Psychological depletion in physicians and nurses exposed to workplace violence: A cross-sectional study using propensity score analysis

Workplace Violence in Health Care: Current State of Affairs and Methods of Prevention

Workplace violence (WPV) is a pervasive issue in health care that has shown rising incidence in recent years. There are several risk factors related to the worker, occupational environment, and patient that predispose to WPV events and should be considered in risk mitigation strategies. WPV has been associated with negative effects on worker health and professional efficacy. Past work has shown that multifactorial intervention models are more effective at improving WPV prevention and response in health care. This review summarizes the statistical trends, risk factors, and negative effects of WPV in health care, as well as interventions to improve prevention and response.

Social Interaction as a vital factor in alleviating depressive symptoms among middle-aged and elderly adults: evidence from the CHARLS

OBJECTIVE

To explore the effect of social interaction on depressive symptoms in middle-aged and elderly adults in China.

METHODS

Data from the 2020 China Health and Retirement Longitudinal Study (CHARLS) were analyzed. Participants were divided into social interaction and non-social interaction groups. Depressive symptoms were assessed using the Center for Epidemiologic Studies Depression Scale (CESD-10). Propensity score matching (PSM) was employed to balance confounding factors, and the average treatment effect (ATT) of social interaction on depressive symptoms was estimated. Binary logistic regression analyzed influencing factors.

RESULTS

A total of 14,741 subjects (76.26%) were included; 9,869 (66.91%) participated in social interaction, and 5,593 (37.94%) had depressive symptoms. After PSM, social interaction significantly negatively affected depressive symptoms (ATT=-0.04, P < 0.05). Binary logistic regression revealed that those with social interaction had a lower risk of depressive symptoms (OR = 0.87, P < 0.05), particularly males (OR = 0.53, P < 0.05). However, older age (60-69: OR = 1.20; 70-79: OR = 1.24), poorer self-rated health (general: OR = 2.20; poor: OR = 4.48; very poor: OR = 7.70), lower satisfaction (general: OR = 1.67; dissatisfaction: OR = 8.10), and infrequent meetings with children (every six months: OR = 1.20; less than half a year: OR = 1.27) were associated with a higher risk of depressive symptoms (P < 0.05).

CONCLUSION

Middle-aged and elderly Chinese adults have a high risk of depressive symptoms, and social interaction significantly reduces this risk. Promoting social interaction and mental health initiatives can improve the health of middle-aged and elderly individuals.

Violence Against Nurses During Care: A Systematic Review

AIMS

To analyse and synthesise knowledge on workplace violence perpetrated by patients and caregivers against nurses, its consequences and strategies to prevent this phenomenon.

DESIGN

A systematic review of the literature was conducted following the method of the Center for Reviews and Determination and reported in accordance with the PRISMA checklist. A pre-defined protocol was designed (PROSPERO ID: CRD42023432271).

METHODS

Three researchers screened eligible studies independently. The Joanna Briggs Institute Critical Appraisal for Analytical Cross-Sectional Studies was used to assess the risk of bias within the studies included.

DATA SOURCES

Quantitative primary studies published between January 2012 and June 2023 were included through specific research strings used in the CINHAL, Scopus, PubMed and PsychInfo databases.

RESULTS

A total of 15 studies were selected, the majority of which were cross-sectional and observational. The consequences related to events of verbal and physical violence were highlighted, ranging from the psychological to the physical effects on nurses' mental health, for example, gastrointestinal symptoms, headache and sleep problems. Four studies analysed the strategies used to cope with such violence.

CONCLUSION

The results showed that aggression on the part of patients affects nurses' health adversely on both a personal and a work level, and makes it necessary to pay more attention to the phenomenon and to find strategies to reduce the incidents, such as developing policies to safeguard the professionals' physical and mental health.

IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE

Nurses and nursing managers should be aware of violence and its consequences on the victims' health. Therefore, it is essential for nursing managers to develop effective policies to reduce violence and its consequences.

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.

Workplace violence, psychopathological symptoms, and deviant workplace behavior among nursing interns in China: a network analysis

BACKGROUND

Workplace violence in healthcare has become a global concern, and nursing interns are not immune to it in clinical settings. It is critical to understand the impact of workplace violence on the psychological and work status of nursing interns.

METHODS

Between April and May 2024, a total of 2213 nursing interns from 12 hospitals in China participated in the study. Data were collected with questionnaires on basic information, the Workplace Violence Scale, the Caregiver Occupational Deviant Behavior Scale, and the DSM-5 Level 1 Cross-Cutting Symptom Measure. The basic analysis was performed using SPSS 24.0 software, and the network structure analysis was constructed using R software to calculate the relationship between the nodes and the centrality index.

RESULTS

In nursing interns, the items with the highest prevalence of workplace violence were verbal assault (32.038%) and threats (10.303%); in psychopathological symptoms, the items with the highest prevalence were anxiety (38.500%), anger (35.337%), and depression (33.439%). The strongest edge within the cluster is "Verbal sexual harassment-Physical sexual harassment," and the strongest edge between clusters is "Verbal assault-Depression." The node with the highest strength, expected influence, and betweenness indices is "Anxiety," and the node with the highest closeness index is "Depression."

CONCLUSIONS

The results demonstrate the effectiveness of the network perspective in elucidating the complex relationships and interconnections between different symptoms. We identified the strongest relationships between nodes, "Depression" and "Anxiety" as the most important symptom. These findings may provide more precise targets for developing interventions for nursing interns.

Impact of the five-pattern personality traits of traditional Chinese medicine on workplace violence and depression among nurses

BACKGROUND

Depression seriously damage the health of nurses. It is not conducive to the provision of medical services and hospital management. Meanwhile, nurses are a highly vulnerable group to workplace violence (WPV), increasing the risk of depression. Nurses with different personalities may have various views and feelings towards WPV, and their impact on depression may also vary. This study aims to reveal the impact of the five-pattern personality traits of traditional Chinese medicine (TCM) on WPV and depression among nurses, providing a new perspective for managers to implement psychological interventions.

METHODS

A cross-sectional study was conducted. 2,788 valid questionnaires nationwide were collected based on Wenjuanxing from June to July 2024. We used Patient Health Questionnaire Depression Scale-9 item, The five- pattern Personality Traits of TCM Scale, and Workplace Violence Scale. We used latent class analysis, structural equation modeling, and simple slope analysis to analyze depression classes, mediating effects, and moderation effects, respectively.

RESULTS

Depression is classified into three types: "Good mental health group" (34.2%), "Moderate depression group" (23.0%), and "Severe depression group" (42.8%). "Taiyang", "Shaoyang", and "Balance of Yin-Yang" personalities alleviate nurses' feelings of WPV, thereby reducing the impact of WPV on depression. The values of mediating effect are -0.402, -0.393, and -0.426, respectively (P < 0.05). "Taiyin" personality exacerbate nurses' perception of WPV, thereby increasing the impact of WPV on depression. The value of mediating effect is 0.418 (P < 0.05). "Taiyang" and "Shaoyang" personalities reduce the impact of WPV on depression of nurses, and the effect become more significant as the scores increase. The values of moderating effect are 0.033 and -0.0563 respectively (P < 0.05). "Taiyin" and "Shaoyin" personalities increase the impact of WPV on depression, and the effect become more significant as the scores increase. The values of moderating effect are -0.0444 and -0.0220 respectively (P < 0.05).

CONCLUSIONS

The prevalence of depression and WPV among Chinese nurses is serious. Excellent personality effectively improve the relationship between WPV and depression. Nursing managers should arrange suitable positions for nurses based on their different personality traits. At the same time, it is necessary to actively cultivate excellent personality traits in nurses to reduce the frequency of WPV and improve their mental health.

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.

Factors Associated with Management of Workplace Violence Competence Among Chinese Nursing Interns

Purpose

The cases of workplace violence (WPV) experienced by nurses and nursing students in recent years has become alarming high. However, managing and developing WPV competence among nursing students remain underreported. Therefore, this study investigated the current status of management of workplace violence competence (MWVC) and identify associated factors affecting their MWVC among nursing interns.

Participants and Methods

A total of 817 nursing interns from six tertiary hospitals in Hunan Province, China, participated in this study in July 2023. Data were collected via online survey questionnaires using the Management of Workplace Violence Competence Scale (MWVCS), the Patient Risk Identification Ability Assessment Questionnaire, and the Professional Identity Questionnaire for Nursing Students (PIQNS).

Results

Among participants, 91.1% were female (n=744), 68.1% (n=556) were between 21 to 23 years old, and 54.1% (n=442) obtained a bachelor's degree. The score of management of workplace violence competence was 123.25 (SD=11.06). The multiple linear regression analysis showed that the diploma degree (B=3.152, p<0.001, 95% CI: 2.087-4.217), witnessed a workplace violence incident in a hospital (B=4.274, p<0.001, 95% CI: 3.164-5.384), trained in WPV prevention skills (B=7.196, p<0.001, 95% CI: 6.007-8.386), patient risk identification ability (B=1.006, p<0.001, 95% CI: 1.163-0.893), and professional identity (B=0.693, p<0.001, 95% CI: 0.571-0.815) were the associated factors of MWVC among nursing interns.

Conclusion

The MWVC among nursing interns was at an intermediate level. To enhance MWVC, it is recommended to strengthen WPV prevention and management training, particularly for interns with diploma degrees, no experience witnessing WPV incidents, no prior training in WPV prevention skill, and lower levels of patient risk identification ability and professional identity. Our findings may guide the establishment of focused training programs and support measures to improve interns' capacity to manage WPV, increasing their professional growth and mental health while giving significant insights and intervention techniques for nursing educators and managers.

Effect of theme game-based learning on psychiatric violence risk assessment and response knowledge, skills, and self-confidence of nursing students: A randomized controlled trial

BACKGROUND

Theme game-based learning has the potential to enrich student learning experiences, leading to improved learning outcomes. Yet, there remains a research gap regarding its application in addressing psychiatric violence, leaving uncertainties about the comparative advantages of theme game-based learning over situational simulation learning strategies.

OBJECTIVES

The goal was to measure the effect of integrating theme game-based learning into psychiatric violence risk assessment and response training on nursing student psychiatric violence-related knowledge, skills, and self-confidence.

DESIGN

This study was a randomized controlled, pre-test, and post-test trial.

SETTING

The study was conducted at a medical university in Guangzhou, Guangdong, China.

PARTICIPANTS

There were 103 third-year nursing undergraduates (intervention group = 51, control group = 52) in the study.

METHODS

An Objective Structured Clinical Exam and the Workplace Violence Management Ability Assessment Questionnaire for Intern Nursing Students were used to assess student skills. The knowledge test and the Confidence in Coping with Patient Aggression Instrument were used to measure student knowledge and self-confidence level before and after intervention.

RESULTS

Nursing students in the theme game-based group demonstrated significantly superior skills and confidence in violence risk assessment and response compared with students in the situational simulation group (p < 0.001, p = 0.039, p = 0.006, respectively). However, there was no significant difference in knowledge of violence risk assessment and response between the two groups (p = 0.510).

CONCLUSION

Theme game-based learning in psychiatric violence risk assessment and response training appeared effective in enhancing the violence management abilities of nursing students.

Work-related violence, occupational stress and psychological distress among medical staff in China: A structural equation modeling analysis

BACKGROUND

Psychological issues and work-related violence are the main challenges faced by medical staff. The situation has become even more prevalent during the COVID-19 pandemic.

OBJECTIVE

This research aimed to analyze the relationships among work-related violence, occupational stress and psychological distress and to further identify the direct or indirect effects of violence on psychological distress.

METHODS

A total of 1,765 medical staff members were surveyed using the Kessler Psychological Distress Scale and Revised Occupational Stress Inventory. Work-related violence was assessed using a self-made 5-question questionnaire. STATA 14.0 and Amos 21.0 software were used for correlation analysis, variance analysis, and structural equation modeling analysis.

RESULTS

A total of 66.1% of the medical staff suffered workplace violence, and 61.2% witnessed workplace violence. The psychological distress score (Kessler 10 Scale) of the medical staff was 22.7±7.67. The psychological strain score and physical strain score were 26.8±7.14 and 24.2±6.51, respectively. Work-related violence (suffered: β= 0.467; witnessed: β= 0.258) and occupational stress (psychological strain: β= 0.269; physical strain: β= 0.317) were predictors of psychological distress, and social support (β= -0.265) was a protective factor. Work-related violence and social support had both direct and indirect effects on psychological distress, and the intermediate factor was occupational stress. The total effects of suffered workplace violence and witnessed workplace violence were 0.181 and 0.092, respectively, and the total effect of social support was -0.262.

CONCLUSIONS

Work-related violence may exacerbate symptoms of occupational stress and psychological distress. Reducing workplace violence and protecting medical staff from work-related violence are extremely important aspects of mental health prevention.

Anxiety and depression in healthcare workers are associated with work stress and poor work ability

Background

Symptoms of anxiety and depression are very common among healthcare workers (HCWs) and could impact the quality of care.

Objective

This study aimed to evaluate the prevalence of these disorders in a public health company and their association with work ability and work-related stress.

Methods

A cross-sectional study involved 80 HCWs being treated for mental disorders (MD), 55 HCWs who said they suffered from MD but were not being treated, and 824 healthy colleagues. All workers completed the Work Ability Index (WAI), the Siegrist's Effort/Reward Imbalance questionnaire (ERI), the Goldberg's scales of anxiety and depression (GADS), and the Warr's scale of job satisfaction.

Results

Three-quarters of workers with MD suffered from anxiety and/or depression. Workers who declared at the periodic medical examination in the workplace that they were being treated for MD had significantly lower levels of work ability than those of their colleagues who declared good mental health. They also reported greater work stress (high effort, low rewards, high overcommitment) and lower job satisfaction than their healthy colleagues. Symptomatic but untreated workers reported significantly lower work ability, lower satisfaction, and greater occupational stress than their healthy colleagues. In the entire sample, there were many workers with symptoms of anxiety or depression who did not declare these disorders during the examination. Overall, there were 328 suspected cases of anxiety (34.2%) and 334 cases of depression (34.8%). Anxious workers [OR = 8.11, 95% confidence interval (CI) = 3.74-17.58] and depressed workers (OR = 4.49, 95% CI = 2.22-9.10) had an increased risk of being classified as having "poor work ability".

Conclusion

The negative association between psychological symptoms and work ability even in undiagnosed/untreated workers demonstrates the usefulness of screening for these symptoms in work environments.

The impact of psychological violence in the workplace on turnover intention of clinical nurses: the mediating role of job satisfaction

BACKGROUND

The global nursing shortage, driven by high turnover rates, significantly impacts healthcare quality. Workplace psychological violence severely affects nurses' mental health and job satisfaction, leading to increased turnover. Despite extensive research on workplace violence, the specific impact of psychological violence on nurses' turnover intentions remains insufficiently explored. This study investigates the mediating role of job satisfaction in the relationship between workplace psychological violence and nurses' turnover intentions.

METHODS

A workplace psychological violence scale, a job satisfaction scale, and a turnover intention questionnaire were utilized to survey 206 clinical nurses in a tertiary-level hospital in Guangzhou City. The study employed a convenience sampling method. Statistical analyses included correlation, mediation analyses., descriptive statistics, multivariate linear hierarchical regression analyses, Pearson correlation analyses, and structural equation models.

RESULTS

Clinical nurses reported a workplace psychological violence score of 0.97 ± 0.79, job satisfaction of 3.16 ± 0.58, and turnover intention of 2.22 ± 0.92. Workplace psychological violence was negatively correlated with job satisfaction (r = -0.516, P < 0.01) and positively correlated with turnover intention (r = 0.418, P < 0.01). Turnover intention was negatively correlated with job satisfaction (r = -0.477, P < 0.01). Mediation analysis indicated that Job satisfaction partially mediated the association between workplace psychological violence and turnover intention. The total effect (β = 0.489) of workplace psychological violence on turnover intention included its direct effect (β = 0.274) and the indirect effect mediated through job satisfaction (β = 0.215), with the mediating effect accounting for 43.97% of the total effect.

CONCLUSIONS

Workplace psychological violence directly predicts nurses' turnover intention, with job satisfaction serving as a mediator in this relationship. Healthcare managers can mitigate psychological violence by improving mental health support, work environments, and organizational culture to enhance job satisfaction and reduce nurse turnover.

Anhedonia severity mediates the relationship between attentional networks recruitment and emotional blunting during music listening

Emotion studies have commonly reported impaired emotional processing in individuals with heightened anhedonic depressive symptoms, as typically measured by collecting single subjective ratings for a given emotional cue. However, the interindividual variation in moment-to-moment emotional reactivity, and associated time-varying brain networks recruitment as emotions are unfolding, remains unclear. In this study, we filled this gap by using the unique temporal characteristics of music to investigate behavioural and brain network dynamics as a function of anhedonic depressive symptoms severity. Thirty-one neurotypical participants aged 18-30 years completed anhedonic depression questionnaires and then continuously rated happy, neutral and sad pieces of music whilst undergoing MRI scanning. Using a unique combination of dynamic approaches to behavioural (i.e., emotion dynamics) and fMRI (i.e., leading eigenvector dynamics analysis; LEiDA) data analysis, we found that participants higher in anhedonic depressive symptoms exhibited increased recruitment of attentional networks and blunted emotional response to both happy and sad musical excerpts. Anhedonic depression mediated the relationship between attentional networks recruitment and emotional blunting, and the elevated recruitment of attentional networks during emotional pieces of music carried over into subsequent neutral music. Future studies are needed to investigate whether these findings could be generalised to a clinical population (i.e., major depressive disorder).

'On the slope of an erupting volcano': A qualitative study on the workplace violence experiences of psychiatric nurses

WHAT IS KNOWN ON THE SUBJECT?: Workplace violence is common in healthcare. Workplace violence remains a complex and serious occupational hazard in healthcare. WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE?: Since there is no study examining detailed explanations of experiences and perspectives of workplace violence among psychiatric nurses, this study will act as a guide for psychiatric nurses. This study provides information about how psychiatric nurses evaluate the concept of workplace violence from their perspective, what it means to them and the effects of workplace violence. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Considering the effects of workplace violence, a preventive, systematic and holistic approach should be used in psychiatry and community mental health centres. Supportive interventions should be used to improve the health and safety of psychiatric nurses and patients.

ABSTRACT

INTRODUCTION: Workplace violence is common in healthcare and remains a complex and serious occupational hazard.

AIM

This research was conducted to assess the workplace violence experiences and perspectives of psychiatric nurses.

METHOD

This study was a qualitative study conducted using a grounded theory approach method. The study was conducted between November 2022 and January 2023. The purposeful sampling method was used, and 11 psychiatric nurses were interviewed. Data were collected with an information form and a semi-structured interview form. The data were analysed using content analysis, and themes were created.

FINDINGS

The ages of the psychiatric nurses ranged from 38 to 57 years. Themes and sub-themes related to the workplace violence experiences and perspectives of psychiatric nurses included the way of violence (rising tension, eruption of the volcano, unintentional violence and turning to ash) and empowerment (ash cloud and ring of fire).

CONCLUSION

Psychiatric nurses stated that they were exposed to verbal and physical violence for many reasons, that this situation seriously affected their physical, mental and social health and that in addition to the devastating effects of violence, they became stronger by developing various skills to protect against violence.

IMPLICATIONS FOR PRACTICE

Supportive interventions should be used to improve the health and safety of psychiatric nurses and patients. Strategies can be developed to include psychiatric nurses in occupational health nursing courses.

Exploring the Impact of Workplace Violence on the Mental Health of Chinese Correctional Officers: A JD-R Model Approach

Background

Correctional officers face widespread workplace violence and the resulting overwork that can profoundly damage their physical and mental health.

Purpose

This study aims to investigate the mediating role of overwork in the relationship between workplace violence and the manifestation of physical and mental health issues among correctional officers.

Methods

This study enlisted 472 eligible participants. Cross-sectional data were obtained using the Chinese version of the Workplace Violence Scale (WVS), while the physical and mental health of correctional officers was evaluated through relevant scales. Analysis involved descriptive statistics, correlation analyses, and tests for mediation models.

Results

The study found significant correlations between workplace violence, overwork, and various mental health variables (depression, anxiety, stress, suicidal ideation, and insomnia), with correlations ranging from 0.135 to 0.822 (p < 0.01). Mediation analysis revealed that workplace violence directly impacts correctional officers' physical and mental health (p < 0.001) and also has an indirect effect through overwork (p < 0.023). These findings underscore the substantial impact of workplace violence on the health of correctional officers, both directly and indirectly.

Conclusion

Workplace violence and overwork significantly contribute to the physical and mental health challenges faced by correctional officers. Overwork acts as a mediator in the relationship between workplace violence and these health issues. The study suggests addressing workplace violence and mental health issues among correctional officers by increasing their numbers, improving the work environment, and implementing enhanced welfare policies.

Prevalence and Determinants of Workplace Violence Against Pediatric Emergency Healthcare Workers and Its Effect on Their Psychological Resilience

The study aimed to determine the prevalence and risk factors of workplace violence (WPV) against pediatric emergency healthcare workers and evaluate the relationship between WPV and psychological resilience. This study is cross-sectional and correlational. According to the results, the prevalence of WPV was 69.8%, and its distribution was as follows: verbal abuse (56.9%), bullying/mobbing (37.6%), physical abuse (12.8%), and sexual abuse (2.2%). Being single/separated/divorced/widowed (odds ratio [OR]: 1.85, 95% confidence interval [CI]: 1.03-3.30), being a physician (OR: 4.74, 95% CI: 1.73-12.96), being a staff member (OR: 2.57, 95% CI: 1.10-5.99), routine direct physical contact with patients/clients (OR: 2.77, 95% CI: 1.40-5.48), and lack of encouragement to report WPV (OR: 3.76, 95% CI: 2.01-7.01) were independent predictors of WPV (P < .05), and WPV was found to be associated with low psychological resilience. Arrangements related to violence prevention, preparation, and intervention should be made and maintained in all pediatric emergency departments.

The Interplay Between Problematic Internet Use, Anxiety, Depression and Functional Impairment in Front-Line Healthcare Workers During the COVID-19 Pandemic

OBJECTIVE

We aimed to assess the interplay between functional impairment and anxiety, depression, and problematic Internet use levels in front-line healthcare workers who work in inpatient clinics of coronavirus disease-2019 (COVID-19) during the COVID-19 pandemic.

METHODS

Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), Internet Addiction Test (IAT), and Sheehan Disability Scale (SDS) were administered to assess the depression, anxiety, problematic Internet use, and functional impairment levels of the participants.

RESULTS

Two hundred thirteen participants were enrolled in the present study. Medical doctors showed significantly higher scores of IAT than the nurses and other medical staff (Kruskal-Wallis=6.519, p=0.038). Levels of SDS total are significantly correlated with scores of IAT (r=0.257, p<0.001), BDI (r=0.383, p<0.001), and BAI (r=0.308, p<0.001). All subdomain scores of SDS (social, family, work) and total scores of SDS were significantly and positively correlated with BAI, BDI, and IAT scores (p<0.05). In the separation mediation analysis, problematic Internet use partially mediated the relationship between anxiety-depression and global functional impairment.

CONCLUSION

Health politicians should produce policies to develop strategies for coping with consequences of anxiety and depression in healthcare professionals during any health crisis. In addition, we should raise healthcare professionals' awareness that problematic Internet use is not suitable for dealing with anxiety and depression and may even lead to increase of functional loss.

Exposure of Pharmacists and Pharmacy Technicians to Violence in Community Pharmacies in Southeast Europe: Frequency and Ethical Considerations

Pharmacists and pharmacy technicians working in community pharmacies are exposed to the risk of violence in their workplaces. Studies have shown that workplace violence is affecting their job satisfaction, productivity, and mental health. This study aims to identify the frequency of different types of violence, as well as the common perpetrators that community pharmacy staff in SEE (Southeast Europe) are dealing with. A cross-sectional study was conducted using an online questionnaire created for this purpose. Selected community pharmacies in Croatia, Serbia, Bosnia and Herzegovina, and Montenegro participated in this study. In total, 732 responses were collected from 24 pharmacy chains or independent pharmacies including all community pharmacy staff. More than 80% of pharmacists and pharmacy technicians reported having been exposed to verbal violence at the workplace, while more than 20% of them reported physical and sexual violence in the preceding 12 months. There were no statistically significant differences between pharmacists and pharmacy technicians, gender, age groups, or countries in relation to exposure to physical, verbal, and sexual violence. The most common perpetrators were identified as patients/clients. More than 90% of pharmacy staff reported they did not receive any kind of support from their employer nor any other help after experiencing a robbery. There is a need for a structured approach to addressing violence in pharmacies including organized support for pharmacy staff. Achieving quality patient care, despite dealing with violent individuals or situations daily, is one of the greatest ethical challenges for healthcare providers in community pharmacies to be empowered.

Associations between workplace violence and suicidal ideation among Chinese medical staff: a propensity score matching analysis

Physical and mental health problems had been identified as the negative outcomes of workplace violence (WPV) against medical staff. Considering the proven associations between physical and mental health and suicidal ideation, it is reasonable to assume that WPV may associate with suicidal ideation. However, few studies were conducted to explore the relationship between WPV and their suicidal ideation against medical staff. Based on a cross-sectional design, 3, 426 medical staff working in general hospitals were interviewed in Shandong Province, China. Socio-demographic characteristics, work-related factors, psychological variables, WPV, and suicidal ideation were evaluated. Propensity score matching (PSM) was performed to explore the association between WPV and suicidal ideation. The prevalence of suicidal ideation among medical staff was 9.1% (312/3426), and 52.2% (1788/3426) of medical staff reported the WPV experience. Before PSM, we found that the association between WPV and suicidal ideation was statistically significant (aOR = 1.606, p < 0.01). After PSM, there was a statistically significant correlation between WPV and suicidal ideation (aOR = 1.525, p < 0.01). This study supported the correlations between WPV against medical staff and their suicidal ideation. The results of PSM further implied that WPV might cause suicidal ideation among medical staff. Psychological health, especially for suicidal ideation, should be paid attention for medical staff with WPV experiences.

Exploring nurses' emotional reactions to and reporting of patient-on-nurse workplace violence: A mixed-methods study

BACKGROUND

Workplace violence, including violent, intimidating, and disruptive acts, commonly occurs in healthcare settings. Type 2 workplace violence in nursing refers to patient/visitor behaviors directed toward clinicians, contributing to physical and psychological harm. Nurse victims often do not report these events to employers or law enforcement, making it challenging to address workplace violence.

OBJECTIVES

Our research examined nurse reactions to Type 2 workplace violence by identifying what behaviors they perceived as aggressive and reportable. Specific aims included: 1) developing and testing video vignettes to portray realistic patient aggression scenarios; 2) identifying nurse understandings of aggressive events that prompt affective reactions, and; 3) examining clinical characteristics related to the nurse victim's likelihood to report.

DESIGN

Through a sequential mixed-methods design, we qualitatively developed novel video vignettes portraying Type 2 workplace violence to experimentally examine how nurses interpreted them within a quantitative repeated measures survey.

METHODS

Two expert nurse research panels (n = 10) created five vignettes, from which nurses (n = 282) completed a survey with 1382 unique responses. Analyses included descriptive statistics and repeated measures ANOVA/regression models.

RESULTS

Video vignettes realistically portrayed workplace violence events, eliciting negative emotional responses among nurses that increased in magnitude with statistical significance as the level of displayed aggression escalated. Statistically significant factors influencing nurse reporting of workplace violence included; 1) the level of aggression displayed by the patient; 2) the level of harm received by the nurse; 3) whether the nurse felt the patient's actions were intentional, and; 4) the nurse's perceived frequency of exposure to workplace violence.

CONCLUSIONS

Results suggested that nurse victims of Type 2 workplace violence experience depression, anger, fear, and anxiety, which may contribute to long-term mental health consequences. Findings also identified factors related to nurse reporting behaviors, which may help mitigate workplace violence in healthcare settings by informing research and promoting workplace practices that encourage reporting and safety.

REGISTRATION

Not registered.

TWEETABLE ABSTRACT

Nurse reactions to workplace violence: Video vignettes reveal escalating aggression's impact on reporting. #EndNurseAbuse #WorkplaceViolence.

Musculoskeletal pain among medical residents: role of workplace safety climate and sexual harassment

BACKGROUND

Workplace factors are important predictors of occurrence of musculoskeletal pain among different occupational populations. In healthcare, a psychologically unsafe work environment can negatively affect the emotional, physical and psychological well-being of physicians. This study aimed to examine the relationship between workplace violence, sexual harassment and musculoskeletal pain among Egyptian physicians in their years of residency.

METHODS

We distributed an online self-administered questionnaire to 101 residents working in various healthcare sectors in Egypt. It included sections on demographic data, working conditions, widespread pain index (WPI), pain interference short-form, workplace violence and harassment questionnaire, psychosocial safety climate questionnaire (PSC) and sexual harassment climate questionnaire.

RESULTS

All residents had at least one painful site on the WPI (range 1-11). The mean WPI was 3.5 ± 2.4, and 39.6% satisfied the criteria of having widespread pain by having at least 4 pain sites. Widespread pain index showed a weak statistically significant negative correlation with workplace PSC score (rho = - 0.272, p = 0.006), and a statistically significant weak positive correlation with the calculated total abuse index (rho = 0.305, p = 0.002). Workplace violence and abuse, as measured by a calculated abuse index was the only significant predictors of widespread pain among residents.

CONCLUSION

WPV was found to be a predictor of musculoskeletal pain among medical residents. Healthcare organizations need to address WPV by employing preventive strategies to minimize its hazardous effects and ensure a safe working environment for physicians.

Workplace violence inflicted by patients or their family members/visitors and its relationship with suicidal ideation among undergraduate medical students during clinical training in China

BACKGROUND

Workplace violence in healthcare settings is a significant public concern that profoundly impacts healthcare workers. However, there is a dearth of knowledge regarding the prevalence of workplace violence and its correlation with suicidal ideation among undergraduate medical students in China during their clinical training. The objective of this study was to evaluate the prevalence of workplace violence inflicted by patients or their family members/visitors and to assess its association with suicidal ideation among undergraduate medical students.

METHOD

The snowballing sampling technique was used to recruit Chinese medical students. A question designed by the research team was used to ask medical students about their encounters with workplace violence. Students' basic demographic information and mental distresses (learning burnout, depression symptoms, anxiety symptoms, alcohol abuse/dependence, excessive daytime sleepiness and history of mental disorders) were also assessed. As appropriate, the data were analysed using descriptive statistics, chi-square tests, independent-sample t-tests and multiple logistic regression.

RESULTS

Out of the 1402 undergraduate medical students who participated, 493 (35.2%) reported having experienced workplace violence inflicted by patients or their family members/visitors, of which 394 (28.1%) were verbal abuse, 14 (1.0%) were physical aggression, and 85 (6.1%) were suffered from both verbal abuse and physical aggression. Furthermore, students exposed to workplace violence were more likely to report suicidal ideation and had a higher prevalence of learning burnout, depression symptoms, anxiety symptoms, alcohol abuse/dependence and excessive daytime sleepiness. Depression symptoms, history of mental disorders, learning burnout and having a partner were significantly associated with suicidal ideation in this population.

CONCLUSION

The prevalence of workplace violence inflicted by patients or their family members/visitors was high among undergraduate medical students in China. This may be associated with their mental distress and suicidal ideation. Consequently, it is crucial to strengthen workplace safety measures and promptly implement interventions to mitigate the potentially serious consequences.

Workplace violence and burnout among Chinese nurses during the COVID-19 pandemic: does the sense of coherence mediate the relationship?

BACKGROUND

Workplace violence has always been a critical issue worldwide before and after the COVID-19 pandemic, which can lead to burnout and turnover. In addition, the burnout and mental stress of nurses during the COVID-19 period have been widely described. To our knowledge, no studies have examined the mediating effect of the sense of coherence on the relationship between workplace violence and burnout among Chinese nurses over time. Therefore, this study aimed to explore the relationship between workplace violence and burnout among Chinese nurses and how the sense of coherence mediates the association.

METHODS

Using a convenience sampling method, 1190 nurses from 4 tertiary grade-A comprehensive hospitals were investigated between September 2021 and December 2021 in 3 provinces of China. The Workplace Violence Scale, Burnout Inventory, and Sense of Coherence scale were used to collect data. Data analysis was conducted using descriptive statistics, Pearson correlation, and regression analysis to estimate direct and indirect effects using bootstrap analysis.

RESULTS

The mean total scores for workplace violence and burnout were 1.67 ± 1.08 and 47.36 ± 18.39, respectively. Workplace violence was significantly negatively correlated with the sense of coherence (r = -0.25) and positively correlated with burnout (r = 0.27). Additionally, a higher level of workplace violence was associated with higher burnout (β = 1.13, 95% CI: 0.68 ~ 1.56). A higher sense of coherence was also associated with lower burnout (β = -0.98, 95% CI: -1.03 ~ -0.92). Workplace violence showed an effect on burnout through a sense of coherence. The direct, indirect and total effects were 1.13, 1.88 and 3.01, respectively. The mediating effect of the sense of coherence accounted for 62.45% of the relationship between workplace violence and burnout.

CONCLUSION

We found that the sense of coherence mediated most workplace violence on burnout. It is imperative for hospital managers to improve nurses' sense of coherence to reduce the occurrence of burnout during COVID-19. Future intervention studies should be designed to strengthen nurses' sense of coherence.

Lived Experience of Violence Perpetrated by Treated Patients and Their Visitors in Intensive Care Units: A Qualitative Study of Nurses

BACKGROUND

Patient and visitor violence (PVV) is a widespread problem for health professionals. Nurses working in intensive care units (ICUs) face a relatively high risk of experiencing PVV, which significantly impacts both the health of nurses and the institution as a whole. The subjective perceptions of ICU nurses regarding PVV are inadequately explored in the literature.

PURPOSE

The purpose of this study was to explore the perspectives, experiences, and perceptions of PVV in ICU nurses and to better understand the precipitating factors of violence.

METHODS

A phenomenological qualitative design and purposive sampling were used. A semistructured interview guide was used to conduct in-depth interviews with 12 ICU nurses with PVV experiences. Giorgi's method of analysis was used to discover and identify the essential categories of experience.

RESULTS

Five main experience categories were identified: family and patient factors as flashpoints, managing suppressed emotions by weathering the emotional storm, spiritual awakening after violence, and strategies for surviving further violence. The participants' experiences with PVV included a range of caring and mental health difficulties. In ICU settings, patient progress is often unpredictable, resulting in discrepancies between patient/family expectations and reality. Because feelings of frustration and powerlessness can eventually cause exhaustion in ICU nurses, implementing effective emotional management, stress adjustment, psychological counseling, team support, and violence intervention programs are crucial.

CONCLUSIONS/IMPLICATIONS FOR PRACTICE

This study provides new information on the process by which nurses can progress from inner trauma to self-recovery, moving from a negative affectivity disposition to a better understanding of threat appraisals and coping response options. Nurses should increase their awareness of the complexity of the phenomenon and of the interplay among the factors underlying PVV. The results of this study suggest that routine confusion and delirium assessments to rule out patients with ICU delirium in ICUs are important to preventing PVV. This study considers some of the implications of the research findings for nursing managers. Interventions, training programs, and/or management action should be used to ensure psychological and mental support is extended to all witnesses of PVV events and not only to those targeted by violence.

Impact of workplace violence against psychological health among nurse staff from Yunnan-Myanmar Chinese border region: propensity score matching analysis

BACKGROUND

Owing to different social background factor in Yunnan-Myanmar Chinese border region, stressful working environment may lead to extra psychological burden among nurse staff in China. However, the prevalence of workplace violence and its effect on psychological characteristics among nurse staff are still unclear. This study aims to explore the effect of workplace violence against psychological health among nurse staff from Yunnan-Myanmar Chinese border region.

METHODS

A cross-sectional survey was conducted among 18 local governmental hospitals in Dehong districts. Participants were 1,774 nurses. Psychosocial characteristics were screened by sleep quality, the 9-item Patient Health Questionnaire for depressive symptoms, the generalized anxiety disorder-7 for anxiety symptoms, the Connor Davidson Resilience Scale - 10 item for resilience, the multidimensional scale of perceived social support for social support, the Chinese version of Work place Violence Scale for workplace violence. Propensity score matching and multivariate linear regression were applied to analyze the data.

RESULTS

The nurse staff with workplace violence have a higher risk of bad sleep quality (b = -0.883, 95%CI = [-1.171, -0.595]), anxiety symptoms (b = 2.531, 95%CI = [2.031, 3.031]) and depressive symptoms (b = 3.227, 95%CI = [2.635, 3.819]), loneliness (b = 0.683, 95%CI = [0.503, 0.863]), perceived cognitive deficits (b = 1.629, 95%CI = [1.131, 2.127]), poor resilience (b = -2.012, 95%CI = [-2.963, -1.061]), and poor social support (b = -5.659, 95%CI = [-7.307, -4.011]).

CONCLUSIONS

Preventing workplace violence can improve mental health outcomes significantly among nurse staff, including loneliness, perceived cognitive deficits, anxiety symptoms, depressive symptoms, sleep quality, resilience and social support.

Interdisciplinary Simulation Training Reduces Restraint Use in the Emergency Department: A Pilot Study

Introduction Safe and effective management of agitated patients poses multiple challenges for healthcare professionals. Patients placed in restraints because of agitated behavior are at a higher risk of complications, including death. This intervention was designed to provide emergency department staff a framework for de-escalation, improve teamwork, and reduce the use of violent physical restraints. Methods Emergency medicine nurses, patient support associates, and protective services officers underwent a 90-minute educational intervention in 2017. A 30-minute lecture focusing on communication and early use of medication for agitation was followed by a simulation using standardized participants, then a structured debriefing. A standardized return-on-learning tool determined participants' reactions to and application of the educational intervention. Additionally, data was collected and reported as a ratio of number of restraints applied each month compared to total emergency department visits that month. Data were analyzed comparing the six months before the education and the subsequent six months after the education. Results A pilot group of 30 emergency department staff members completed the educational intervention. The intervention contributed to the overall decrease in restraint use in the department. Most participants (86%) felt more confident in their ability to manage agitated patients. Conclusion An interdisciplinary simulation-enhanced educational intervention successfully reduced use of restraints in the emergency department and improved staff attitudes toward de-escalation techniques for agitated patients.

Understanding influencing attributes of COVID-19 vaccine preference and willingness-to-pay among Chinese and American middle-aged and elderly adults: A discrete choice experiment and propensity score matching study

Background and objective

COVID-19 has imposed burdens on public health systems globally. Owing to the urgency of vaccination, this study aimed at comparing the differences in preference and willingness to pay of COVID-19 vaccine among Chinese and American middle-aged and elderly adults.

Methods

A cross-sectional survey containing demographic questions, rating their acceptance of COVID-19 vaccination with and without recommendations from friends, family members or employers (the social cues referred to in our study), and a discrete choice experiment understanding COVID-19 vaccine preference and willingness to pay was conducted to collect data. Propensity score matching was utilized to adjust confounding factors of baseline characteristics and the relative importance of respondents' preference for each attribute and its level was estimated using a conditional logit model. Then, willingness to pay was calculated.

Results

In total, 3,494 (2,311 and 1,183 from China and the United States, respectively) completed the questionnaire, among which 3,444 questionnaires were effective. After propensity score matching, 1,604 respondents with 802 from the US and 802 from China were included. Under the influence of the social cues, Chinese respondents' vaccine acceptance decreased from 71.70 to 70.70%, while American respondents' vaccine acceptance increased from 74.69 to 75.81%. The discrete choice experiment showed that American respondents regarded the efficacy of COVID-19 vaccine as the most important attribute, whereas Chinese respondents attached the highest importance to the cost of vaccination. But overall, the COVID-19 vaccine with the higher efficacy, the milder adverse effect, the lower cost, and the longer duration will promote the preference of the public in both countries. Additionally, the public were willing to spend the most money for a reduction in COVID-19 vaccine adverse effect from moderate to very mild (37.476USD for the United States, 140.503USD for China), followed by paying for the 1% improvement in its efficacy and paying for the one-month extension of its duration.

Conclusion

Given the impact of social cues on vaccine acceptance, Chinese government should promote reasonable vaccine-related information to improve national vaccination acceptance. Meanwhile, considering the influence of COVID-19 attributes on public preference and willingness to pay, regulating the vaccine pricing, improving the efficacy of the vaccine, reducing its adverse effect, and prolonging the duration of the vaccine works will contribute to vaccine uptake.

The mediating role of resilience between perceived social support and sense of security in medical staff following the COVID-19 pandemic: A cross-sectional study

Background

The COVID-19 pandemic not only posed a serious threat to public life and health but also had a serious impact on people's mental health, especially that of medical staff. Perceived social support is an important factor in one's sense of security.

Objective

Following the COVID-19 pandemic, the goal is to explore the potential mediating role of resilience in the relationship between perceived social support and the sense of security of Chinese medical personnel.

Methods

The multi-stage proportionally stratified convenience sampling method was adopted to select 4,076 medical professionals from 29 hospitals in Guangdong Province between September 2020 and October 2020. The Sense of Security Scale for Medical Staff, the Chinese version of the Connor-Davidson Resilience Scale, and the Perceived Social Support Scale were employed in this study. For statistical analysis and structural equation modeling (SEM), the SPSS 23.0 and Amos 24.0 software packages were used. Regression analysis was used to select the control variables to be included in the SEM. SEM analysis was conducted to verify the mediating effect of resilience on the relationship between perceived social support and a sense of security.

Results

Pearson's correlation analysis showed that perceived social support and resilience were positively associated with a sense of security (correlation coefficients range from 0.350 to 0.607, P < 0.01), and perceived social support (correlation coefficients range from 0.398 to 0.589, P < 0.01) was positively associated with resilience. Structural equation modeling revealed that resilience played a partial mediating role in the association between perceived social support and a sense of security (60.3% of the effect of perceived social support on security was direct, and 39.7% of the effect was mediated by resilience).

Conclusions

Hospital managers should make efforts to develop resilience. Interventions based on resilience should be developed to enhance the perception of social support and strengthen one's sense of security.

The mediating role of self-efficacy between workplace violence and PTSD among nurses in Liaoning Province, China: A cross-sectional study

Purpose

Nurses are at high risk for workplace violence, which can lead to psychological problems. The purpose of this study was to determine the relationship between workplace violence, self-efficacy, and PTSD, and to further explore whether self-efficacy mediates the relationship between workplace violence and PTSD among Chinese nurses.

Materials and methods

This cross-sectional study was conducted in Liaoning Province, China in 2020. A total of 1,017 valid questionnaires were returned. Each questionnaire included the Workplace Violence Scale, the General Self-Efficacy Scale, the Post-traumatic Stress Disorder Scale (PTSS-10), and demographics information. A hierarchical multiple regression approach was used to explore the mediating role of self-efficacy in the relationship between workplace violence and PTSD. The mediation model was then tested by the PROCESS macro in SPSS.

Results

A total of 1,017 nurses were included in this study, and the average score of PTSD among Chinese nurses was 26.85 ± 13.13 (mean ± SD). After further adjustment for control variables, workplace violence was positively associated with PTSD, explaining 13% of the variance. High self-efficacy was associated with low PTSD, explaining 18% of the variance. Self-efficacy partially mediated the role of workplace violence and PTSD.

Conclusion

The high scores of PTSD among Chinese nurses demand widespread attention. Workplace violence is an important predictor of PTSD in nurses. Self-efficacy is a significant factor in improving PTSD in nurses and mediates the relationship between workplace violence and PTSD. Measures and strategies to improve self-efficacy may mitigate the effects of workplace violence on PTSD in nurses.

Impact of workplace violence on anxiety and sleep disturbances among Egyptian medical residents: a cross-sectional study

BACKGROUND

Workplace violence (WPV) against healthcare workers is a common occurrence worldwide, especially among young physicians and medical residents. This study aimed to explore the negative health impacts of WPV among medical residents in Egypt, and their perception regarding how safe it is to report violence.

PURPOSE

To investigate the prevalence of WPV among medical residents, its possible negative health impacts, specifically on sleep quality and mental health, and the perceived workplace safety climate.

METHODS

This is a cross-sectional analytic study, using a convenience sample through an online questionnaire. An abuse index was calculated, generalized anxiety disorder (GAD) and sleep quality were collected from the reported outcomes.

RESULTS

The study sample included 101 residents (86.1% females). The most common reported form of abuse was verbal abuse, with the most common reported perpetrators being senior staff members (59.4%). About 86% of participants were classified as poor sleepers, while 59.4% had GAD, and there were significant positive correlations between GAD and Global Pittsburgh Sleep Quality Index (PSQI) scores with the abuse index. More than one third (35.6%) of residents reported a very high-risk Psychosocial Safety Climate (PSC) score, and 31.6% of them either strongly agreed or agreed that reporting a sexual harassment claim would be dangerous.

CONCLUSION

Workplace violence is common among Egyptian medical residents, with a significant negative impact on sleep quality and a rising risk of GAD. The promotion of a safe workplace environment is essential in protecting the health and wellbeing of medical residents.

Association between Workplace Violence and Depressive Symptoms among Primary Healthcare Professionals in Shandong, China: Meaning in Life as a Moderator

BACKGROUND

Workplace violence (WPV) is common in healthcare settings. However, the association between WPV and depressive symptoms has not been explored among primary healthcare professionals, especially in China. The assumption of the moderating effort of meaning in life on the association has also not been tested. The purposes of the study are to investigate the relationship between WPV and depressive symptoms and identify the moderating role of meaning in life among primary healthcare professionals in China.

METHODS

In this study, we collected 2530 valid questionnaires. The participants were composed of primary healthcare professionals in Shandong province, China. WPV, meaning in life (including presence of life and search for life), depressive symptoms, and some social-demographic variables were evaluated. The SPSS macro was used to build the moderating relationship.

RESULTS

WPV was positively correlated with depressive symptoms (β = 9.09, p < 0.001), and meaning in life was negatively associated with WPV and depressive symptoms (β = -0.13, p < 0.05) among primary healthcare professionals in China. For primary healthcare professionals with low presence of life, presence of life aggravated the relationship.

CONCLUSIONS

The current study has verified the association between WPV and meaning in life, and the relationship between WPV and depressive symptoms has been supported among primary healthcare professionals in China. Meaning in life and presence of life as moderators play crucial roles in the relationship between WPV and depressive symptoms.

Factors Associated with Burnout in Healthcare Professionals

Burnout in healthcare professionals remains an ongoing concern. There are a number of variables associated with reactivity to stress in healthcare staff. This study wants to identify risk factors which predispose healthcare professionals to burnout.

MATERIAL AND METHODS

The cross-sectional study included a group of 200 subjects, medical staff and auxiliary staff from the national health units, who gave their free consent to answer the questions regarding the level of perceived stress at work. The screening tool used was disseminated through the Google Forms platform, maintaining the anonymity of the participants.

RESULTS

Resident doctors (42%) responded predominantly, reporting the highest level of burnout, with nurses (26.5%) being the least affected (χ² = 36.73, p < 0.01). Less work experience is correlated with increased burnout (rho = 0.29, p < 0.01). Reactivity to stress was highly associated with workplace, with ambulance staff being the most vulnerable (χ² = 6.58, p < 0.05). Participants' relationship status significantly influenced the burnout rate, the unmarried, with or without a partner, being more affected (χ² = 16.14, p < 0.01). There are no significant differences between male and female gender, regarding the average level of burnout (U = 1.47; p > 0.05), nor between living in a house or apartment (U = 4.66; p > 0.05). Positive associations were identified between the level of burnout and variables such as: management pressure, administrative work, routine, regretting decisions regarding patients, harassment at work and sacrifice of personal time.

CONCLUSIONS

The results of this study identify age, profession, workplace seniority and relationship status as factors associated with burnout in medical personnel.

Workplace violence and the risk of post-traumatic stress disorder and burnout among nurses: a systematic review and meta-analysis

AIM

This review examined the association between workplace violence and the risk of post-traumatic stress disorder (PTSD) and burnout among nurses.

BACKGROUND

The extent to which workplace violence is associated with an increased risk of PTSD and burnout in nurses remains unclear.

EVALUATION

We searched nine electronic databases (PubMed, Cochrane, Embase, Web of Science, CINAHL, PsycINFO, Chinese Biomedical, China National Knowledge Internet, and WANFANG).

KEY ISSUES

Overall, 114 full-text studies were identified; 43 met the inclusion criteria, of which 10 were included in the meta-analysis. Compared to their counterparts with non-exposure to workplace violence, nurses experiencing it had 2.13 and 2.25 times higher odds of reporting PTSD and burnout after adjusting the confounding factors. Additionally, the moderator and mediator factors might help reduce the risk of both in this population.

CONCLUSION

This study indicated that workplace violence increases the risk of PTSD and burnout.

IMPLICATIONS FOR NURSING MANAGEMENT

Our review identified the magnitude of the association between exposure to workplace violence and the reported symptoms of PTSD and burnout in nurses. Furthermore, multi-targeted efforts directed at the identified social/organisational, task-related, and individual resources might help mitigate their harmful impact in the aforementioned population.

Impact of workplace violence on South Korean nurses' turnover intention: Mediating and moderating roles of depressive symptoms

AIM

To identify the mediating and moderating roles of depressive symptoms in the relationship between workplace violence and nurses' turnover intention in South Korea.

BACKGROUND

Workplace violence and depressive symptoms are known to influence turnover intentionsof employees.

INTRODUCTION

Among healthcare workers, nurses may be at the greatest risk of exposure to workplace violence because they have frequent contact with patients and families of patients. Depressive symptoms reported to be related to workplace violence are one set of factors affecting turnover intention.

METHODS

A cross-sectional study was designed and employed to investigate mediation and moderation roles of depressive symptoms between workplace violence and turnover intention.

RESULTS

Verbal violence and sexual harassment increased depressive symptoms, which in turn increased turnover intentions in a sample of Korean nurses. Depressive symptoms showed partial mediation effects between verbal violence and sexual harassment and turnover intention. Depressive symptoms showed moderating effects on sexual harassment and turnover intention.

DISCUSSION

It is necessary to reduce turnover intention not only by preventing violence but also by managing depressive symptoms in nurses who have experienced verbal violence and sexual harassment.

CONCLUSION

Depressive symptoms were shown to have a mediating and moderation roles on the relationship between WPV and turnover intention.

IMPLICATIONS FOR NURSING AND HEALTH POLICY

Hospital managers such as hospital and nursing directors should provide effective policies to prevent verbal violence and sexual harassment to reduce turnover intention in the workplace. It is needed to educate patients and patient caregivers about the importance of preventing violence against nurses. Policies should be established to provide regular check-ups for depressive symptoms and psychological support for nurses who have experienced WPV.

Impact of occupational exposure on job satisfaction and overall happiness among Chinese physicians and nurses: A cross-sectional study

AIMS

To investigate the impact of occupational exposure on job satisfaction and overall happiness, and to identify related factors of job satisfaction and overall happiness among physicians and nurses.

BACKGROUND

Occupational exposure against physicians and nurses has become one of the most serious public health issues worldwide.

METHODS

A cross-sectional study was conducted among physicians and nurses from 14 public tertiary hospitals using purposive sampling. Propensity score matching was used to compare job satisfaction and overall happiness among physicians and nurses with and without occupational exposure. Furthermore, binary logistic regression analysis was used to identify and analyze the influencing factors of job satisfaction and overall happiness.

RESULTS

A total of 2139 physicians and nurses (55.59%) from 3791 participants had experienced occupational exposure hazards. Before matching, the job satisfaction and overall happiness among the physicians and nurses was 38.54% and 42.14%, respectively. Participants who experienced occupational exposure were more likely to develop job dissatisfaction (OR = 1.08, 95%CI: 0.90-1.28) and overall unhappiness (OR = 1.24, 95%CI: 1.05- 1.46) than those who did not. Participants' work experience, self-evaluated health status, satisfaction with the work environment, evaluation of doctor-patient relationship, and stress were common factors affecting job satisfaction and overall happiness.

CONCLUSIONS

Our findings suggest that physicians and nurses who experience occupational exposure are more likely to develop job dissatisfaction and overall unhappiness, especially if they have shorter work experience and a tense or neutral relationship with patients.

IMPLICATIONS FOR NURSING MANAGEMENT

It is necessary to pay attention to the occupational exposure. When physicians and nurses experience occupational exposure, managers could provide support to prevent job dissatisfaction and unhappiness.

Emotional State of Chinese Healthcare Workers During COVID-19 Pandemic

Objective

Anti-epidemic work against coronavirus disease (COVID) has become routine work in China. Our study was intended to investigate the emotional and psychological state of healthcare workers and look for the association between sociodemographic factors/profession-related condition and emotional state.

Methods

A cross-sectional survey was conducted online among healthcare workers from various backgrounds. Symptoms of anxiety and depression were assessed by the Chinese versions of the seven-item Generalized Anxiety Disorder (GAD-7) and the nine-item Patient Health Questionnaire (PHQ-9), respectively. Supplementary questions (Supplementary Material) were recorded to describe the participants’ information about workplace violence, profession, and attitude related to the COVID pandemic. Wherever suitable, independent t-test, and one-way ANOVA were performed to detect group differences of GAD-7 and PHQ-9 total scores after grouping by sociodemographic variables, respectively, such as age, gender, marital status, educational level, after-tax income, department category, job title, experience of workplace violence, and anti-epidemic participation. Multiple linear regression analyses (stepwise method) were utilized in order to look for the potential associated factors of GAD-7 and PHQ-9 total scores.

Results

A total of 2,139 questionnaires with valid response were completed. Approximately 86.44% of participants had minimal symptoms of anxiety, 11.08% mild, 1.59% moderate, and 0.89% severe. Meanwhile, 81.34% had minimal symptoms of depression, 14.07% mild, 2.90% moderate, 1.17% moderately severe, and 0.51% severe. Student’s t-test showed that participants with female gender, with experience of workplace violence scored higher on both GAD-7 and PHQ-9, and participants with experience of anti-epidemic front-line work during pandemic scored lower on both GAD-7 and PHQ-9. ANOVA showed that participants aging from 31 to 40, with higher educational level, with middle level of annual after-tax income, with department of internal medicine or surgery, or with middle level of job title scored higher on both GAD-7 and PHQ-9. Regression analyses showed that female gender, high job title, and the experience of workplace violence positively were associated with anxiety or depression. Doctoral education, department (other vs. psychiatry), job enthusiasm, and professional self-identity were negatively associated with anxiety or depression. Additionally, psychological support was negatively associated with depression.

Conclusion

As the epidemic prevention and control against COVID-19 become normalized in China, emotional state of healthcare workers deserves extensive attention. Our study revealed that gender, educational level, department category, job title, the experience of workplace violence, job enthusiasm, and professional self-identity are the most important influencing factors of physician’s anxiety and depression. Self-tailored psychological intervention should be based on the predisposing factors above to mentally prepare healthcare workers for this long-lasting battle against COVID-19.

The effect of the COVID-19 pandemic on health care workers' anxiety levels: a meta-analysis

Background

The COVID-19 pandemic has been declared a public health emergency of international concern, causing excessive anxiety among health care workers. Additionally, publication bias and low-quality publications have become widespread, which can result in the dissemination of unreliable information. A meta-analysis was performed for this study with the following two aims: (1) to examine the prevalence of anxiety among health care workers and determine whether it has increased owing to the COVID-19 pandemic and (2) to investigate whether there has been an increase in publication bias.

Methods

All relevant studies published between 2015 and 2020 were searched in electronic databases (namely Web of Science, PubMed, Embase, PsycInfo, PsyArXiv, and medRxiv). The heterogeneity of the studies was assessed using the I 2 statistic. The effect size (prevalence rate of anxiety) and 95% CI for each study were also calculated. We used moderator analysis to test for the effect of the COVID-19 pandemic on health care workers' anxiety levels and to detect publication bias in COVID-19 studies. We assessed publication bias using funnel plots and Egger's regression.

Results

A total of 122 studies with 118,025 participants met the inclusion criteria. Eighty-eight articles (75,066 participants) were related to COVID-19, 13 articles (9,222 participants) were unrelated to COVID-19 (i.e., articles related to other outbreaks, which were excluded), and 21 preprints (33,737 participants) were related to COVID-19. The pooled meta-analysis prevalence was 33.6% (95% CI [30.5-36.8]; 95% PI [6.5-76.3]). Moderator analysis revealed no significant differences between articles related to COVID-19 and those unrelated to COVID-19 (p = 0.824). Moreover, no significant differences were found between articles and preprints related to COVID-19 (p = 0.843). Significant heterogeneity was observed in each subgroup. An Egger's test revealed publication bias in both articles and preprints related to COVID-19 (p < 0.001).

Conclusions

Determining whether the anxiety state of health care workers is altered by the COVID-19 pandemic is currently difficult. However, there is evidence that their anxiety levels may always be high, which suggests that more attention should be paid to their mental health. Furthermore, we found a substantial publication bias; however, the quality of the studies was relatively stable and reliable.

Effects of Integrated Workplace Violence Management Intervention on Occupational Coping Self-Efficacy, Goal Commitment, Attitudes, and Confidence in Emergency Department Nurses: A Cluster-Randomized Controlled Trial

Patient and visitor violence (PVV), the most prevalent source of workplace violence, is largely ignored, underreported, and a persistent problem in emergency departments. It is associated with physical injuries, psychological distress, and occupational stress in nurses. A randomized controlled trial was conducted in Taiwan from January to December 2020. This study aimed to test the efficacy of an integrated Workplace Violence Prevention and Management Training Program on PVV in 75 emergency department (ED) nurses from a hospital. Cluster sampling was used because the policy of subdivision strategy was enforced during the COVID-19 pandemic. ED nurses received either the intervention or 1-hour in-service class. Data were collected from questionnaires. Data were analyzed mainly by the repeated measure analysis of variance and generalized estimating equations. The intervention had positive effects on developing stronger goal commitment, improving occupational coping self-efficacy, increasing confidence in ability to deal with violent situations, and modifying attitudes toward the causes and management of PVV in ED nurses (p < 0.05). The marginal R2 of the generalized estimating equation model for goal commitment, occupational coping self-efficacy, confidence, attitudes toward aggression in ED and aggressive behavior variables was high as 0.54 (p < 0.001), 0.45 (p < 0.001), 0.58 (p < 0.001), 0.29 (p < 0.05), and 0.72 (p < 0.001), respectively. These study models could effectively predict changes in the mean values. The benefit was driven by the effect of the intervention in ED nurses. Thus, the intervention, when applied in conjunction with routine in-service class, could exert synergistic improvements on outcomes measured in nurses.

Dilemmas and Repercussions of Workplace Violence against Emergency Nurses: A Qualitative Study

Nurses received the highest rate of workplace violence due to their close interaction with clients and the nature of their work. There have been relatively few qualitative studies focus on nurses' perceptions of and experiences with the antecedents, dilemma and repercussions of the patient and visitor violence (PVV), leaving a considerable evidence gap. The aim of this study was to explore nurses' experience of PVV in emergency department, the impact of PVV on quality of care, and supports needed after exposure to such incidents. We conducted semi-structured interviews with a purposive and snowball sample of nurses, and analyzed the content of the interview transcripts. A total of 10 nurses were approached and agreed to participate. Those participants ranged in age from 24 to 41 years old, eight female and two male nurses, and the majority of them (80%) held a university Bachelor degree in nursing. The average time in nursing practice was 7.2 years. We conceptualized five analytical themes, which comprised: (1) multifaceted triggers and causes of PVV; (2) experiences following PVV; (3) tangled up in thoughts and struggle with the professional role; (4) self-reflexivity and adjustment; and, (5) needs of organizational efforts and support following PVV. This paper provides compelling reasons to look beyond solely evaluating the existence of workplace, and considering the perceived professional inefficacy, impacts of being threatened or assaulted in nurses. There are also urgent needs in provision of prevention and management of workplace training programs to ensure the high-quality nursing care.

Nurses' Quality of Life Scale: validation and psychometric properties

The Nursing Quality of Life Scale (NQOLS) is a 28-item self-report measure evaluating the four dimensions of nurses' quality of life, namely, the physical, emotional, working, and social dimensions. The purpose of this study is to assess the psychometric properties, including validity and reliability, of the NQOLS. The study enrolled 1,105 nurses who provided direct assistance to patients. The NQOLS factorial structure was tested using a cross-validation approach via Exploratory Structural Equational Modeling, which confirmed the instrument's four-dimension structure. Reliability was assessed using omega coefficients, proving excellent for all factors. Cluster analysis identified five distinct groups, each composed of participants sharing a substantial similarity with respect to their profile in the NQOLS. These five identifiable clusters presented significant differences not only in the NQOLS but also in the risk of work-related stress, emotional labour and burnout. The results show that NQOLS is a simple, reliable, lean tool for measuring nurses' overall QoL, whose various parts can additionally be used to answer specific research questions.

Workplace Violence and Turnover Intention Among Psychiatrists in a National Sample in China: The Mediating Effects of Mental Health

BACKGROUND

Workplace violence (WPV) in healthcare has received much attention worldwide. However, scarce data are available on its impact on turnover intention among psychiatrists, and the possible mechanisms between WPV and turnover intention have not been explored in China.

METHODS

A cross-sectional survey was conducted among psychiatrists in 41 tertiary psychiatric hospitals from 29 provinces and autonomous regions in China. A stress-strain-outcome (SSO) model was adopted to examine the effects of WPV on mental health and turnover intention. The association and mediation by burnout and stress were examined by multivariate logistic regression (MLR) and generalized structure equation modeling (GSEM).

RESULTS

We invited 6,986 psychiatrists to participate, and 4,520 completed the survey (64.7% response rate). The prevalence of verbal and physical violence against psychiatrist in China was 78.0 and 30.7%, respectively. MLR analysis showed that psychiatrists who experienced verbal violence (OR = 1.15, 95% CI = 1.10-1.21) and physical violence (OR = 1.15, 95% CI = 1.07-1.24) were more likely to report turnover intention. GSEM analysis showed that burnout (β = 4.00, p < 0.001) and stress (β = 1.15, p < 0.001) mediated the association between verbal violence and turnover intention; similarly, burnout (β = 4.92, p < 0.001) and stress (β = 1.80, p < 0.001) also mediated the association between physical violence and turnover intention.

CONCLUSIONS

Experience of WPV is a significant contributor to turnover intention among psychiatrists. Mental health status, such as burnout and stress level significantly mediated the association. Policy makers and hospital administrators need to be aware of this association. Action is needed to promote mental health among the psychiatrists to improve morale and workforce sustainability.

Workplace violence against frontline clinicians in emergency departments during the COVID-19 pandemic

Background

Frontline clinicians working in emergency departments (ED) were at disportionate risk of workplace violence (WPV). We investigated the prevalence of WPV and its relationship with quality of life (QOL) in this group of health professionals in China during the COVID-19 pandemic.

Methods

A cross-sectional, online study was conducted. The nine-item Workplace Violence Scale measured WPV.

Results

A total of 1,103 ED clinicians participated in this study. The overall prevalence of WPV against ED clinicians was 29.2% (95% CI [26.5%-31.9%]). Having family/friends/colleagues infected with COVID-19 (Odds Ratio (OR) = 1.82, P = 0.01), current smoking (OR = 2.98, P < 0.01) and severity of anxiety symptoms (OR = 1.08, P < 0.01) were independently and positively associated with WPV, while working in emergency intensive care units (OR = 0.45, P < 0.01) was negatively associated with WPV. After controlling for covariates, clinicians experiencing WPV had a lower global QOL compared to those without (F_{(1, 1103)} = 10.9,P < 0.01).

Conclusions

Prevalence of workplace violence against ED clinicians was common in China during the COVID-19 pandemic. Due to the negative impact of WPV on QOL and quality of care, timely preventive measures should be undertaken for ED clinicians.

Rethinking "zero tolerance": A moderated mediation model of mental resilience and coping strategies in workplace violence and nurses' mental health

AIMS

This study aimed to investigate whether the impact of workplace violence (WPV) on nurses' mental health varies with mental resilience and coping strategies.

BACKGROUND

Workplace violence is a serious threat to nurses' mental health, and its impact on nurses' mental health is influenced by many factors.

METHOD

A cross-sectional study involving 349 participants was conducted over 12 months. The data were analyzed using SPSS 25.0 and SPSS PROCESS macro.

RESULTS

In total, 82.52% of nurses were exposed to WPV. WPV not only affects mental health directly but also indirectly through mental resilience. Coping strategies had a moderating effect among WPV, mental resilience and mental health. When nurses coped with psychological violence with intolerance, WPV had a stronger negative effect on their mental health. When nurses coped with psychological violence with tolerance but coped with physical violence with intolerance, mental resilience had a stronger positive effect on their mental health.

CONCLUSIONS

Good mental resilience and coping with psychological violence with tolerance while coping with physical violence with intolerance can help buffer WPV and promote mental health.

CLINICAL RELEVANCE

Employers who have a "zero tolerance" policy regarding WPV need to re-examine how they currently operate.

Experience of Violence and Factors Influencing Response to Violence Among Emergency Nurses in South Korea: Perspectives on Stress-Coping Theory

INTRODUCTION

This cross-sectional study aimed to explore the experiences of workplace violence involving emergency nurses and to identify the factors influencing the response to violence on the basis of the stress-coping theory formulated by Lazarus and Folkman.

METHODS

Using a cross-sectional design, a structured questionnaire was administered to measure the experience of violence, perceived stress, coping actions after violence, resilience (Connor-Davidson Resilience Scale), and responses to violence. The participants were 131 nurses who were working in the emergency departments in 9 of 11 general hospitals in 2 cities in South Korea. The collected data were analyzed using descriptive statistics, t tests, analyses of variance, Pearson correlations, and hierarchical multiple regression analyses.

RESULTS

The most frequent type of violence was verbal violence, and the main offender involved in all types of violence was the patient. The methods for coping with violence were mainly passive, and emotional responses were the most frequently reported response to violence. In the final model (explanatory power = 41.5%), with response to violence as the dependent variable, the effects of the experience of violence disappeared, and only the effects of perceived stress and resilience remained.

DISCUSSION

The results of this study suggest that internal factors such as perceived stress and resilience have a more meaningful effect on the response to violence than the experience of violence itself. The findings are expected to serve as assessment data for preparing interventions and policies around prevention of, and effective coping regarding, workplace violence toward emergency nurses.

Associations Between Workplace Violence, Mental Health, and Physical Health among Korean Workers: The Fifth Korean Working Conditions Survey

BACKGROUND

Workplace violence (WPV) is a global public health problem and a threat to the health of Korean workers. This study assessed the prevalence and risk factors of WPV and its association with mental and physical health among Korean workers.

METHODS

Data obtained for 50,205 respondents to the Fifth Korean Working Conditions Survey were utilized for this study. Verbal abuse, threats, physical violence, and sexual harassment were assessed individually and as a composite for "any WPV." Workers were characterized by education, income, shift work status, access to a health and safety education program, work sector and overall health. Descriptive analyses and multiple logistic regression analyses were used to estimate the prevalence of WPV and its association with mental and physical health.

FINDINGS

Overall, 5.6% of workers reported experiencing one of four forms of WPV. The prevalence of verbal abuse, threats, physical violence, and sexual harassment were 4.9%, 0.7%, 0.2%, and 1.1%, respectively. Most perpetrators were customers. Prevalence of WPV was associated with lower education level, poor health status, long working hours, shift work, and no experience of health and safety education; 9.0% of service workers experienced violence. Workers who had experienced WPV were more likely to experience anxiety, sleep-related problems, depressive symptoms, back pain, headache/eye strain, and overall fatigue.

CONCLUSIONS/APPLICATIONS TO PRACTICE

Workplace violence is a serious occupational and public health concern in Korea. These results suggest managing WPV may improve workers' well-being and that violence-prevention strategies, policies, and regulations should be implemented across most industries.

Mediating role of coping styles on anxiety in healthcare workers victim of violence: a cross-sectional survey in China hospitals

OBJECTIVE

The purposes of this study were to evaluate the rate of workplace violence in county hospitals in China and its impact on healthcare workers and to explore the relationship between hospital violence, coping styles and anxiety to provide effective procedures for reducing anxiety among healthcare workers.

METHODS

The study used stratified sampling to select 1200 healthcare workers from 30 county hospitals in China to conduct a questionnaire survey. Of these, 1030 were valid questionnaires, and the effective response rate was 85.83%. We collected demographic characteristics of our participants and administered the following scales to them: Workplace Violence, Trait Coping Style, Self-rating Anxiety. Data were statistically analysed.

RESULTS

The results showed that 67.28% of healthcare workers in county hospitals in China had experienced workplace violence in the previous 12 months, with prevalent verbal violence (66.12%) followed by physical violence (15.24%). Workplace violence in hospitals was negatively related to positive coping (r=-0.091, p<0.01) but positively related to negative coping (r=0.114, p<0.001) and anxiety (r=0.298, p<0.001). Positive and negative coping was negatively (r=-0.085, p<0.01) and positively (r=0.254, p<0.001) associated with anxiety respectively. Positive and negative coping influenced both hospital workplace violence and anxiety in healthcare workers who were victims of violence. Compared with positive coping, the mediating effect of negative coping was stronger (95% CI -0.177 to -0.006).

CONCLUSIONS

The incidence of workplace violence among healthcare workers in county-level hospitals in China is relatively high, and there is a correlation between hospital violence, coping styles and anxiety. Positive and negative coping play a mediating role in the impact of hospital violence on healthcare workers' anxiety. Therefore, hospital administrators should actively promote healthcare workers' transition to positive coping strategies and minimise the negative impact of anxiety on them.

The components of workplace violence against nurses from the perspective of women working in a hospital in Tehran: a qualitative study

Background

Based on the World Health Organization (WHO), workplace violence can affect events where employees are abused, attacked or threatened in their workplace, and it also has some consequences such as safety, welfare, and health. Like other types of violence, workplace violence and aggression are an increasing phenomenon. Moreover, workplace violence not only disrupts interpersonal and organizational relationships, but it also impairs the persons self-esteem and affects their physical and mental health and well-being. Thus, this study aimed to explain the components of workplace violence against nurses from the perspective of women working in a hospital in Tehran, which was conducted through the qualitative method and content analysis.

Methods

In this study Purposive sampling included 21 female nurses who were working in different wards of the hospital. Also, female nurses were selected with maximum diversity in terms of work experience, age, and the wards they were working in. in this study the semi-structured interview was the main method of data collection. The interview transcriptions were extracted and then divided into meaningful units. For strengthening and confirming the results and accuracy of the research, the author used the data acceptability, credibility, accuracy, validity, believability, verifiability, reliability, and transferability.

Results

During the data analysis process of this study, the first 15 classes with the same characteristics were put together and then divided into 6 classes. Afterwards, based on the common features at a more abstract level, they were converted into 2 themes. Based on the findings, violence against women in the workplace occurs at two levels, that namely interpersonal violence and organizational coercion.

Conclusion

Therefore, it is necessary for managers to commit to lay the groundwork for reducing violence in the hospital, as well as barriers to report these cases especially the hospital managers and officials should create awareness on workplace among the staff, patient and visitors and must ensure stringent actions to prevent it.

[Workplace violence against emergency service nurses: an integrative reviewViolência no trabalho contra os profissionais de enfermagem em serviços de emergência: revisão integrativa]

Objective

Learn the worldwide frequency of physical and verbal violence against emergency service nurses, and its health and occupational impact.

Methods

An integrative review study was conducted in February 2020 of the MEDLINE, LILACS, CINAHL, and SciELO bibliographic databases, using the descriptors "Nurses," "Workplace Violence," "Physical Aggression," "Psychological Aggression," "Stress, Psychological," "Psychological Trauma," "Aggression," "Health Impact Assessment," "Health Impact," "Impacts on Health," "Impact Assessment, Health," and "Occupational Health."

Results

Of the articles located, 18 were included in the analysis. The studies confirmed that the health workers most affected by violence were nurses, and the most common types of violence were verbal aggression, followed by physical violence. In the hospital, these assaults most often occurred in the emergency service. The correlated impact on nurses' health included stress, emotional exhaustion, anxiety, and fear, among other symptoms. With regard to occupational impact, significant indirect accounts related to the reduction in productivity were evident. All these aspects led nurses to consider leaving their jobs in emergency services.

Conclusions

The results enabled identifying a risk profile for violence against nurses in emergency services, seen in the high incidence of physical and verbal violence that led to reduced productivity on the job and the onset of symptoms of burnout syndrome.