with occupational violence towards pharmacists in Nigeria.

Methods:

A cross-sectional study was conducted among pharmacists practicing in Nigeria, using an online survey (Google Form™). Occupational violence was assessed using a validated questionnaire. The survey was conducted and reported based on the Checklist for Reporting Results of Internet E-Surveys (CHERRIES). Participants were recruited by sharing the survey link via social media platforms including WhatsApp, Facebook, LinkedIn, and Twitter.

Results:

A total of 263 respondents returned the online questionnaire, with a completion rate of 99.2%. The prevalence of occupational violence was 92.7% (95% CI, 90 to 96). Violent events occurred among 48.7% of pharmacists with at least six years of experience, and 68.4% of hospital pharmacists. The commonly reported factors associated with the violence include long waiting times in the pharmacy (36.5%), refusal to fulfil aggressor’s demands (22.1%), and counseling/poor communication (21.7%). Events related to verbal abuse were reported among 95% of the participants. The prevalence of violence was significantly higher among hospital pharmacists, compared with those practicing in administration/regulatory, and in community pharmacies (chi-square=10.213 (2); p=0.006). Similarly, physical aggression was higher among hospital pharmacists (chi-square=10.646 (2), p = 0.005).

Conclusions:

The prevalence of occupational violence towards pharmacists practicing in Nigeria appeared to be high. Major factors associated with the violence were refusal to fulfil aggressors’ demands and frustrations due to long waiting times at pharmacy. Recommended strategies to slowdown the incidences of violence were improved pharmacists’ workforce, interprofessional harmony, and penalties against perpetrators.

Violence against health personnel before and during the health contingency COVID-19

BACKGROUND

Violence against health personnel is an understudied phenomenon in Mexico, which has increased during periods of health contingency.

OBJECTIVE

To identify the prevalence and type of violence against health professionals before and during the COVID-19 health contingency and determine the characteristics of the worker with the highest exposure.

MATERIAL AND METHODS

Cross-sectional descriptive study, carried out during April of 2020, in 562 health workers, who answered a sociodemographic identification card and a questionnaire to know the characteristics, types and consequences of aggression before and during the contingency, through an electronic and anonymous platform. A non-probabilistic sampling (snowball) was used in different states of Mexico.

RESULTS

47.7% of the participants experienced aggressions, 12.8% verbal type and 34.9% verbal/physical aggressions during the last year, where women showed to be more attacked (chi squared = 12.12, p = 0.000). During health contingency, 16.8% perceived aggression, 13.2% verbal type and 3.6% verbal/physical aggression, with nurses being the most attacked (chi squared = 5.57, p = 0.018). A logistic regression model confirmed that being a woman and belonging to nursing profession has, respectively as far as 2.5 and 3 times more risk of suffering violence.

CONCLUSIONS

Violence against health personnel requires immediate strategies, especially in critical periods in the community, where aggressions occur inside and outside of hospitals, which have an impact on worker's safety and health institutions.

Workplace Violence in Healthcare: Another Perspective

N/a.

Workplace violence against emergency department nurses in Oman: a cross-sectional multi-institutional study

AIM

To examine the prevalence, characteristics and factors associated with workplace violence against emergency department nurses in Oman.

BACKGROUND

Violence against healthcare professionals, including nurses, is a global public health problem. Understanding the epidemiology of violence is crucial for the implementation of appropriate preventative and management policies.

METHODS

We conducted a multi-centre cross-sectional study in February 2019 utilizing a widely employed self-report questionnaire developed by the World Health Organization. We invited all emergency department nurses working in four governmental hospitals in Al-Sharqiyah and Al-Dakhiliyah Governorates of Oman to participate in the study.

RESULTS

Of the 103 respondents, most were Omani (57.3%), female (73.8%), and 30 years or older (65%). The majority (87.4%) were exposed to violence in the past 12 months, and non-physical violence (84.5%) was over fourfold greater than physical violence (18.4%). Most physical and non-physical incidents took place during weekends (68.4% and 82.8%, respectively) and in the afternoon or night shifts (78.9‬% and 93.1%, respectively), and family members and visitors were the most common perpetrators of violence (62.6% physical and 66.7% non-physical). Non-Omani nurses (P = 0.03) and those with education less than a bachelor's degree (P = 0.007) were less likely to experience physical violence.

DISCUSSION/CONCLUSION

Workplace violence is highly prevalent among emergency department nurses in Oman. Future studies should investigate violent incident reporting, and the causes and consequences of workplace violence on nurses' psychological and physical well-being, work functioning and the quality of care provided to patients.

IMPLICATIONS FOR NURSING POLICY

The high prevalence of workplace violence is alarming and demonstrates the need for additional interventions to reduce violence and limit its consequences on healthcare professionals and patients' quality of care. Findings from this study can be used to implement changes in existing anti-violence policies.

Workplace Violence in Healthcare: A Single-Center Study on Causes, Consequences and Prevention Strategies

INTRODUCTION

Workplace violence is one of the main risk factors in the professional world. Healthcare workers are at higher risk when compared to other sectors. Our study aimed to characterize physical and verbal violence in a public hospital and to define occupational health prevention and surveillance strategies.

MATERIAL AND METHODS

Single center observational cross-sectional study, carried amongst healthcare workers in a public hospital in Lisbon. A qualitative survey was carried out through six in-depth interviews. A quantitative survey was carried through questionnaires delivered to 32 workers. A significance level of 5% was accepted in the assessment of statistical differences. The Mann-Whitney test and the Fisher's exact test were used to calculate p values.

RESULTS

The main results are: (1) 41 violence incidents were reported in the quantitative phase; (2) 5/21 [23.81%] victims notified the incident to the occupational health department; (3) 18/21 [85.71%] victims reported a permanent state of hypervigilance; (4) 22/28 [78.57%] participants self-reported poor or no familiarity with internal reporting procedures; (5) 24/28 [85.71%] participants believed it is possible to minimize workplace violence.

DISCUSSION

Workplace violence is favored by unrestricted access to working areas, absence of security guards and police officers or scarce intervention. The low notification rate contributes to organizational lack of action. The state of hypervigilance reported in our study reflects the negative effects of threatening occupational stressors on mental health.

CONCLUSION

Our results show that workplace violence is a relevant risk factor that significantly impacts workers' health in a noxious manner, deserving a tailored occupational health approach whose priority areas and strategies have been determined.

Prevalence of Workplace Violence Types against Personnel of Emergency Medical Services in Iran: A Systematic Review and Meta-Analysis

Objective: Workplace violence is one type of occupational hazards that is increasingly growing worldwide. In the health system, one of the important groups subject to workplace violence is emergency medical services (EMS) personnel, who provide emergency services for patients and casualties as the first responders. The aim of this study was to determine the prevalence of workplace violence and its different types among Iranian EMS personnel. Method : This study was conducted based on PRISMA guideline for systematic review and meta-analysis. The data were extracted from Scopus, PubMed, Web of Science, Google Scholar, SID and MagIran databases using Persian and English keywords. The search was conducted up to December 2018 without any limitation in publication year. The qualities of selected papers were assessed by STROBE checklist. I² index was used to evaluate heterogeneity, and random effects model was used in meta-analysis. Data were analyzed using Stata14. Results: A total of 9 studies entered the meta-analysis. The total sample size was 1257 Iranian EMS personnel, with an average age of 32.21 ± 2.01 years. The prevalence of physical, verbal, and cultural workplace violence among EMS personnel was 36.39% (CI 95%:27.29-45.50, P<0.001, I² = 90.8%), 73.13% (95% CI=68.64-77.62, P=0.013, I² = 62.7%), and 16.51% (95% CI =3.49- 29.53, p<0.001. I² = 94.7%), respectively. Conclusion: Considering the high prevalence of workplace violence among EMS personnel in Iran, more studies should be conducted to determine the underlying causes of EMS staff workplace violence in Iran. Training violence prevention methods as well as assigning national protective rules are highly suggested. Insufficient studies on Workplace violence among EMS personnel in Iran and high heterogeneity were the limitations of this study.

Workplace Violence Against Nurses in Psychiatric Hospital Settings: Perspectives from Saudi Arabia

Objectives

Workplace violence (WPV) has become a world-wide concern. This study aimed to measure the prevalence of WPV among nurses working in psychiatric hospitals in Saudi Arabia.

Methods

This cross-sectional study was conducted at three psychiatric hospitals in Saudi Arabia between March and May 2017. Participants completed a self-reported questionnaire which was used to measure the prevalence and explore the associated factors of WPV. A multivariate logistic regression analysis was also performed.

Results

A total of 310 nurses (response rate: 62%) were included in this study. The prevalence of WPV against nurses was 90.3%, of which 57.7% had been exposed to both physical and verbal abuse. More nurses were exposed to WPV during the morning shift than the evening shift (58.4% versus 42.3%). Violent behaviour was exhibited mostly by the patients themselves (81.3%). Over half of the nurses (57.4%) required medical intervention in such cases. The majority of nurses felt either stressed (64.2%) or anxious (53.5%) and 34.2% felt depressed after the incident. Multivariate logistic regression analysis revealed that time of violence, source of violence, patient dissatisfaction with medical care and lack of organisational support for nurses were significantly associated with the occurrence of WPV in psychiatric units.

Conclusion

WPV has reached an alarming rate among nurses in psychiatric hospitals in Saudi Arabia. It is crucial to invest in the prevention of WPV by constant training of workers and a mutual policy with the police and the civic prosecutor in Saudi Arabia on how to respond to violent psychiatric patients.

Changes in prevalence of workplace violence against doctors in all medical specialties in Norway between 1993 and 2014: a repeated cross-sectional survey

OBJECTIVES

The aim of this study was to investigate whether reported prevalence of experienced threats, real acts of violence and debilitating fear of violence among Norwegian doctors have increased over the last two decades.

DESIGN

Repeated cross-sectional survey.

SETTING

All healthcare levels and medical specialties in Norway.

PARTICIPANTS

Representative samples of Norwegian doctors in 1993 (n=2628) and 2014 (n=1158).

MAIN OUTCOME MEASURES

Relative risk (RR) of self-reported prevalence of work-time experiences of threats and real acts of violence, and of being physically or psychologically unfit during the last 12 months due to fear of violence, in 2014 compared with 1993, adjusted by age, gender and medical specialty.

RESULTS

There were no differences in self-reported threats (adjusted RR=1.01, 95% CI 0.95 to 1.08) or real acts (adjusted RR=0.90, 95% CI 0.80 to 1.03) of violence when comparing 2014 with 1993. The proportion of doctors who had felt unfit due to fear of violence decreased from 1993 to 2014 (adjusted RR=0.53, 95% CI 0.39 to 0.73). Although still above average, the proportion of doctors in psychiatry who reported real acts of violence decreased substantially from 1993 to 2014 (adjusted RR=0.75, 95% CI 0.60 to 0.95).

CONCLUSIONS

A substantial proportion of doctors experience threats and real acts of violence during their work-time career, but there was no evidence that workplace violence has increased over the last two decades. Still, the issue needs to be addressed as part of the doctors' education and within work settings.

[Aggressions towards Primary Health Care Workers in Madrid, Spain, 2011-2012]

OBJECTIVE

The number of aggressions towards health care professionals has risen over the past few years. There are no previous studies in primary care covering an entire region and to all professional categories. The aim of this study was to characterize aggressions in Primary Care in the Community of Madrid.

METHODS

Multicenter cross-sectional study. Analysis of a Registration System that reports any type of aggression suffered by Primary Care workers, in the Community of Madrid. The study variables included sociodemographic characteristics of the aggressor and the victim, the type of aggression (verbal or physical abuse), its causes and consequences. We described median, intercuartilic range and frequencies. Logistic regression was performed calculating odds ratio and their 95% confidence intervals.

RESULTS

1,157 assaults were reported, 53.07% suffered by doctors. Physical assault occurred in 4.7% of the cases. The main reason was dissatisfaction with the care (36.1%). The non-medical staff showed less risk of being physically assaulted (OR: 0.38; CI95%: 0.17-0.86). The perpetrator profile was male (56.8%), aged between 31-40 (26.8%) years. Health care victim profile was female (84%), aged between 45-60 years. 10% of professionals reported some form of aggression, 5,9% of aggression were submitted to court.

CONCLUSIONS

The risk of assault is higher in health personnel, particularly physicians. There were significant differences by gender and age, both in the profile of the aggressor and the victim.

Workplace Violence in Mental Health: A Victorian Mental Health Workforce Survey

The international literature suggests workplace violence in mental health settings is a significant issue, yet little is known about the frequency, nature, severity and health consequences of staff exposure to violence in Australian mental health services. To address this gap, we examined these aspects of workplace violence as reported by mental health services employees in Victoria, Australia. The project used a cross-sectional, exploratory descriptive design. A random sample of 1600 Health and Community Services Union members were invited to complete a survey investigating exposure to violence in the workplace, and related psychological health outcomes. Participants comprised employees from multiple disciplines including nursing, social work, occupational therapy, psychology and administration staff. A total of 411 members responded to the survey (26% response rate). Of the total sample, 83% reported exposure to at least one form of violence in the previous 12 months. The most frequently reported form of violence was verbal abuse (80%) followed by physical violence (34%) and then bullying/mobbing (30%). Almost one in three victims of violence (33%) rated themselves as being in psychological distress, 54% of whom reported being in severe psychological distress. The more forms of violence to which victims were exposed, the greater the frequency of reports of psychological distress. Workplace violence is prevalent in mental health facilities in Victoria. The nature, severity and health impact of this violence represents a serious safety concern for mental health employees. Strategies must be considered and implemented by healthcare management and policy makers to reduce and prevent violence.

A Systematic Literature Review: Workplace Violence Against Emergency Medical Services Personnel

Context

In spite of the high prevalence and consequences of much workplace violence against emergency medical services personnel, this phenomenon has been given insufficient attention. A systematic review can aid the development of guidelines to reduce violence.

Objectives

The research question addressed by this paper is, “What are the characteristics and findings of studies on workplace violence against emergency medical services personnel”?

Data Sources

A systematic literature review was conducted using online databases (PubMed, Scopus, Google Scholar, and Magiran) with the help of experienced librarians.

Study Selection

Inclusion criteria comprised studies in the English or Persian language and researcher’s access to the full text. There was no limit to the entry of the study design. Exclusion criteria included lack of access to the full text of the article, studies published in unreliable journals or conferences, and studies in which the results were shared with other medical or relief groups and there was no possibility of breaking down the results.

Data Extraction

A “Data extraction form” was designed by the researchers based on the goals of the study that included the title and author(s), study method (type, place of study, sample size, sampling method, and data collection/analysis tool), printing location, information related to the frequency of types of violence, characteristics of victims /perpetrators, and related factors.

Results

The papers reviewed utilized a variety of locations and environments, methods, and instrument samplings. The majority of the studies were performed using the quantitative method. No intervention study was found. Most studies focused on the prevalence of violence, and their results indicated that exposure to violence was high. The results are presented in six major themes.

Conclusions

Workplace violence and injuries incurred from it are extensive throughout the world. The important causes of violence include the shortage of training programs dealing with violence, lack of violence management protocols, and delays in response times. Therefore, afterthought and resolve are more crucial than ever. Workplace violence reduction strategies and suggestions for future studies are also discussed.

Workplace Violence Experienced by Substitute (Daeri) Drivers and Its Relationship to Depression in Korea

Workplace violence is related to various health effects including mental illness such as anxiety or depression. In this study, the relationship between the experience of workplace violence and depression in substitute drivers in Korea, namely, daeri drivers, was investigated. To assess workplace violence, questions regarding types and frequency of the experience of violence over the past year were asked to the daeri drivers. In order to assess the risk of depression, the Center for Epidemiological Studies Depression Scale was used. Odds ratios with 95% confidence intervals of depression were estimated using multiple logistic regression analysis. All of the daeri drivers had experienced instance of verbal violence while driving and 66 of the drivers (34.1%) had been in such a situation more than once in the past quarter of a year. Sixty-eight daeri drivers (42.2%) had experienced certain type of physical violence over the past year. Compared to daeri drivers who had experienced workplace verbal violence less than 4 times and who had not experienced workplace physical violence over the past year, higher odds ratio was observed in daeri drivers who had experienced workplace verbal violence or physical violence, more than 4 times and more than one time respectively, after adjustment. Experience of verbal or physical type of workplace violence over the past year increased the risk of depression in the daeri drivers. Because violence against drivers can compromise the safety of the driver, the customer, and all the passengers, it is imperative that the safety and health of daeri drivers be highlighted.

Understanding small business engagement in workplace violence prevention programs

PURPOSE

Worksite wellness, safety, and violence prevention programs have low penetration among small, independent businesses. This study examined barriers and strategies influencing small business participation in workplace violence prevention programs (WVPPs).

APPROACH

A semistructured interview guide was used in 32 telephone interviews.

SETTING

The study took place at the University of North Carolina Injury Prevention Research Center.

PARTICIPANTS

Participating were a purposive sample of 32 representatives of small business-serving organizations (e.g., business membership organizations, regulatory agencies, and economic development organizations) selected for their experience with small businesses.

INTERVENTION

This study was designed to inform improved dissemination of Crime Free Business (CFB), a WVPP for small, independent retail businesses.

METHODS

Thematic qualitative data analysis was used to identify key barriers and strategies for promoting programs and services to small businesses.

RESULTS

Three key factors that influence small business engagement emerged from the analysis: (1) small businesses' limited time and resources, (2) low salience of workplace violence, (3) influence of informal networks and source credibility. Identified strategies include designing low-cost and convenient programs, crafting effective messages, partnering with influential organizations and individuals, and conducting outreach through informal networks.

CONCLUSION

Workplace violence prevention and public health practitioners may increase small business participation in programs by reducing time and resource demands, addressing small business concerns, enlisting support from influential individuals and groups, and emphasizing business benefits of participating in the program.

High prevalence of workplace violence among nurses working at public health facilities in Southern Ethiopia

BACKGROUND

The rising rate of workplace violence in health care facilities has become a major problem for health care providers including nurses. However, evidences are lacking in Ethiopia particularly in the study area. The aim of this study is to assess the prevalence and associated factors of workplace violence among nurses working at health care facilities in Hawassa City Administration, Southern Ethiopia.

METHODS

An institution-based cross-sectional study was conducted on 660 randomly selected nurses working at public health facilities in Hawassa City Administration in April 2014. A pre-tested and structured questionnaire was used to collect the data. Data were entered using EPI-Info and exported to SPSS for further analysis. Descriptive statistics were done. Logistic regression analyses were used to see the association between different variables and the outcome variable. Odds ratios with 95% Confidence Interval (CI) were computed to determine the presence and strength of the association.

RESULTS

In this study, the prevalence of workplace violence was 29.9% [95% CI: 26.5, 33.5)] of which physical violence accounted for 36 (18.22%), verbal abuse for 172 (89.58%) and sexual harassment for 25 (13.02%). Female sex [AOR=2.00, 95% CI: (1.28, 2.39)], short work experience [AOR=8.86, 95% CI: (3.47, 22.64)], age group of 22-25 [AOR=4.17, 95% CI: (2.46, 7.08)], age group of (26-35) [AOR=1.9, 95% CI (1.16, 3.1)], work in emergency [(AOR=4.28, 95% CI: (1.39, 4.34)] and work in the Inpatient Department [(AOR=2.11, 95% CI: (1.98, 2.64)] were the factors positively associated with workplace violence.

CONCLUSIONS

A significant proportion of nurses faced violence while providing care at in public health facilities. Being female, younger age, short work experience, and assignment in emergency and inpatient departments were positively associated with workplace violence. Policy makers and stakeholders should focus on workplace violence prevention strategies.

Nurses exposure to workplace violence in a large teaching hospital in Iran

BACKGROUND

Workplace violence is one of the factors which can strongly reduce job satisfaction and the quality of working life of nurses. The aim of this study was to measure nurses' exposure to workplace violence in one of the major teaching hospitals in Tehran in 2010.

METHODS

We surveyed the nurses in a cross-sectional design in 2010. The questionnaire was adapted from a standardized questionnaire designed collaboratively by the International Labor Office (ILO), the International Health Organization (IHO), the International Council of Nurses (ICN), and the Public Services International (PSI). Finally, in order to analyze the relationships among different variables in the study, T-test and Chi-Square test were used.

RESULTS

Three hundred and one nurses responded to the questionnaire (a response rate of 73%). Over 70% of the nurses felt worried about workplace violence. The participants reported exposure to verbal abuse (64% CI: 59-70%), bullying-mobbing (29% CI: 24-34%) and physical violence (12% CI: 9-16%) at least once during the previous year. Relatives of hospital patients were responsible for most of the violence. Nurses working in the emergency department and outpatient clinics were more likely to report having experienced violence. Nurses were unlikely to report violence to hospital managers, and 40% of nurses were unaware of any existing policies within the hospital for reducing violence.

CONCLUSION

We observed a considerable level of nurse exposure to workplace violence. The high rate of reported workplace violence demonstrates that the existing safeguards that aim to protect the staff from abusive patients and relatives are inadequate.

Prevalence of low back pain among nurses: predisposing factors and role of work place violence

Background:

Ergonomic factors predispose nurses to low back pain (LBP). Few studies have clarified the role of workplace violence in LBP occurrence.

Objectives:

The present study was designed to investigate acute and chronic LBP in Iranian nurses and its association with exposure to physical violence as well as its personal and ergonomic risk factors.

Materials and Methods:

In this analytic cross sectional study, the rate of acute and chronic LBP and contributing factors were investigated among 1246 nurses using a validated questionnaire. Statistical analysis was performed by chi square, student t-test, and logistic regression, to determine the association between independent variables and LBP.

Results:

In total, 1246 nurses, consisting of 576 (46.23%) males and 670 (53.77%) females, were included. The mean age and the mean years of employment were 31.23 ± 5.33 and 16.18 ± 7.05, respectively. Both acute low back pain (ALBP) and chronic low back pain (CLBP) were associated with physical violence experience. Moreover, acute and chronic LBP were predicted by positive past history of LBP as well as two ergonomic factors, frequent bending and frequent carrying of patients.

Conclusions:

Besides a history of low back pain and ergonomic factors, physical violence may be considered a contributing factor for acute low back injuries. Special attention to all personal, occupational, and psychological risk factors is recommended.

Unreported workplace violence in nursing

BACKGROUND

Workplace violence occurs on a frequent basis in nursing. Most violent acts remain unreported. Consequently, we do not know the actual frequency of the occurrence of workplace violence. This requires research of nurses' actions following workplace violence and identification of reasons why most victims do not report violent acts in the appropriate manner.

AIM

To explore violence in nursing as experienced by nurses in Slovenia.

METHODS

A survey was carried out with a representative sample of nurses in Slovenia. The questionnaire Workplace Violence in Nursing was submitted to 3756 nurses, with 692 completing the questionnaire.

RESULTS

A total of 61.6% of the nurses surveyed had been exposed to violence in the past year. Most victims were exposed to psychological (60.1%) and economic violence (28.9%). Victims reported acts of violence in formal written form in a range from 6.5% (psychological violence) to 10.9% (physical violence). The largest share of victims who did not report violence and did not speak to anyone about it were victims of sexual violence (17.9%). The main reason for not reporting the violence was the belief that reporting it would not change anything, followed by the fear of losing one's job.

CONCLUSIONS

Only a small share of the respondents reported violence in written form, the main reason being the victims' belief that reporting it would not change anything. This represents a severe criticism of the system for preventing workplace violence for it reveals the failure of response by leadership structures in healthcare organizations.

IMPLICATIONS FOR NURSING AND HEALTH POLICY

Professional associations and the education system must prepare nurses for the prevention of violence and appropriate actions in the event of violent acts. Healthcare organizations must ensure the necessary conditions for enabling and encouraging appropriate actions following violent acts according to relevant protocols.