Nurse exposure to physical and nonphysical violence, bullying, and sexual harassment: A quantitative review

Attitudes towards protecting Emergency Medical Services (EMS) staff from violence and aggression: a survey of adults in Wales

OBJECTIVE

To explore the Welsh public's views of violence and aggression (V&A) directed at EMS (emergency medical services) staff, awareness of policy changes and the reach of media campaigns.

DESIGN/SETTING/PARTICIPANTS

Survey involving non-probabilistic purposive sampling of 1010 Wales adults (aged 18+) from a matched panel, representative of the population, derived from a UK YouGov panel of >360 000 adults registered.

RESULTS

Most (62.5%) participants had heard of V&A directed towards EMS staff; 81.1% had heard about it through the media. 21.0% of participants had witnessed V&A towards EMS staff; younger participants were more likely to have witnessed an incident 18.7% via a social setting and 81.1% through the media. 90.4% disagreed with the statement that V&A towards EMS staff can be acceptable in some cases, and 53.3% were not aware of related media campaigns. Participants thought intoxication with alcohol (92.4%), drugs (90.5%) and altered mental status following illness and/or injury (84.3%) would likely contribute to V&A towards EMS staff. 22.0% of participants were aware of the Assaults on Emergency Workers Act. Although I thought the act was unlikely to deter perpetrators who were intoxicated with drugs (75.2%), alcohol (75.2%), with altered mental status following illness and/or injury (75.6%) or other member of the public (42.4%). Younger participants were more likely to think the act would deter those intoxicated with drugs, alcohol, with altered mental status following illness and/or injury and other members of the public. Those with social grades of C2/D/E thought the act was likely to deter those intoxicated with drugs.

CONCLUSION

There is good public awareness of V&A directed towards EMS staff in Wales who find it unacceptable. Our survey found limited awareness and perceived effectiveness of related legislation and media campaigns in the last 2 years. Participants thought legislation would not deter those intoxicated with drugs, alcohol or altered mental status. Therefore, we recommend further research to understand and develop evidence-based interventions for these groups of people. We also recommend amplifying messages targeted towards young people and through social settings where V&A may be encountered.

The Association Between Workplace Violence and Psychological Distress Among Nurses Working in Psychiatric Hospitals in Jordan

PURPOSE

To assess the prevalence of workplace violence (WPV) and investigate factors that contribute to psychological distress among psychiatric nurses in Jordan.

METHOD

In this cross-sectional, correlational study, a convenience sampling technique was used to recruit 190 psychiatric nurses.

RESULTS

Mean scores for WPV and psychological distress were 13.22 (SD = 2.51) and 56.11 (SD = 23.29), respectively. All psychiatric nurses reported incidences of verbal aggression from patients and their families, and a significant majority (92.6%) admitted to experiencing physical violence in the past year. For every unit increase in WPV scores, there was an average increase of 0.631 points in psychological distress (p < 0.001).

CONCLUSION

Findings suggest that psychiatric nurses working in psychiatric hospitals experience a high level of WPV, resulting in moderate psychological distress. It is suggested to enhance nurses' knowledge regarding the risk factors of WPV to decrease the occurrence of this phenomenon. Furthermore, implementing educational initiatives designed to support psychiatric nurses in alleviating psychological distress resulting from WPV would yield positive outcomes. [Journal of Psychosocial Nursing and Mental Health Services, 63(4), 43-51.].

Resilience as a moderator of the effects of types of workplace bullying and job performance

BACKGROUND

Workplace bullying is a problem that can occur in any occupation or organization and is a stressful and negative experience for employees; resilience helps employees to better resist workplace bullying. The purpose of this study was to examine whether resilience moderates the effects of workplace bullying on job performance and to determine whether this moderating effect differs between three types of bullying: personal, work-related, and physical bullying.

METHODS

A self-administered, paper-based questionnaire was distributed to full-time nurses at three regional hospitals in Taiwan. Cross-sectional data on workplace bullying behaviors, resilience and job performance were collected from 422 nurses using a questionnaire survey. Data were collected using the Job Performance Scale, the Negative Acts Questionnaire, and the Resilience Scale (CD-RISC-10), and the resulting data were analyzed using SPSS 21 and the PROCESS macro.

RESULTS

Resilience moderated the positive relationship between personal, physical bullying and job performance (b = .11, p < .05; b = .17, p < .05), but did not moderate the effects of work-related bullying.

CONCLUSIONS

The findings of this study highlight the need for organizations to be proactive in preventing work-related bullying and to promote and enhance individual resilience. Managers need to be aware of the detrimental effects of work-related bullying, which can damage employees' physical and mental health and contribute to workplace toxicity.

Impact of violence on work morale on Taiwanese nurses: The moderator of perceived organizational support

AIM

This study aimed to investigate the impact of workplace violence on work morale, of nurses specifically focusing on work satisfaction and work commitment, and whether perceived organizational support moderates this relationship.

BACKGROUND

Prior research on this topic has predominantly explored the effects of workplace violence on the emotional antecedents of nurses' turnover intentions, with limited attention given to organizational factors. The literature and evidence on this subject are inconsistent and often contradictory. Moreover, studies that address contingency factors within the dynamics of this relationship are lacking.

METHODS

A sample of 550 nurses at a medical center in Taiwan provided the initial data collection pool, from which 300 respondents were selected for further analysis. To evaluate the proposed hypotheses, partial least squares structural equation modeling was applied.

FINDINGS

When considered in the context of affective events theory and social support theory, the findings confirm workplace violence has significant effects on both work satisfaction and work commitment. Additionally, perceived organizational support acted as a moderating factor in this relationship.

CONCLUSION

This study aligns with the Sustainable Development Goals established by the United Nations, particularly those concerning addressing gender equality (key themes addressed by goal 5: workplace violence and harassment) to foster a supportive work environment for women. This research contributes to the literature by elucidating the specific moderating mechanisms through which perceived organizational support influences the relationship between workplace violence and work morale.

IMPLICATIONS FOR NURSING AND NURSING POLICY

The results of this study have a significant impact on international nursing policies focused on enhancing the safety and involvement of female nurses in the workplace, especially regarding workplace violence issues. Hospital administrators should create a positive nursing work environment that maintains nurses' morale and reduces the negative effects of workplace violence. Additionally, organizations should provide nurses with supportive resources or establish policies to enhance nurses' work morale.

Prevalence and associated factor of verbal abuse against nurses: A systematic review

BACKGROUND

Nurses who experience verbal abuse often report negative emotions, which can affect their work status and nurse-patient relationship. However, to the best of our knowledge, no study has summarized the prevalence of verbal abuse among nurses by different perpetrators and related risk factors.

AIM

This review aimed to synthesize the prevalence of verbal abuse among nurses and identify the most common sources and related risk factors.

METHODS

PubMed, Web of Science, Embase, and the Cochrane Library electronic databases were searched from inception to 15 October 2024, and observational studies reporting the prevalence of verbal abuse among nurses were selected. In this systematic review, the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed. Methodological quality was appraised using a revised version of the Newcastle-Ottawa Quality Assessment Scale, and the STATA software was used for meta-analysis; PROSPERO registration number: CRD42022385401.

RESULTS

The search identified 458 records, of which 45 met the inclusion criteria. The overall prevalence of verbal abuse was estimated at 67% (95% CI: 61-72). Verbally abused nurses reported patients' relatives, friends (48%, 95% CI: 42-55), and physicians (39%, 95% CI: 20-58) as the main perpetrators of verbal abuse. Personal factors, work area, and work characteristics were the main factors related to verbal abuse among nurses.

CONCLUSIONS

The overall prevalence of verbal abuse among nurses was more than 65%, especially in the emergency department, and South or Southeast Asian countries had a significantly lower prevalence of verbal abuse than other countries. Physicians and patients' relatives were the main sources of verbal abuse. Hospital administrators should prevent various effects of verbal abuse on nurses' physical and mental health.

IMPLICATIONS FOR NURSING AND HEALTH POLICY

Developing safe workplaces and effective interventions to protect nurses is essential. Supervisors and institutions should thoroughly monitor verbal abuse. Additionally, organizations need to focus on preventive measures and provide the necessary administrative, legal, and psychological support to nurses who are exposed to verbal abuse to ensure nursing care sustainability.

Relationship between workplace violence and occupational health in emergency nurses: The mediating role of dyssomnia

BACKGROUND

Violence in the workplace is a common concern within the health care field, particularly in the high-intensity, high-risk and high-stress environment of the emergency and critical care department. Workplace violence poses significant risks to their physical, psychological and sleep quality. Therefore, it is essential to explore the mechanisms through which workplace violence impacts the occupational health of emergency and critical care nurses.

AIM

To explore how dyssomnia affects the relationship between workplace violence and emergency and critical care nurses' health, as well as to determine the degree of interaction between workplace violence, dyssomnia and somatic symptoms.

STUDY DESIGN

This cross-sectional survey study included 1540 emergency and critical care nurses from 30 tertiary hospitals across 20 provinces and autonomous regions in mainland China, conducted between 26 December 2023 and 18 January 2024. Spearman correlation analysis was employed to evaluate the relationship among workplace violence, sleep disorders and somatic symptoms. A mediated structural equation model analysis was performed utilizing the Latent Moderated Structural Equations (LMS) method. In this manuscript, we adhered to the STROBE checklist.

RESULTS

In total, 85.0% (1309) of emergency and critical care nurses had experienced workplace violence in the preceding year, and 59.3% (913) had developed dyssomnia. Significant path coefficients were found for workplace violence on sleep (β = 0.333, 95% confidence interval = [0.276, 0.388], p < .01), sleep on somatization symptoms (β = 0.572, p < .01) and workplace violence on symptoms (β = 0.307, 95% confidence interval = [0.254, 0.359], p < .01). The mediating effect of dyssomnia between workplace violence and somatization symptoms in emergency and critical care nurses accounted for 38% of the total effect, indicating a significant mediating effect.

CONCLUSION

Sleep disorders were found to mediate the link between workplace violence and somatic symptoms, suggesting that measures other than sleep-specific interventions are required to reduce the risk of somatization symptoms developing in emergency and critical care nurses. In addition, the conjunction effect of workplace violence and sleep highlighted the benefits of simultaneous and integrated interventions to mitigate health risks for nurses.

RELEVANCE TO CLINICAL PRACTICE

The study's findings stress the importance of physical and mental health and sleep quality interventions for emergency and critical care nurses, given the strong connection between sleep disorders and workplace violence. Nursing administrators are encouraged to explore interventions such as individual counselling, a reasonable shift system and adequate time off for emergency and critical care nurses to alleviate sleep disorders, ultimately enhancing their overall physical and mental health.

Occupational violence against nursing staff in the surgical wards of Murzuq locality hospitals, Libya (2024)

BACKGROUND

Occupational violence is a significant issue for nurses worldwide, impacting their well-being, job satisfaction, and patient care quality. This study investigated the prevalence, types, and effects of such violence on nursing staff in surgical wards in Murzuq locality hospitals, Libya, to inform effective prevention strategies.

METHODS

This cross-sectional study examined occupational violence against nursing staff in surgical wards across three hospitals in Murzuq, Libya. Using a convenience sampling approach, data were collected from 50 nurses in general surgical and emergency surgical wards over four weeks through a self-administered questionnaire. The variables included demographic data (gender, experience) and information on violence types, sources, impacts, and reduction strategies. The data were analysed via SPSS v27, with descriptive statistics applied. For inferential statistics, the chi-square test and Fisher's exact test were conducted at a significance level of 0.05. Ethical approval was obtained from the academic research committee of Fezzan University, and informed consent was secured from all participants.

RESULTS

Verbal insults (60%) and discrimination (64%) were the most reported types of violence. Patient companions (68%) were identified as the primary source, followed by patients (40%) and colleagues (28%). Occupational violence significantly impacted nurses' lives, with 62% reporting stress, 48% experiencing decreased job satisfaction, and 28% considering leaving their jobs. Additionally, 40% reported difficulty concentrating due to violence. Significant associations were found between gender and sources of violence (p ≤ 0.001) and between years of experience and types, sources, and impacts of violence (p ≤ 0.001).

CONCLUSION

These findings underscore the need for gender-sensitive interventions, comprehensive training, and support mechanisms to address workplace violence. Future research should explore the long-term effects of violence on nursing staff and the effectiveness of tailored interventions in different healthcare settings. The results highlight the critical role of improving work conditions and organizational policies to enhance workplace safety for nurses.

Pitfalls and Platforms in Workplace Violence Prevention

OBJECTIVE

To identify common pitfalls of workplace violence (WPV) prevention programs, as well as platforms for effective WPV prevention and management. This discussion paper elaborates on these pitfalls and platforms, sharing ideas on how to maintain safety and provide support for both colleagues and patients.

METHODS

The American Psychiatric Nurses Association (APNA) Council for Safe Environment (CSE) members met monthly to discuss WPV prevention, guided by evidence-based information, clinical expertise, and scholarly work. Concepts around WPV prevention were organized into common pitfalls in WPV prevention programs and optimum WPV prevention platforms. Pitfalls include reliance on attempts to control patients through strict rules, restrictions, and risk identification and monitoring. Alternatively, effective platforms include engagement-focused, relationship-based, trauma-informed and recovery-oriented practices. Education to develop staff skills and expertise beyond crisis prevention training and violence assessment is highlighted, giving voice to nurses' intuitive expertise in preventing, identifying, and diverting aggressive behaviors. Peer and organizational support interventions for nurse victims of violence are also examined.

RESULTS

Safe environments are enhanced when staff are actively engaged in efforts to discern and meet individual needs, engage with the patient, build trust, and communicate hope for recovery. Organizational cultures founded on concepts of trauma-informed care can provide the support victims of violence need to recover and develop resilience and post-traumatic strength.

CONCLUSION

Risk management strategies alone are ineffective means of preventing WPV in psychiatric settings. Organizations must strike a balance between ensuring safety and providing a therapeutic atmosphere.

Education and training interventions for healthcare workers to prevent sexual harassment

OBJECTIVES

This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To assess the effectiveness of education and training interventions on improving knowledge and skills for managing sexual harassment, and to assess their impact on the incidence of sexual harassment towards healthcare workers in healthcare settings. We will include all forms of sexual harassment committed by patients, visitors, and co-workers.

Unveiling the veil: Exploring experiences of patient-initiated workplace violence in long-term care and mental health and substance use settings

BACKGROUND

This paper focuses on patient-initiated workplace violence (referred to WPV hereafter) towards healthcare workers in long-term care (LTC) and mental health and substance use (MHSU) care settings. While an extensive body of evidence has thoroughly examined WPV, our understanding of what takes place immediately before or during a violent incident, known as 'on-the-spot' experiences is limited.

OBJECTIVE

This study examined (a) 'on-the-spot' experiences, (b) contributing factors, and (c) warning signs of impending WPV using the experiences of healthcare worker victims and witnesses and healthcare attendees in LTC and MHSU.

METHODS

The study was conducted in one LTC home and two MHSU units in British Columbia, Canada. In-depth semi-structured virtual interviews were conducted with 17 participants from June to September 2023. Workplace Health Indicator Tracking and Evaluation (WHITE) data included 38 WPV incidents occurring between January 2022 to March 2023. Data were analyzed using thematic analysis.

RESULTS

Six participants (35%) identified as both victims and witnesses of WPV, four participants (24%) as only victims, and five participants (29%) as only witnesses. Contributing factors to WPV encompassed two main themes and their subthemes: (1) patient/resident factors (cognitive impairment and neurodevelopmental conditions); (2) healthcare factors (lack of continuity of care across healthcare, community and family, care provision, approaches and skills in interactions with patients/residents, access to safety tools and security personnel, and unmet needs and workload and human resource challenges).

CONCLUSION

WPV may be reduced through access to specialized care, adoption of team-based care and person-centered care approaches, addressing resource constraints, and offering context-specific training.

Prevalence, consequences, and contributing factors beyond verbal and physical workplace violence against nurses in peripheral hospitals

Background

Globally, nearly one-third of workplace violence (WPV) occurs in the health sector. Exposure to WPV among Jordanian nurses has been widely speculated to be underreported. Understanding of the factors contributing to WPV among nurses and their consequences is limited.

Objectives

This study aimed to examine the consequences and contributing factors of WPV and explore suggestions for reducing WPV among nurses working in peripheral hospitals.

Methods

This descriptive, cross-sectional study included 431 Jordanian nurses. Data were collected using a self-report instrument between December 2022 and June 2023. A modified version of the ILO/ICN/WHO/PSI Workplace Violence in the Health Sector Country Case Study Questionnaire developed and validated in 2003 was used.

Results

The ages of the participants ranged from 20 to 49 years. A total of 349 nurses (81%) had experienced verbal violence, while 110 (25.5%) had experienced physical violence. Of the 110 nurses who were physically attacked, 44 (40 %) reported that an investigation was conducted to determine the cause of the incident. Approximately 38.2% of incidents involving physical violence in the last 12 months involved the use of weapons. The current study revealed that 59.6% of the nurses reported that verbal incidents were common in their workplace. The highest level of agreement among all participants was leniency in applying penalties to perpetrators of violence inside hospitals. The majority of participants (95.8%) agreed that improving staff-patient communication skills would effectively reduce violence.

Conclusion

Creating awareness among healthcare professionals, patients, and the general public regarding the impact of WPV and the importance of respect and professionalism is crucial.

Association between workplace violence from patients and the mental health status of healthcare workers in Zhuhai China: a cross-sectional study

Objective

Workplace violence (WPV) poses a serious occupational risk. This study aims to explore the association between WPV from patients and the occurrence of insomnia, depression, and anxiety among healthcare workers.

Methods

Information about the WPV from patients was collected by a self-designed questionnaire. Generalized Anxiety Disorder-7 (GAD-7), Patient Health Questionnaire-9 (PHQ-9), and Insomnia Severity Index (ISI) were used for the assessment of mental health. Logistic regression was used to explore the association between WPV from patients and insomnia, depression, and anxiety. Mediation analysis was used to evaluate the mediation effect of depression and anxiety on the relationships between WPV from patients and insomnia.

Results

Of 10,413 included healthcare workers, 40.05% experienced verbal violence, 6.44% experienced physical violence from patients in the past year. There is a significant association between verbal violence and insomnia (OR = 1.780, 95% CI: 1.591-1.990), depression (OR = 1.823, 95% CI: 1.640-2.026), and anxiety (OR = 1.831, 95% CI: 1.606-2.087), as well as physical violence (insomnia: OR = 1.220, 95% CI: 1.002-1.481; depression: OR = 1.274, 95% CI: 1.052-1.540; anxiety: OR = 1.316, 95% CI: 1.058-1.630). Moreover, depression and anxiety mediated the relationship between WPV and insomnia, the mediated proportion was 62.21% in the association between verbal violence and insomnia, and 60.22% in the association between physical violence and insomnia.

Conclusions

The association between WPV from patients and heightened risks of mental health issues emphasizes the necessity of supportive work environments. Recognizing the mediating role of depression and anxiety stresses the significance of tailored mental health training for healthcare staff.

[Job satisfaction and violence in the clinical relationship in Physical Therapists in Spain]

OBJECTIVE

To assess the job satisfaction (JS) of physiotherapists in Spain and their relationship with occupational violence, as with other socio-demographic, health, and occupational factors.

DESIGN

A cross-sectional study was conducted. Setting Primary, community, and hospital attention level at public and private care in Spain.

PARTICIPANTS

Physiotherapists in Spain who have been working for at least 3months during the last year, and with complete answer to the required variables (n=2,590).

MAIN MEASUREMENTS

Information was collected through a questionnaire distributed online. A descriptive quantitative analysis and 3 logistic regression models were performed. In the first model, sociodemographic and violence variables were included as independent variables, in the second, health-related variables, and in the third, occupational variables.

RESULTS

The average JS of physiotherapists is 7.26 points, being 8 or more in 46.8% of the cases, with a higher percentage in men". Referring not having suffered psychological violence was related to a higher probability of having JS, even controlling for the rest of the variables studied (OR1=0.485; OR2=0.611; OR3=0.697, respectively for each model). Variables related to health (state of health, symptoms, consumption of tobacco/alcohol/other substances) and to the work environment (working day, work area, autonomy, relationship with superiors/colleagues) were statistically significantly related to JS.

CONCLUSIONS

Almost 47% of the respondents had very high JS values. Certain areas of work as well as positive health factors have been linked to very high JS. Psychological violence is the form of violence that, independently of the other factors analysed, leads to lower JS.

Nurses' Workplace Violence Reporting Behaviours and Reasons for Not Formally Reporting: A Cross-Sectional Secondary Analysis

AIM

To investigate predictors of nurses' reporting behaviours and their reasons for not formally reporting.

BACKGROUND

Underreporting of workplace violence (WPV) among nurses contributes to gaps in WPV prevention measures, as it cannot be fully understood. WPV is classified according to its source (Type II: patients and visitors, Type III: coworkers) and forms (physical assault, threat of assault, emotional abuse, verbal sexual harassment and sexual assault).

DESIGN

This is a secondary analysis of cross-sectional survey data collected in 2019 from British Columbia (BC), Canada.

METHODS

This study had a sample of 4109 BC nurses. Multinomial logistic regression was used to analyse predictors of reporting behaviours. Reasons for not reporting were analysed descriptively.

RESULTS

Informal reporting to management or through a patient safety incident report was less likely when nurses experienced threat of assault, emotional abuse and verbal sexual harassment from both Type II and III sources and physical assault from Type III sources. Higher perceptions of WPV prevention efforts increased odds of informal and formal reporting through employee incident procedures. Believing that nothing would change after reporting remained among the top three reasons for not formally reporting across all WPV sources and forms. Nurses also commonly selected not knowing the formal process, lack of leadership support and other reasons stated in an open-text response.

CONCLUSION

Findings indicate that nurses in BC, Canada, perceive many barriers to formal WPV reporting. Formal reporting systems should address these barriers so that healthcare organisations can effectively track WPV and have data to inform WPV prevention measures.

IMPLICATIONS

To promote WPV reporting, healthcare organisations need multifaceted interventions including confidential and simplified reporting systems, leadership support to follow-up with nurses and education and training on reporting systems.

REPORTING METHOD

The authors of this manuscript have adhered to the relevant EQUATOR guidelines based on the STROBE cross-sectional reporting method.

PATIENT OR PUBLIC CONTRIBUTION

No patient or public contribution.

A study on the workplace cultural violence against nurses: a systematic review and meta-analysis

INTRODUCTION

Cultural violence includes any offensive behavior regarding ethnicity, race, language, religion, and place of birth devaluing human dignity. The purpose of this study was to investigate workplace cultural violence against nurses by systematic review and meta-analysis.

MATERIALS AND METHODS

The guideline of Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) was followed. The search was independently conducted in ISI, Cochrane Library, Google Scholar, PubMed, and Scopus by two researchers. We used mesh keywords to recruit publications from different regions of the world between 2002 and 2017. Data was analyzed using meta-analysis and STATA software. To determine the heterogeneity, Q and I2 indices were used.

RESULTS

A total of 50 articles were found from which 8 were ultimately included in the systematic review process. The overall rate of workplace cultural violence among nurses was 17.25% (95% CI 16.83-17.66, I2 = 99.7%, P = 0.0001). Also, the rate of workplace cultural violence against nurses and patients' relatives and companions was 8.21% (95% CI 7.61-8.81, I2 = 99.7%, P = 0.0001). The meta-regression of cultural violence in terms of sample size and year of study rendered a significant decrease in the violence rate by increasing years and sample size (P < 0.001).

CONCLUSION

Although not all cases of cultural violence are reported and recorded, the rate of cultural violence against nurses is decreasing according to the results of our study. Nevertheless, by providing good services and appropriate education to patients, the overall incidence of cultural violence is expected to be further reduced.

Differences in workplace violence and health variables among professionals in a hospital emergency department: A descriptive-comparative study

INTRODUCTION

Workplace violence is a relevant social problem due to its high prevalence and serious consequences. A quarter of workplace violence occurs in the healthcare sector. Evidence shows differences among professionals, with emergency department workers being especially vulnerable, presenting a higher risk of suffering mental and physical health problems, as well as threats to their professional and social integrity.

OBJECTIVE

To explore the frequency with which emergency department professionals are exposed to user violence and violence by their own coworkers; as well as to analyze the differences between different professionals in exposure to violence in the workplace and some of its most studied consequences such as burnout, job satisfaction, engagement, and general health.

METHODS

A descriptive comparative study was carried out with a sample of 120 emergency department workers from three hospitals in Alicante. The majority were healthcare professionals (84.2%), women (61.7%), obtaining a mean age of 41.8 years (SD = 10.8). Sociodemographic and occupational variables, user violence, violence among colleagues and superiors, general health, burnout, engagement, and job satisfaction were evaluated.

RESULTS

A high prevalence of both physical and non-physical user violence in the healthcare setting was observed, especially affecting nursing and administrative assistants. In addition, significant differences were identified between professionals in terms of non-physical user violence, burnout, engagement, and job satisfaction. Administrative staff suffer greater non-physical user violence, while nursing assistants show higher levels of engagement. Regarding job satisfaction, nurses report higher intrinsic satisfaction. Medical staff, nurses and nursing assistants show higher levels of extrinsic satisfaction compared to administrative staff.

DISCUSSION

Our results are consistent with other studies in which a relationship between exposure to violence and job satisfaction is observed. In addition, administrative staff appear to be the professionals most exposed to violence from both patients and coworkers. These results provide evidence for future research focused on improving the work environment and health of emergency department professionals.

Global meta-analysis of physicians' experiences of workplace sexual harassment by patients

The World Health Organization recognises that sexual harassment is an occupational hazard in medicine, but the prevalence of sexual harassment by patients is unknown. This global meta-analysis found that a pooled prevalence of 45.13% of 18 803 physicians from several specialities (e.g. internal medicine and surgery) have ever experienced it. Hospitals should implement protective measures such as panic alarms for night shifts and isolated wards.

Assessment of the Prevalence and Patterns of Violence against Healthcare Workers in Nigeria: A Multicentre Study

BACKGROUND

In Nigeria, violence against healthcare has adversely affected the access to and delivery of healthcare services with serious consequences for healthcare workers (HCWs). This study assessed the prevalence and patterns of violence against HCWs in areas of armed conflict, areas of other situation of violence and areas not affected by conflict in Nigeria.

METHODOLOGY

A cross-sectional study utilising a mixed method approach comprising both quantitative survey and qualitative data collection methods. All the categories of HCWs in public healthcare facilities participated in the study. Ethical approval for this study was obtained from the respective Health and Research Ethics Committees of the respective study sites.

RESULTS

A total of 1,218 HCWs comprising Borno State, 407 (33.4%), Plateau State, 401 (32.9%) and the Federal Capital Territory 410 (43.7%) were interviewed. The overall prevalence of physical and psychological violence was 16.7% and 62.4%, respectively. Pushing and slapping were the predominant forms of physical violence. Weaponized violence with weapon was the highest in conflict areas. Verbal abuse, threats, bullying and harassment were the predominant forms of psychological violence. The major consequences of violent attacks on the HCWs were lack of job satisfaction, loss of confidence, low self-esteem, decreased productivity and post-traumatic stress disorder.

CONCLUSIONS

The overall prevalence of violent attacks on HCWs was high. The perpetrators of violent attacks were mainly patient relatives and patients/clients. The factors predisposing to violent attacks were patients-related issues, service delivery, working conditions of the hospitals, expectations of patient relatives and impatience of hospital staff.

Exploring perceptions of reporting violence against healthcare workers in the emergency department: A qualitative study

BACKGROUND

Violence against healthcare workers is a pervasive, yet in many cases, under-reported problem. This is due to various factors, including lack of time, support and a universal understanding of what constitutes a reportable event. This study explored facilitators and barriers to reporting workplace violence among emergency department nurses.

METHODS

In this descriptive, qualitative study, researchers conducted open-ended interviews with emergency nurses considered to be "high-" and "non-reporters" of violent events and analyzed for themes.

RESULTS

Participants cited consistent factors associated with less reporting, factors associated with more reporting and effectiveness of existing safety measures.

CONCLUSIONS

To encourage the reporting of violent events, frequently cited barriers and facilitators should be addressed. Strategies such as integrating reporting mechanisms into the health record, creating nuanced definitions of reportable events, and consistent education with positive feedback can promote reporting by staff. These efforts should be combined with prevention strategies to ensure we are collecting correct data about the success or failure of these programs.

Safeguarding healthcare professionals from sexual harassment in the workplace: urgent need for effective training and education

Sexual harassment (SH) is a particularly harmful type of harassment that can inflict lasting psychological harm on victims. Within the healthcare sector, it negatively impacts teamwork, communication, and potentially compromises patient care. While concerns about workplace SH, including in healthcare, are long-standing, the #MeToo movement has brought renewed scrutiny to this issue since late 2017. Despite increased awareness, evidence suggests that SH remains prevalent in healthcare settings and shows no signs of decline over time. Therefore, there is an urgent need for effective training and intervention measures to enhance the identification of potential sexually offensive behaviors, thus fostering a work environment characterized by respect and inclusivity.

Prevalence and predictors of workplace sexual harassment of nurses in the Central Region of Ghana: a cross-sectional online survey

OBJECTIVE

We investigated the prevalence and predictors of workplace sexual harassment against nurses in the Central Region of Ghana.

DESIGN

A cross-sectional online survey.

SETTING

Central Region of Ghana.

PARTICIPANTS

A total of 1494 male and female nurses from various healthcare facilities in the Central Region participated in this survey from August to September 2021.

MAIN OUTCOME MEASURES

The prevalence of sexual harassment was determined using the Sexual Experiences Questionnaires and the Workplace Violence in the Health Sector Questionnaires. We used descriptive statistics to analyse participants' characteristics and the occurrence of sexual harassment. Binary logistic regression was used to determine the predictors of sexual harassment. The survey instrument yielded a reliability value of 0.82.

RESULTS

The prevalence of sexual harassment was 43.6% when behaviour-based questions were applied and 22.6% when a direct question was used. The main perpetrators of sexual harassment were male physicians (20.2%), male nurses (15.4%), male relatives of patients (15.1%) and male patients (11.6%). Unfortunately, only a few victims lodged complaints of harassment. Compared with males, female nurses were more likely to be sexually harassed (adjusted OR, aOR 1.59, 95% CI 1.23 to 2.07). Moreover, nurses with higher work experience (aOR 0.86, 95% CI 0.80 to 0.93), those married (aOR 0.54, 95% CI 0.41 to 0.72) and those working in private or mission/Christian Health Association of Ghana health facilities (aOR 0.49, 95% CI 0.36 to 0.68) were less likely to be sexually harassed.

CONCLUSIONS

The prevalence of workplace sexual harassment against nurses in the Central Region of Ghana is high and may compromise quality healthcare delivery in the region. Therefore, managers of healthcare facilities and the Ghana Health Service need to institute antisexual harassment interventions, including education, training and policy, with a focus on females in general, but especially those who are not married, less experienced and those working in public health facilities.

Implementing Trauma-Informed Care-Settings, Definitions, Interventions, Measures, and Implementation across Settings: A Scoping Review

Traumatic experiences can have long-lasting negative effects on individuals, organizations, and societies. If trauma is not addressed, it can create unsafe cultures with constant arousal, untrusting relationships, and the use of coercive measures. Trauma-informed care (TIC) can play a central role in mitigating these negative consequences, but it is unknown how and in which way(s) TIC should be implemented. Our objective was to conduct a scoping review that systematically explored and mapped research conducted in this area and to identify existing knowledge about the implementation of TIC. The search was conducted on the CINAHL, Cochrane, Embase, ERIC, Medline, PsycINFO, and Web of Science databases, and more than 3000 empirical papers, published between 2000 and 2022, were identified. Following further screening, we included 157 papers in our review, which were mainly from the USA, Australia, New Zealand, and Canada, focusing on study settings, methodologies, and definitions of TIC, as well as the types of interventions and measures used. This review shows that TIC is a complex and multifaceted framework, with no overarching structure or clear theoretical underpinnings that can guide practical implementations. TIC has been defined and adapted in varied ways across different settings and populations, making it difficult to synthesize knowledge. A higher level of agreement on how to operationalize and implement TIC in international research could be important in order to better examine its impact and broaden the approach.

Sexual Harassment at Work: Scoping Review of Reviews

Background

This article presents a scoping review of reviews on the topic of Sexual Harassment (SH) in the workplace, a subject that has garnered significant global attention. The phenomenon of SH poses a critical challenge to equal opportunity and gender equity in the workplace.

Aim

The review aims to synthesize existing research, focusing on the antecedents, consequences, and interventions related to SH.

Methods

The inclusion and exclusion criteria were established based on the research question, which was adapted from the PICO strategy. A protocol was devised following the "DS-CPC" format, which encompasses considerations related to Documents, Studies, Construct, Participants, and Contexts. The search was carried utilizing several automated databases, specifically focusing on the fields of Psychology, Behavioral Sciences, and Health. Preliminary search yielded a total of 468 articles, and the review ultimately encompassed a total of 22 articles.

Results

This review critically examines the complexity of SH, including the role of bystanders, the perpetuation of myths and misconceptions, and the exploitation of power imbalances by harassers. It also explores the manifestation of SH in male-dominated workplaces and the varying levels of organizational awareness and response to such incidents. The review highlights the importance of fostering an organizational culture that not only acknowledges and protects victims but also implements effective measures to penalize perpetrators.

Implications

It aims to elucidate the intricacies of SH and advocate for a workplace environment characterized by respect and accountability. Through this comprehensive analysis, the article seeks to inform and guide future research, policy development, and organizational practices concerning SH.

A participatory and comprehensive intervention to improve violence prevention in two high-risk occupations: effect and process evaluation of a stepped wedge cluster randomised trial

BACKGROUND

Work-related violence committed by clients, patients, and customers represents a major occupational health risk for employees that needs to be reduced.

METHODS

We tested a comprehensive violence prevention intervention involving active participation of both employees and managers in the Prison and Probation Service (PPS) and on psychiatric wards in Denmark. We used a stepped wedge cluster randomised controlled trial design. We measured the degree of implementation of the intervention by registration of fidelity, reach, and dose and used a mixed-effects regression analysis to estimate the effects of the intervention.

RESULTS

We recruited 16 work units for the intervention, but three work units dropped out. The average implementation rate was 73%. In the psychiatric wards, the intervention led to statistically significant improvements in the primary outcome (an increase in the degree to which managers and employees continuously work on violence prevention practices based on their registration and experiences), but none statistically significant improvements in any of the secondary outcomes. In the PPS units, the intervention did not lead to a statistically significant improvement in the primary outcome, but to statistically significant improvements in three secondary outcomes.

CONCLUSION

Most work units were able to carry out the intervention as planned. The intervention showed mixed results regarding the primary outcome. Nevertheless, the results indicate improvements also in the sector where a change in the primary outcome was not achieved. The results point at that a participatory and comprehensive approach could be a viable way of working with violence prevention in high-risk workplaces.

TRIAL REGISTRATION

ISRCTN86993466: 20/12/2017.

Classifying Studies on Workplace Violence for Visiting Nurses Using the Social-Ecological Model: A Scoping Review

PURPOSE

To prevent workplace violence (WV) against visiting nurses (VNs), understanding the influencing factors is crucial. To better comprehend potential violence prevention strategies, the U.S. Centers for Disease Control and Prevention has presented the four-level social-ecological model (SEM) at the 1) individual, 2) relationship, 3) community, and 4) societal levels. This study aims to quantify WV studies against VNs, examine the influencing factors, identify gaps based on SEM levels, and propose future research and policy directions.

DESIGN

A scoping review was conducted following the five-stage protocol proposed by Arksey and O'Malley in 2005.

METHODS

Systematic searches, including manual searches, were performed using English and Korean databases. Published journal articles including editorials on WV against VNs were included, irrespective of the publication date.

FINDINGS

Sixty journal articles were finally selected. Until the 1990s, most of the literature comprised editorials, with empirical research emerging after the 2000s. Classifying studies by SEM level, many studies have focused on individual (86.7%) and community (66.7%) factors, but fewer have addressed relationship (21.7%) and societal (16.7%) factors.

CONCLUSIONS

The study revealed that much research has focused on individual-centered training, with gaps in risk assessment tool development, training incorporating relational aspects, standardized protocols, and understanding of the impact of legal rights and policies. This article advocates a comprehensive approach that considers all SEM levels to address WV against VNs.

CLINICAL EVIDENCE

The findings confirm a research gap, which suggests the direction for future research and policies. Stakeholders should be urged to implement evidence-based strategies that contribute to safer work environments for VNs.

Prevalence and predictors of workplace violence against nurses in Africa: A systematic review and meta-analysis

Background and Aims

Workplace violence (WPV) against nurses is a pervasive global issue, yet the extent of this phenomenon in the African context remains insufficiently explored. This review aimed to synthesize the available literature to identify the prevalence and predictors of WPV against nurses in Africa.

Methods

A systematic search was conducted across MEDLINE, CINAHL, PsycINFO, and Scopus, to identify studies published from 2000 to October 2023. The pooled prevalence of WPV and it subtypes were estimated using random-effect meta-analysis. Heterogeneity between studies was quantified with I 2 statistics. Subgroup analysis and meta-regression were performed to identify sources of heterogeneity.

Results

This review included 27 studies, involving 9831 nurses. The pooled prevalence of WPV was 62.3% (95% confidence interval [CI]: 51.6-72.0). Verbal abuse emerged as the most common form of WPV, with a prevalence rate of 51.2% (95% CI: 41.3-61.1), followed by threat 23.3% (95% CI: 6.5-57.2), bullying 22.9% (95% CI: 14.0-35.2), physical abuse 15.1% (95% CI: 11.0-20.4), and sexual harassment 10.3% (95% CI: 5.9-17. 5). The proportion of WPV varied across geographical areas in Africa; however, the differences were not significant. The predictors of WPV encompassed demographic factors, personal habits, workplace characteristics, and nurses' past experience.

Conclusion

WPV against nurses is prevalent in Africa and transcends geographical boundaries in this region. This underscores the urgent need for targeted interventions and policy changes to address this issue in Africa.

Workplace Violence against Nurses Working at Private Teaching Hospitals of Kathmandu: A Descriptive Cross-sectional Study

INTRODUCTION

Workplace violence in hospitals is a global concern and is considered as a major occupational hazard for all health care providers including the nurses. The aim of this study was to assess the status of workplace violence against nurses at hospitals in Kathmandu and determine the actions taken to investigate its cause.

METHODS

A descriptive cross-sectional study was conducted among a convenient sample of 100 registered nurses employed in Nepal Medical College and Teaching Hospital, and Kathmandu Medical College and Teaching Hospital. All eligible nurses who were willing to participate irrespective of their academic fulfilment, from all different shifts and of age below 45 years were included. Data were collected using a structured questionnaire and analysed using SPSS software. Ethical approval was taken from the Institutional Review Committee (IRC) of Nepal Medical College and Kathmandu Medical College.

RESULTS

Among 100 participants, the prevalence of workplace violence was 72 (72%) (62.13-80.52, 95% Confidence Interval). Verbal abuse accounted to 50 (69.44%), followed by physical violence accounting 17 (23.61%). Action was taken to investigate the causes of both physical violence 5 (29.41%) and verbal abuse 2 (4%) by the hospital administration 3 (60%) in physical violence and 2 (100%) in verbal abuse and police 2 (40%) in physical violence.

CONCLUSIONS

The study reveals a troubling reality, as the vast majority of nurses reported experiencing various forms of violence in their workplace. So, addressing this issue immediately could protect nurses' well-being and ensure quality care which benefits both healthcare professionals and patients.

Fear of violence and working department influences physical aggression level among nurses in northwest Ethiopia government health facilities

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.

Healthcare Workers: Heroes or Victims? Context of the Western World and Proposals to Prevent Violence

Episodes of direct violence against healthcare workers and social workers represent a worrying and widespread phenomenon in Western countries. These violent attacks, whether verbal or physical, occur in various work environments, targeting professionals working in private facilities, medical practices, or those employed within the National Health System facilities. We conducted a search using a single search engine (PubMed) using the terms "violence against healthcare workers AND Western" for the period 2003-2023, identifying 45 results to which we added to the literature through hand searching. Our review thus analyzed the sector literature to highlight the phenomenon of violence against healthcare workers, particularly in Western countries. We began with an analysis of the problem and then focused on the true purpose of the study, which is to propose new solutions to protect healthcare workers in all work settings. Consequently, we aim to improve both the working environment for healthcare professionals and to enhance the overall healthcare and public health outcomes.

PTSD prevalence and factors in intern nursing students after COVID-19 full liberalization in China: a cross-sectional study

Objective

This study aimed to assess the prevalence of post-traumatic stress disorder (PTSD) and its influencing factors among intern nursing students after the full liberalization of the COVID-19 prevention and control policy in China.

Methods

Participants completed the online survey from January 14 to January 19, 2023. A demographic questionnaire, COVID-19 and internship-related questionnaire, the Fear of COVID-19 scale, the Primary Care PTSD Screen, and the Connor-Davidson Resilience Scale were used to conduct the online survey.

Results

Of 438 participants, 88.4% tested positive for COVID-19 in the last 6 months. The prevalence of fear, resilience, and PTSD was 16.9, 15.5, and 11.2%, respectively. Direct care of COVID patients in hospital (OR = 2.084, 95%CI 1.034 ~ 4.202), the experience of occupational exposure (OR = 2.856, 95%CI 1.436 ~ 5.681), working with an experienced team (OR = 2.120, 95%CI 1.070 ~ 4.198), and fear COVID-19 (OR = 8.269, 95%CI 4.150 ~ 16.479) were significantly and positively associated with PTSD in nursing internship students.

Conclusion

After COVID-19 full liberalization in China, intern nursing students still experienced pandemic-related mental distress, which can bring PTSD. Adequate support and counseling should be provided, as needed, to intern nursing students who are about to enter the workforce and have experienced severe PTSD symptoms related to COVID-19. Our findings indicated that should understand the importance of screening, formulate intervention strategies and preventive measures to address psychosocial problems, and provide coping skills training to intern nursing students.

A latent profile analysis of resilience and the associations with flourishing in emergency nurses exposed to workplace violence in China

Workplace violence (WPV) exposure has been particularly prevalent in emergency nurses, coupled with negative mental health outcomes. Few explored resilience after WPV exposure using the perspective of positive mental health. We aimed to identify latent profiles of resilience and examine associations with flourishing in emergency nurses with WPV exposure. A total of 1241 Chinese emergency nurses were surveyed on the frequency of WPV exposure, resilience, and flourishing. Eight hundred and twenty five participants (90.1% female, 86.6% aged 20-39) reported WPV exposure at least once in the past 3 months. Latent profile analysis identified profiles of resilience as low resilience (15.0%), moderate decision respond and interpersonal link with low rational thought and flexible adaption (18.0%), moderate resilience (31.0%), high decision respond, interpersonal link, and rational thought with moderate flexible adaption (16.0%), and high resilience (20.0%). Higher flourishing was observed in profiles of moderate resilience, high decision respond, interpersonal link, and rational thought with moderate flexible adaption, and high resilience. We differentiated profiles of resilience and the associations with flourishing in emergency nurses with WPV exposure, which informed targeted interventions for promoting positive mental health.

Development and validation of the nurses sexual harassment scale in Iran

INTRODUCTION

In recent years, the prevalence of sexual harassment has become a global problem, and nursing, like other professions, has not been immune to this issue. By having a valid and reliable instrument, healthcare personnel can be helped in preventing and managing this problem and reduce its negative consequences on mental health and well-being. The aim of this study was developing and psychometrically measuring the Nurses Sexual Harassment Scale.

MATERIALS AND METHODS

This study is the second phase of a mixed method study. Initially in the first phase, a qualitative approach with conventional content analysis was used to explain nurses' experiences of sexual harassment in the workplace. To design the Nurses Sexual Harassment Scale, qualitative data and literature were reviewed. In the quantitative phase (second phase), the target scale was psychometrically evaluated using content validity (14 experts), face validity (12 nurses with being sexually harassed), construct validity (316 nurses working in hospitals affiliated to Kerman University of Medical Sciences), and reliability (internal consistency and repeatability).

RESULTS

A 15-item scale with two components: "latent sexual harassment" (9 items) and "manifest sexual harassment" (6 items), which explained 68.4% of the total variance was developed. Also, due to the strong correlation between the Nurses Sexual Harassment Scale and the Impact of Event Scale-Revised (r = 0.67), convergent validity was confirmed. Also, the scale of the present study had good reliability (Cronbach's alpha coefficient = 0.94, Omega coefficient = 0.94, and ICC = 0.92).

CONCLUSION

Given the importance of sexual harassment among nurses, measuring the dimensions of this problem may allow professionals to plan interventions to prevent it. Overall, the results of the present study showed that the psychometric properties of the " Nurses Sexual Harassment Scale" with 15 items are acceptable and this scale can be used in the clinical environment. A further study within the nursing community is recommended to confirm the findings.

A cross-sectional survey on the relationship between workplace psychological violence and empathy among Chinese nurses: the mediation role of resilience

BACKGROUND

Workplace violence is one of the most serious public health issues worldwide in healthcare occupations, nurse is a profession which faces the greatest risk of exposure to workplace violence among healthcare occupations.

OBJECTIVE

The present study aimed to explore the relationship between workplace psychological violence and empathy among Chinese nurses, and further examine the mediation role of resilience in this relationship.

METHOD

A cross-sectional survey was conducted among a convenience sample of clinical registered nurses in Xinjiang China from 29 September 2023 to 19 October 2023.The online questionnaire, contained the general information form, the Workplace Psychologically Violent Behaviors Instrument, the Jefferson Scale of Empathy-Healthcare Professionals Version, and the Connor-Davidson Resilience Scale, was used to collect data. The IBM SPSS statistics software version 22.0 was used to perform data analyses in forms of descriptive statistics, correlation analysis, and mediation analysis.

RESULT

This survey recruited a convenience sample of 1613 clinical registered nurses aged 22 to 55 years who come from diverse ethnicities and worked in different departments. A total of 534 nurse experienced psychological violent, which yielded a positive rate of 33.1% for psychological violent among nurses. Pearson analysis reported a negative correlation between psychological violences and empathy (r=-0.724, P < 0.01) as well as a negative correlation between psychological violences and resilience (r=-0.681, P < 0.01). Mediation analysis reported that resilience mediated the negative relationship between psychological violence and empathy, the mediation effect accounted for ab/(ab + c') = 23.40% of the total effect.

CONCLUSION

This study supported an inverse ralationship between psychological violence and empathy among Chinese nurses where resilience acted as a protective factor to mediated the negative impacts of psychological violences on empathy These results directed health policies and clinical interventions to equip nurses with resilience to copy with and recover from workplace psychological violence.

Medical Students' Self-Perceptions of Harassment During Clinical Placement

Objectives

Exploring workplace dynamics during clinical placement is crucial to determine whether medical students are encountering safe and meaningful learning experiences. The aim of this original article is to describe medical students' reported harassment experiences whilst on clinical placement.

Design

Medical students in years 4 to 6 were invited to participate in the survey. In this mixed-methods study, data collection included demographic information, responses to the Generalized Workplace Harassment Questionnaire, and qualitative commentaries.

Results

Two hundred and five students completed the questionnaire. Medical students experienced harassment in areas of verbal aggression, disrespect, isolation/exclusion, threats/bribes, and physical aggression. Concerning levels of occurrence were noted for disrespect, isolation/exclusion, and verbal aggression.

Conclusions

Many medical students in this study reported experiencing harassment during their clinical placements indicating that harassment during clinical placement continues to be of concern in medical education. The findings indicate that further initiatives need to be designed to identify and respond to these cases of workplace harassment and that power imbalance and safe reporting appear to be further issues of concern. It was evident that students need to feel safe enough to be able to report harassment experiences to allow managers and educators to address the full extent of the problem.

The reality of occupational harm incurred by Japanese home health care nurses, the hazardous situations they face, and protective measures: a cross-sectional study

Objectives: To gain a comprehensive understanding of the occupational hazards encountered by home health care nurses in Japan and to elucidate the reality of harm they incur, the hazardous situations, and the protective measures taken.

Methods:A questionnaire survey of managers of home health care nursing agencies in Japan was conducted, and 355 valid responses were obtained. The survey questions concerned the occupational hazards experienced by home health care nursing staff. The occupational hazards were classified into 6 categories, and responses were obtained regarding harm, hazardous situations, and protective measures in each category.

Results: The types of harm that occurred at highest rates during the previous 3 years were emotional abuse by the patient or their family members, lower back pain resulting from improper posture while providing care, sexual harassment by the patients and their family members, automobile accidents while traveling to home care sites, and allergic reactions to the environment at home care sites. Some hazardous situations were caused by the unique environments of home care sites.

Conclusions: In order to prevent the occurrence of harm, the development of risk assessment tools, educational initiatives to increase awareness of occupational hazards, and consideration of the financial and technical support that will enable the use of assistive devices in the practice of nursing techniques were considered necessary. The development of effective guidelines and manuals specific to the occupational hazards encountered by home health care nurses is an important challenge.

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 email 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 was 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.

Second-Level Nurses' Experiences of Workplace Violence: A Scoping Review

Aim

To synthesise and map what is known about second-level nurses' workplace violence experience.

Background

Workplace violence has become a topic of focus in nursing over recent years. Research demonstrates that there is a growing body of literature focusing on first-level nurses' workplace violence experiences, but those of second-level nurses, a crucial component of the health workforce in many countries, have not been well explored. Evaluation. A scoping review was conducted from January 2000 up to March 2022 using Arksey and O'Malley's framework and databases, including ABI/Inform Collection, CINAHL, DOAJ, EBSCOhost, and ProQuest Central. Key Issues. Eighteen studies were included in the final review. The review identified three key findings related to second-level nurses' workplace violence experience. (1) They were found to have experienced physical and non-physical violence. Among non-physical violence, they reported experiencing bullying, mobbing, sexual harassment, racial discrimination, nurse-to-nurse conflict, and electronic abuse. (2) They were more likely than first-level nurses to experience physical violence, and (3) often data from second-level nurses were combined with those of first-level nurses; hence, it was difficult to identify the specific experiences of second-level nurses.

Conclusion

The review contributes to new knowledge highlighting the second-level nurses' workplace violence experiences worldwide. The review indicated that there are gaps identified and there is a need for greater understandings of workplace violence in second-level nurses to understand the scope of their problem and the nature of their experiences. Implications for Nursing Management. Nurse managers play a critical role to develop and implement effective policies and evidence-based interventions to improve the working conditions of the second-level nurses. The results of this current review can be used to guide nurse managers and organisations in providing adequate support to reduce and prevent WPV and advocate for a positive workplace culture.

Workplace bullying in pharmacy - a study on prevalence, impacts and barriers to reporting

PURPOSE

The study aims to estimate the prevalence of workplace bullying, personal and work-related impacts, reporting practices for bullying, and the reasons for not reporting bullying incidents in the New Zealand pharmacy sector.

DESIGN/METHODOLOGY/APPROACH

An online survey was conducted among registered pharmacists and pharmacist interns in New Zealand from June to August 2020. The questionnaire comprises both close-ended and semi-structured free-text questions. Goldberg's 12-item General Health Questionnaire (GHQ-12) assessed the respondents' general psychological health status, and a 22-item Negative Acts Questionnaire-Revised (NAQ-R) was used to estimate bullying prevalence together with the self-rated/self-labeled questions. The qualitative information obtained from the free-text responses was used to support and elaborate on the quantitative results.

FINDINGS

The self-labeled prevalence of workplace bullying was 36.9%, with almost 10% reporting it occurring almost daily to several times per week. The 54.7% prevalence based on the NAQ-R assessment compares well with the prevalence of witnessing the incidents (58.5%). Psychological distress symptoms were experienced by 37.1% in pre-COVID and 45.3% during COVID-year 1. Supervisors or direct managers were the commonest perpetrators (32.7%). Only 28.8% of those who experienced bullying had reported the incidents formally.

RESEARCH LIMITATIONS/IMPLICATIONS

This study is cross-sectional, and the relationships indicated are bi-directional. The consistency of the results is reassuring, however inferring causality of effect is challenging. Future studies and analyses should focus on this. This study suggests that in the pharmacy environment bullying from the top is reasonably prevalent, is not commonly reported and requires the design and implementation of prevention and management strategies that take into account and mitigate these bullying factors. Professional pharmacy leadership organizations, National Health Authority and Pharmacy regulators could play a significant role in awareness and training to reduce bullying with the development and promotion of strategies to curb it and improve reporting.

ORIGINALITY/VALUE

This is the first paper to describe the prevalence and impact of workplace bullying, and the practices of reporting bullying incidents in the New Zealand pharmacy sector. Based on empirical evidence, pharmacists represent a small share of total healthcare workforce, yet the overall prevalence of bullying is consistent with professions with much larger numbers such as medicine and nursing.

Quitting one's job or leaving one's profession: unexplored consequences of workplace violence and discrimination against health professionals

BACKGROUND

Although workplace violence and discrimination against healthcare workers are global and universal phenomena, and violence at work is recognized as a serious and growing problem, in Switzerland, hardly anything is known about the related consequences on job changes and career endings, which are two major staffing challenges present in the notoriously understaffed healthcare sector.

METHOD

Data collected from a written survey conducted among 1,840 hospital employees, of which 1,441 were health professionals, were used to evaluate and estimate the prevalence and impact of specific and cumulated forms of workplace violence and discrimination on the work climate and particularly on subsequent turnover intentions and career endings. Established multi- and single-item measures were used as predicting, intervening and outcome variables. Relative frequencies stratified for nurses, physicians and therapists were calculated to estimate and differentiate the size of the phenomena under study. Furthermore, crosstabulations, as well as multivariate regression analyses, were performed to explore the associations of interest.

RESULTS

Every fifth to sixth nurse and every seventh to eighth physician reported having had intentions to change jobs or leave the profession within the past year. These intentions become much more prevalent across all health professions when one or even two or more different forms of violence and/or discrimination at work are experienced and reported. Accordingly, the relative risks for intending to quit one's job or leave one's profession increase significantly and steadily with a growing number (1, 2 +) of different experienced forms of violence and/or discrimination at work compared to the reference group of those who are nonaffected (aOR from 2.5 up to 5.4). This fairly strong association was only slightly reduced (aOR from 2.1 to 4.0) when work climate was additionally taken into account as a potential intervening variable. Although work climate only partly accounted for the association under study, a poor work climate was an additional strong predictor and independent risk factor for intentions to turnover (aOR = 6.4) or leave the profession (aOR = 4.2).

CONCLUSIONS

Experiences of workplace violence and discrimination and the resulting poor work climate both together and independent of each other seem to be important causes of job changes and career endings among healthcare workers in Switzerland.

Visualization and bibliometric analysis of occupational exposure among nurses in Asia

Background

Occupational exposure is of increasing concern, posing a serious threat to nurses, especially in the event of a public health emergency. Bibliometrics sheds novel light on the current state of research and factors influencing nurses' occupational exposures, illuminating hot topics and trends in the literature. Bibliometrics is essential to analyze the potential harm to nurses in Asia.

Methods

Data were extracted from the Web of Science Core Collection on August 6, 2022 with the following search terms: TS= (nurses) AND (TS= (occupational exposure OR occupational health)). CiteSpace and VOSviewer were used to analyze national and institutional collaborations, reference clustering, citations and co-citations of journals and keyword bursts, and HistCite was used to analyze the citation historiography map. To analyze the data and generate statistical charts, Origin and Microsoft Excel were utilized.

Results

A total of 1448 studies on nurses' occupational exposure in Asia were identified. China Medical University had the most publications among Asian institutions, and China had the largest share among Asian countries. Most articles on nurses' occupational exposure in Asia were in the Journal of Occupational Health, and the journal with the highest impact factor was the Journal of Nursing Management. The COVID-19 outbreak caused a substantial shift in the direction of studies on nurses' occupational exposure in Asia. Mental health is a current hot topic, while sharps injuries and bodily fluid exposure are long-term priorities for attention.

Conclusions

The hotspots of research on nurses' occupational exposure in Asia focus on mental health, burnout, blood exposure, infection, and sharps injury. Due to the COVID-19 pandemic, recent research has concentrated on personalized mental health care and the development of protective equipment, and cross-disciplinary collaboration may be a new trend in the future.

Competence in managing workplace violence among nursing interns: Application of latent class analysis

AIM

To identify subtypes of competence in managing workplace violence (WPV) among nursing interns and to assess between-group differences.

BACKGROUND

Nursing interns are reported to be a vulnerable population for experiencing workplace violence during their clinical placement. Although WPV could have a negative impact on nursing interns' health and attitudes towards the nursing profession, little is known about nursing interns' competence in workplace violence management or its influencing factors.

DESIGN

A cross-sectional study.

METHODS

Between March to April 2023, nursing interns at three tertiary general hospitals in Anhui Province, China, completed questionnaires including a general information questionnaire, the Management of Workplace Violence Competence Scale (MWVCS), the Utrecht Work Engagement Scale (UWES-9), the Emotional Labour Scale for Nurses (ELSN) and were classified into subtypes by latent class analysis. Subsequently, univariate analysis and multivariate logistic regression were performed to identify the influencing factors by subtypes.

RESULTS

A total of 264 questionnaires were valid and the overall mean age of the participants was 21.06 ±1.41 years. Four classes were identified: low competency group (15.5%), low cognition-low coping competency group (18.2%), low cognition-medium to high competency group (21.6%) and high competency group (44.7%). The results of multinomial logistic regression analysis showed that placement hospitals with a WPV management department, emotional control effort in profession dimension and emotional pretense by norms dimension in the Emotional Labour Scale for Nurses, pursuing further education and vigour dimension in the Utrecht Work Engagement Scale were influencing factors of the potential categories of WPV management competence.

CONCLUSIONS

Four classes were identified and there was competence variability among nursing interns. More attention should be given to nursing interns who did not receive WPV-related training in their school or placement hospital.

Workplace Violence Against Nurses in Canada: A Legal Analysis

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.

Application of the theory of planned behaviour for predicting the determinants of workplace violence reporting behaviour among public hospital healthcare workers in Malaysia: A cross-sectional study

Introduction

Reporting workplace violence (WPV) is a crucial preventive measure. Given the great impact of WPV on mental health and well-being, this study aimed to determine the prevalence and determinants of WPV reporting among healthcare workers (HCWs).

Method

A total of 557 public hospital HCWs in Melaka were recruited via probability sampling. A questionnaire guided by the theory of planned behaviour was developed, pre-tested and distributed. Malaysians with a minimum employment period of 12 months who experienced WPV within the same period in the selected public hospitals were eligible for inclusion. Multiple logistic regression analysis was conducted to determine the association between the independent variables and WPV reporting.

Results

Psychological violence was the most common WPV (80.3%), with only 177 (31.8%) respondents reporting such. The respondents who had high subjective norm (adjusted odds ratio [AOR]=2.160, 95% confidence interval [CI]=1.32-3.53) and perceived behavioural control scores (AOR=3.976, 95% CI=2.41-6.55); were clinical (AOR=2.679, 95% CI=1.43-5.02) and non-clinical (AOR=4.271, 95% CI=2.23-8.18) support staff; experienced physical WPV (AOR=13.157, 95% CI=3.83-45.24) and both physical and psychological WPV (AOR=2.029, 95% CI= 1.13-3.65); and perceived that WPV was intentional (AOR=11.111, 95% CI=6.50-19.00) were more likely to report WPV.

Conclusion

HCWs who experience physical WPV have the highest likelihood to report, followed by those who perceive WPV as intentional. The prevalence of reported WPV among public hospital HCWs is low, potentially underestimating its true occurrence owing to underreporting. Ensuring readily available reporting mechanisms for WPV, especially the psychological type, is crucial for HCWs.

Sexual workplace violence in the health sector in Saudi Arabia: a cross sectional study

BACKGROUND

Sexual workplace violence occurs worldwide with increasing prevalence, causing psychological and physical injuries. However, only few reports from the Kingdom of Saudi Arabia have investigated the most involved health specialty and its association with other factors, such as working and sociodemographic conditions. The aim of this study was to determine the prevalence of workplace sexual violence over 12 months, from May 2018 to May 2019, circumstances related to the event, and consequences for the perpetrator and survivor and to identify associated factors among all healthcare workers (HCWs) in Saudi Arabia.

METHODS

This cross-sectional study included all HCWs registered with the Saudi Commission for Health Specialties who worked for > 1 year in the health sector (government or private) in Saudi Arabia until May 2019. A non-probability convenient sampling technique was used. A modified self-administered questionnaire sent via email was utilized to assess workplace violence. Descriptive statistics were used to report percentages and frequencies, while advanced statistics, such as bivariate analysis, were used to determine associations. Multivariate logistic binary regression analysis was used to assess the combined and individual associations between relevant predictors of exposure of HCWs to recent sexual violence at the workplace.

RESULTS

In total, 7,398 (male, 51.3%; female, 48.7%) HCWs were electively enrolled in the study (mean age 40 ± 8.62 years). Most were non-Saudi (60%). Overall, 3.9% were sexual violence survivors. Approximately 60.7%, 51.4%, 48.3%, and 65.9% of female workers, nurses, Saudi natives, and night shift workers (18:00 to 07:00), respectively, were significantly exposed to sexual violence. Furthermore, approximately 54.8% of those with direct physical contact with patients had a higher rate of exposure to sexual harassment (p = 0.001).

CONCLUSIONS

The prevalence of sexual violence is low but remains a risk to HCWs, especially those working night shifts and having direct physical contact with patients. Thus, more support, specific strategies, and policies are needed to reduce the rate of occurrence, protect HCWs, and prevent such events. The underreporting of cases may be skewing the magnitude of the problem; thus, more education and additional research in Saudi Arabia are needed regarding sexual violence experienced by HCWs.

Post-traumatic responses to workplace violence among nursing professionals: a collaborative and comparative study in South Korea and Hong Kong

BACKGROUND

Workplace violence has had a significant and negative psychological impact on nursing professionals worldwide. Concerted worldwide efforts to improve work environments have not yet removed nursing professionals from the threat of violence. It is highly essential to conduct comparative research in various working environments where the nurses of each country have unique experiences of workplace violence. The aim of this study was to examine the differences in the rate, associated factors, and post-traumatic responses to workplace violence between South Korean and Chinese nurses in Hong Kong among East Asian countries.

METHODS

A cross-sectional, correlational study design recruited a total of 471 registered nurses (319 South Korean nurses and 152 Chinese nurses in Hong Kong; overall response rate = 78.5%) at online communities in South Korea and Hong Kong. The data were collected by conducting a Qualtrics survey from January 15, 2020, to July 24, 2021. A structured questionnaire was administered for data collection, including rate of workplace violence, perception of workplace violence, attitudes toward workplace violence, coping styles, post-traumatic cognitions, post-traumatic stress disorder, post-traumatic growth, and mental health indicators (depression, anxiety, and stress). T-test, chi-squared, and binary logistic regression analyses were conducted.

RESULTS

In our sample, 30.7% South Korean nurses and 31.6% Chinese nurses in Hong Kong had experienced workplace violence. South Korean and Chinese nurses in Hong Kong with experience of workplace violence had lower perceptions of it. Nurses with experience of workplace violence reported lower levels of mental health, and this trend was more prominent among South Korean nurses.

CONCLUSIONS

Our study findings showed a positive association between workplace violence and post-traumatic responses in both settings. We found that the close monitoring of post-traumatic responses associated with workplace violence could be improved by enhancing nurses' perception of workplace violence.

Female patient violence experienced by female qualified nurses working in an inpatient psychiatric department

Whilst there is an increasing prevalence of healthcare staff facing aggression, psychiatric nurses are thought to be most at risk; with such events being a hazard to their physical, emotional and psychological health. This study explored how patient violence is experienced by qualified nurses employed in an in-patient psychiatric facility in the Kingdom of Saudi Arabia (KSA). As male and female patients and nurses are segregated in Saudi healthcare settings, this study focused on female patient violence against female psychiatric nurses. Both the immediate and more long-term impacts were explored, together with approaches that could potentially facilitate avoiding, reducing and managing aggression within the work setting. The study adopted a qualitative descriptive design and used purposive sampling to recruit nine psychiatric nurses working in an in-patient setting, from a single KSA medical facility. Inclusion criteria required participants to be licensed, registered nurses, who, during the last 10 years, had worked in an acute in-patient psychiatric ward for adult females, and to have experienced some form of patient aggression. Semi-structured, one-to-one interviews were used to gather data, which was then subjected to thematic analysis. Two dominant themes were identified: (i) occurrence of violence and (ii) determination of violence. It was concluded that female psychiatric nurses were adversely affected by aggression towards them from female patients. Although the nurses considered this behaviour to be part of their nursing role, they reported minimal support from institutional managers, peers and their relatives.

Exploring the experience of undergraduate nursing students following placement at psychiatric units in China: A phenomenological study

AIM

To explore undergraduate nursing students' experiences of psychiatric placements.

BACKGROUND

Placement is an important learning phase for undergraduate nursing students and the placement experiences may affect their career choices. However, nursing students' experiences of psychiatric placements have not been fully explored in China.

DESIGN

This study adopted a descriptive, phenomenological design.

METHODS

After psychiatric placement, a semi-structured interview was conducted in June 2022 among 22 final-year undergraduate nursing students using purposive sampling. The data were analysed using Colaizzi's seven-step analysis method.

RESULTS

Five themes were identified: i) destigmatising mental illness; ⅱ) beneficial communication; ⅲ) gaining confidence; iv) disappointment and sadness; and v) fear and discomfort.

CONCLUSION

Nursing students experienced various positive experiences and negative emotions during their psychiatric placement. Further research should explore and validate appropriate educational strategies to optimise students' placement experiences to increase their career interest in psychiatric nursing.

Association of workplace bullying and burnout with nurses' suicidal ideation in Bangladesh

Suicidal ideation is a complex phenomenon influenced by several predisposing, contextual, and mediating factors that seem more common among healthcare workers, especially nurses. We investigated the association of bullying and burnout with suicidal ideation among Bangladeshi nurses and identified the associated factors. We conducted a cross-sectional study among 1264 nurses in Bangladesh between February 2021 and July 2021. We applied a modified Poisson regression model with robust error variance to determine the association of bullying and burnout with suicidal ideation. Among 1264 nurses, the female was 882 (70.02%), and the mean age was 28.41 (SD = 5.54) years. The prevalence of high levels of suicidal ideation was 13.26%. In the Poison regression model, high risk bullying (RR = 6.22, 95% CI 3.13-12.38), targeted to bullying (RR = 7.61, 95% CI 3.53-16.38), and burnout (RR = 8.95, 95% CI 2.84-28.20) were found to be significantly associated with suicidal ideation. Furthermore, we found significant interaction between workplace bullying and burnout with suicidal ideation (p < 0.05). The high prevalence of bullying, burnout, suicidal ideation, and their association indicate an unsafe workplace for the nurses. Initiatives are needed to make a favorable work environment to improve nurses' overall mental health and reduce suicide ideation.

Workplace bullying and violence in health sector in Saudi Arabia

Workplace bullying violence (BV), with psychological and physical impacts, is increasing globally. However, studies from Saudi Arabia investigating which specialties are most exposed, and linking them with other factors, such as sociodemographic conditions, are scarce. This study aimed to estimate the prevalence of workplace BV over a 12-month period and determine the circumstances related to the event, consequences for the attacker, and targeted personnel among all healthcare providers in the Kingdom of Saudi Arabia (KSA). This analytical cross-sectional study included all health providers registered with the Saudi Commission for Health Specialties who worked for more than 1 year in the healthcare sector (governmental or private) in the KSA until May 2019. In total, 7398 healthcare workers were electively enrolled in the study; 51.3% were men, and 48.7% were women, with a mean age of 40 ± 8.62 years. They were mostly (60%) non-Saudi. Overall, 26.6% encountered BV. Those who worked in the private sector, in shifts, especially evening shifts, were significantly more exposed. Furthermore, pharmacists had the highest prevalence of workplace violence. The prevalence of BV is moderately high; however, it is a serious issue faced by healthcare workers, especially those working night shifts. Pharmacists were more likely to experience bullying. This demonstrates that more support, specific strategies, and policies are required to reduce the occurrence of workplace BV, protect healthcare providers, and prevent attacks. Underreporting these situations may give an incorrect indication of the magnitude of the problem; thus, more education and further studies in the KSA are needed.