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McLaughlin L, Khemthong U. The Prevalence of Type II Workplace Violence in US Nurses 2000 to 2022: A Meta-Analysis. West J Nurs Res 2024; 46:248-255. [PMID: 38229584 DOI: 10.1177/01939459231222449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2024]
Abstract
BACKGROUND Physical violence against nurses is a concern in the United States; however, its prevalence is not well quantified. OBJECTIVE We sought to describe the prevalence of workplace violence against nurses in the United States over a 22-year period. METHODS A meta-analysis was performed following a literature search of English texts through Scopus, CINAHL Plus, and Ovid MEDLINE. Inclusion criteria included the following: (1) primary reports of workplace violence incidents in the United States against nurses, (2) perpetrator was a patient, family member, or visitor, and (3) publications between January 1, 2000, and June 21, 2022. Reports where prevalence rates for nurses could not be calculated were excluded. Study quality was assessed using the Strengthening the Reporting of Observational Studies in Epidemiology checklist. RESULTS Thirty-seven studies met the inclusion criteria; 27 030 nurses were included. The pooled prevalence of workplace violence was 0.35 (95% confidence interval [CI]: 0.29-0.42; Q = 3189.40; I2 = 98.87). Pooled rates of workplace violence increased from 30% in 2000 to 2004 to 43% in 2020 to 2022; however, the overlapping CIs indicate that the increase may not be statistically significant. The mean prevalence of reported workplace violence among nurses who work in the emergency department, in corrections, and psychiatric mental health settings (pooled prevalence = 0.59, 95% CI: 0.46-0.71) was higher than that of nurses who worked in all other settings (pooled prevalence = 0.24, 95% CI: 0.18-0.30). CONCLUSIONS Workplace violence is a significant and potentially increasing problem for nurses in the United States. This critical problem requires an effective response from nurse policymakers.
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Affiliation(s)
| | - Usa Khemthong
- School of Nursing, Saint Louis University, St. Louis, MO, USA
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2
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Berger S, Grzonka P, Frei AI, Hunziker S, Baumann SM, Amacher SA, Gebhard CE, Sutter R. Violence against healthcare professionals in intensive care units: a systematic review and meta-analysis of frequency, risk factors, interventions, and preventive measures. Crit Care 2024; 28:61. [PMID: 38409034 PMCID: PMC10898135 DOI: 10.1186/s13054-024-04844-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Accepted: 02/19/2024] [Indexed: 02/28/2024] Open
Abstract
BACKGROUND To assess the frequency, risk factors, consequences, and prevention of violence against healthcare workers in intensive care units. METHODS PubMed, Scopus, Google Scholar, EMBASE, Cochrane, and Web of Science were searched for studies on violence against healthcare workers in adult intensive care units. Risk factors, patient characteristics, and implications for healthcare workers were collected. Study quality, bias, and level of evidence were assessed using established tools. RESULTS Seventy-five studies with 139,533 healthcare workers from 32 countries were included. The overall median frequency of violence was 51% (IQR 37-75%). Up to 97% of healthcare workers experienced verbal violence, and up to 82% were victims of physical violence. Meta-analysis of frequency revealed an average frequency of 31% (95% CI 22-41%) for physical violence, 57% for verbal violence (95% CI 48-66%), and 12% for sexual violence (95% CI 4-23%). Heterogeneity was high according to the I2 statistics. Patients were the most common perpetrators (median 56%), followed by visitors (median 22%). Twenty-two studies reported increased risk ratios of up to 2.3 or odds ratios of up to 22.9 for healthcare workers in the ICU compared to other healthcare workers. Risk factors for experiencing violence included young age, less work experience, and being a nurse. Patients who exhibited violent behavior were often male, older, and physically impaired by drugs. Violence was underreported in up to 80% of cases and associated with higher burnout rates, increased anxiety, and higher turnover intentions. Overall the level of evidence was low. CONCLUSIONS Workplace violence is frequent and underreported in intensive care units, with potential serious consequences for healthcare workers, calling for heightened awareness, screening, and preventive measures. The potential risk factors for violence should be further investigated. SYSTEMATIC REVIEW REGISTRATION The protocol for this review was registered with Prospero on January 15, 2023 (ID CRD42023388449).
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Affiliation(s)
- Sebastian Berger
- Clinic for Intensive Care, Department of Acute Medicine, University Hospital Basel, Petersgraben 4, 4031, Basel, Switzerland.
| | - Pascale Grzonka
- Clinic for Intensive Care, Department of Acute Medicine, University Hospital Basel, Petersgraben 4, 4031, Basel, Switzerland
| | - Anja I Frei
- Clinic for Intensive Care, Department of Acute Medicine, University Hospital Basel, Petersgraben 4, 4031, Basel, Switzerland
| | - Sabina Hunziker
- Medical Faculty, University of Basel, Basel, Switzerland
- Medical Communication and Psychosomatic Medicine, University Hospital Basel, Basel, Switzerland
| | - Sira M Baumann
- Clinic for Intensive Care, Department of Acute Medicine, University Hospital Basel, Petersgraben 4, 4031, Basel, Switzerland
| | - Simon A Amacher
- Clinic for Intensive Care, Department of Acute Medicine, University Hospital Basel, Petersgraben 4, 4031, Basel, Switzerland
- Medical Communication and Psychosomatic Medicine, University Hospital Basel, Basel, Switzerland
| | - Caroline E Gebhard
- Clinic for Intensive Care, Department of Acute Medicine, University Hospital Basel, Petersgraben 4, 4031, Basel, Switzerland
- Medical Faculty, University of Basel, Basel, Switzerland
| | - Raoul Sutter
- Clinic for Intensive Care, Department of Acute Medicine, University Hospital Basel, Petersgraben 4, 4031, Basel, Switzerland
- Medical Faculty, University of Basel, Basel, Switzerland
- Department of Clinical Research, University of Basel, Basel, Switzerland
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3
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Carey I, Hendricks K. Workplace violence against healthcare workers using nationally representative estimates of emergency department data, 2015-2017. Am J Ind Med 2023; 66:333-338. [PMID: 36726213 DOI: 10.1002/ajim.23463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Revised: 01/13/2023] [Accepted: 01/18/2023] [Indexed: 02/03/2023]
Abstract
INTRODUCTION Workers in the healthcare industry are at increased risk for workplace violence. The goal of this analysis is to determine the rate of injuries healthcare workers incurred as a result of intentional violence by patients in the workplace. METHODS Injuries linked to workplace violence that were treated in US emergency departments from 2015 to 2017 were identified using data from the National Electronic Injury Surveillance System-Occupational Supplement (NEISS-Work). All estimates and 95% confidence intervals were calculated using SAS® 9.4 Proc Survey to incorporate the stratified sample design of NEISS-Work. RESULTS Approximately 1.14 million injuries to workers in the healthcare industry were treated in US hospital emergency departments between 2015 and 2017. Intentional injuries by another person accounted for 15% of these healthcare-related injuries. The results also showed that male healthcare workers' rate of injuries was 2.3 times higher than their female counterparts despite composing a smaller proportion of the workforce. Injury rates were highest among the less-than-25 age group, and decreased as healthcare workers' age increased. CONCLUSIONS Workplace violence is a serious problem in today's healthcare settings that affects both employees and patient care. Although violence in the healthcare industry has been researched for decades, there has been an increase in violent incidents in this industrial sector. The disparity in injury rates by sex and age are areas of concern. Further research in these areas is necessary to understand the root causes of these incidents and inform violence prevention strategies.
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Affiliation(s)
- Imani Carey
- Surveillance and Field Investigations Branch, Division of Safety Research, NIOSH, Morgantown, West Virginia, USA.,School of Public Health, West Virginia University, Morgantown, West Virginia, USA
| | - Kitty Hendricks
- Surveillance and Field Investigations Branch, Division of Safety Research, NIOSH, Morgantown, West Virginia, USA
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4
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Otachi JK, Robertson H, Okoli CTC. Factors associated with workplace violence among healthcare workers in an academic medical center. Perspect Psychiatr Care 2022; 58:2383-2393. [PMID: 35388480 DOI: 10.1111/ppc.13072] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Revised: 03/10/2022] [Accepted: 03/13/2022] [Indexed: 12/22/2022] Open
Abstract
PURPOSE We examined demographic, work-related, and behavioral factors associated with witnessing and/or experiencing workplace violence among healthcare workers. DESIGN AND METHODS Utilizing a correlational design, we analyzed the data to determine the associative factors related to workplace violence among the participants. FINDINGS More than half of the participants (54.5%) reported witnessing (23.8%) or experiencing (30.7%) workplace violence. There were significant differences between health provider groups in witnessing or experiencing workplace violence (Χ2 = 41.9[df12], p < 0.0001). Moreover, the experience of workplace violence differed by practice setting (Χ2 = 65.9[df14], p < 0.0001), with highest rates occurring in psychiatric (45.1%) and emergency (44.1%) services. PRACTICE IMPLICATIONS Findings may inform research, policies, and practice interventions to assess risks for workplace violence and implement preventative policies within high-risk professional groups and settings.
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Affiliation(s)
- Janet K Otachi
- NIH HEAL Initiative, Healing Communities Study, Substance Use Priority Research Area, University of Kentucky, Lexington, Kentucky, USA
| | - Heather Robertson
- Mental and Behavioral Health Nursing, Behavioral Health Wellness Environments for Living and Learning (BH WELL), University of Kentucky College of Nursing, Lexington, Kentucky, USA
| | - Chizimuzo T C Okoli
- Behavioral Health Wellness Environments for Living and Learning (BH WELL), University of Kentucky College of Nursing, Lexington, Kentucky, USA
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Odes R, Chapman S, Ackerman S, Harrison R, Hong O. Differences in Hospitals' Workplace Violence Incident Reporting Practices: A Mixed Methods Study. Policy Polit Nurs Pract 2022; 23:98-108. [PMID: 35317690 PMCID: PMC9234774 DOI: 10.1177/15271544221088248] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Workplace violence (WV) is a significant and growing problem for health care workers. Increased recognition of the need for improved protections has led to policy initiatives at the state and federal levels, including national Joint Commission requirements that went into effect January 2022. California's WV prevention legislation was phased in during 2017-2018 and requires hospitals to use a new incident reporting system, the Workplace Violent Incident Reporting System (WVIRS) for Hospitals. We analyzed WVIRS data collected during the first three years of its implementation, July 1, 2017 - June 30, 2020. In addition, we collected qualitative data from six California hospitals/hospital systems during 2019-2020 to better understand reporting practices. Over the three-year period, the 413 hospitals using the WVIRS reported between zero and six incidents per staffed bed. Sixteen hospitals (3.9%) reported two or more incidents per staffed bed while the rest reported fewer than two incidents. Qualitative analysis identified that reporting procedures vary considerably among hospitals. Several organizations rely on workers to complete incident reports electronically while others assign managers or security personnel to data collection. Some hospitals appear to report only those incidents involving physical harm to the worker. Regulatory guidance for reporting practices and hospitals' commitment to thorough data collection may improve consistency. As hospitals throughout the U.S. consider practice changes to comply with new WV standards, those engaged in implementation efforts should look closely at reporting practices. Greater consistency in reporting across facilities can help to build evidence for best practices and lead to safety improvements.
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Affiliation(s)
- Rachel Odes
- Postdoctoral Fellow, National Clinician Scholars Program, University of California San
Francisco, 490 Illinois St., Floor 7, San Francisco, CA 94158
| | - Susan Chapman
- Professor, Department of Social and Behavioral Sciences, School of
Nursing, University of California San
Francisco, 490 Illinois Street, San Francisco CA 94158
| | - Sara Ackerman
- Associate Professor, Department of Social and Behavioral Sciences,
School of Nursing, University of California San
Francisco, 490 Illinois Street, San Francisco CA 94158
| | - Robert Harrison
- Sr Physician Diplomate, Department of Occupational and Environmental
Medicine, School of Medicine, University of California San
Francisco, 2330 Post Street, San Francisco CA 94115
| | - OiSaeng Hong
- Professor, Community Health Systems, School of Nursing, University of California San
Francisco, 2 Koret Way, San Francisco CA 94143
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Organizational Factors Are Key Predictors of Physicians’ Confidence in Handling Workplace Violence. Healthcare (Basel) 2022; 10:healthcare10040637. [PMID: 35455815 PMCID: PMC9031724 DOI: 10.3390/healthcare10040637] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Revised: 03/18/2022] [Accepted: 03/23/2022] [Indexed: 02/01/2023] Open
Abstract
Many studies have investigated health-care workers’ confidence in handling workplace violence with the aim of preventing negative outcomes and fear of such events. The aim of this cross-sectional study was to identify the predictors of physicians’ confidence in handling workplace violence. A self-administered questionnaire was used to collect data on various factors related to workplace violence against physicians in four regional teaching hospitals in northern Taiwan. Of the 180 respondents, 78 (43.3%) had experienced workplace violence in the 3 months preceding the study; they were assigned to the “victim group”. The others (102 respondents) were assigned to the “nonvictim group”. According to multiple linear regression analysis, the factors significantly associated with physicians’ confidence in handling workplace violence in the victim group were perceived organizational support and workplace violence-related training courses. In the nonvictim group, affiliated department and perceived safety climate were key factors. Organizational factors are key predictors of physicians’ confidence in handling workplace violence. Therefore, hospital managers should strive to bolster physicians’ confidence in handling workplace violence. For victims of workplace violence, team-based trainings may improve their interpersonal skills and perceived support from colleagues, both of which can prevent workplace violence events and the repetition of such events.
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7
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Alsharari AF, Abu-Snieneh HM, Abuadas FH, Elsabagh NE, Althobaity A, Alshammari FF, Alshmemri MS, Aroury AM, Alkhadam AQ, Alatawi SS. Workplace violence towards emergency nurses: A cross-sectional multicenter study. Australas Emerg Care 2021; 25:48-54. [PMID: 33602656 DOI: 10.1016/j.auec.2021.01.004] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Revised: 01/24/2021] [Accepted: 01/24/2021] [Indexed: 10/22/2022]
Abstract
BACKGROUND Workplace violence (WPV) against nurses continues to be a challenge within healthcare systems worldwide. Quantifying the burden of WPV in emergency departments will inform the design of appropriate interventions. This study aimed to determine the prevalence, pattern and factors associated with WPV among emergency nurses working in Saudi Arabia. METHODS A multicenter descriptive online survey was conducted using a standardized self-administered questionnaire. Emergency nurses working in public hospitals in the country were invited to participate. Data were analyzed with descriptive statistics and multivariate logistic regression. RESULTS The study recruited 849 emergency nurses, most (73.7%) had experienced WPV in the past two years; 47.4% experienced physical violence and 94.3% experienced non-physical violence. Most exposures to WPV occurred during the afternoon shifts (70.8%), and mainly perpetrated by family members or relatives of the patients (88.3%). CONCLUSION WPV encountered by emergency nurses in Saudi Arabia is alarmingly high, and underreported by the affected nurses. Increased workload, inadequate staffing levels, poorly enforced visitor policy, unmet expectations, and a lack of clarity in reporting were the most frequent causes of WPV. There is a need to reassess the current occupational safety measures in the emergency departments in the country.
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Affiliation(s)
| | - Hana M Abu-Snieneh
- College of Applied Medical Sciences, Nursing Department, Jouf University, Saudi Arabia
| | - Fuad H Abuadas
- College of Applied Medical Sciences, Nursing Department, Jouf University, Saudi Arabia
| | - Nahed E Elsabagh
- College of Applied Medical Sciences, Nursing Department, Jouf University, Saudi Arabia
| | - Abdulellah Althobaity
- Faculty of Applied Medical Sciences, Nursing Department, Taif University, Saudi Arabia
| | - Farhan F Alshammari
- College of Nursing, University of Hail, Saudi Arabia; Ministry of Health, Saudi Arabia
| | | | - Ammar M Aroury
- College of Applied Medical Sciences, Nursing Department, Jouf University, Saudi Arabia; College of Nursing and Health Sciences, Flinders University, Adelaide, Australia
| | - Arab Q Alkhadam
- College of Applied Medical Sciences, Nursing Department, Jouf University, Saudi Arabia
| | - Suliman S Alatawi
- College of Nursing, University of Hail, Saudi Arabia; Ministry of Health, Saudi Arabia
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8
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Kelly EL, Fenwick KM, Brekke JS, Novaco RW. Sources of Social Support After Patient Assault as Related to Staff Well-Being. JOURNAL OF INTERPERSONAL VIOLENCE 2021; 36:NP1003-NP1028. [PMID: 29294965 PMCID: PMC6445776 DOI: 10.1177/0886260517738779] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Patient assault is a serious issue for the well-being of staff in psychiatric hospitals. To guide workplace responses to patient assault, more information is needed about social support from different sources and whether those supports are associated with staff well-being. The present study examines social support after patient assault from work-based and nonwork-based sources, and whether inpatient psychiatric staff desires support from them and perceive the support received as being effective. Received support across sources was examined in relations to staff well-being (physical health, mental health, anger, sleep quality) and perceptions of safety. Survey data was collected from 348 clinical staff in a large public forensic mental hospital. Among the 242 staff who reported an assault in the last year, 71% wanted support and 72% found effective support from at least one source. Generally, effective support from supervisors, coworkers, and their combination was associated with better well-being. Support from nonwork sources was related to less concerns about safety, but not to other well-being measures. However, 28% of staff did not receive effective support from any source postassault. Gaps in support as reported in this study and as found by other investigators call for systematic programming by hospital organizations to enhance the well-being of clinical staff, which in turn has implications for patient care.
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Affiliation(s)
- Erin L Kelly
- University of Southern California, Los Angeles, USA
- University of California, Los Angeles, USA
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9
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Enosh G, Freund A, Goldblatt H, Drach-Zahavy A, Guindy M, Ofer-Bialer G. Whose fault is it? Attribution of causes of patient violence among exposed and unexposed community-based family physicians. HEALTH & SOCIAL CARE IN THE COMMUNITY 2021; 29:175-184. [PMID: 32627279 DOI: 10.1111/hsc.13080] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/12/2019] [Revised: 02/24/2020] [Accepted: 06/03/2020] [Indexed: 06/11/2023]
Abstract
Extensive research has dealt with violence directed at healthcare workers in hospital settings; however, few studies have examined community-based settings. Furthermore, there is also scant literature regarding the perceptions of healthcare providers who were exposed to violence, compared to those who were not. This study aims to narrow these gaps in the literature by examining community-based family physicians' (CBFPs) perceptions in a large national Health Maintenance Organisation (HMO) regarding patient-initiated violence. Using a voluntary online survey, directed at all CBFPs working at the HMO, 412 CBFPs were surveyed on the following issues: exposure to violence initiated by patients or their family members; perceptions of violent occurrences and possible safety measures. The differences between CBFPs who had been exposed to violence and those who had not were compared. The majority of CBFPs reported experiencing verbal attacks (64%), and a small percentage experienced property-related violence (11.7%) or physical violence (3.4%). Comparing CBFPs who were exposed to violence with those who were not, regarding their perceptions of the 'causes of violence', revealed three differentiating factors: 'waiting time', 'failure to meet the patient's expectations' and 'the nature of the physician-patient encounter'. Regarding the desired preventive actions, the four differentiating factors were as follows: 'reduction in the number of patients per physician', 'improved queue management processes', 'longer meetings' and 'violence prevention training'. Conducting separate analyses, according to violence type (verbal abuse, vandalism or physical violence), indicated finer differentiations. In terms of Attribution Theory, one might argue that CBFPs who were directly exposed to patients' aggression attributed internal locus to the attacker, and tended to blame the attacker's personal characteristics and cultural values. Conversely, family CBFPs who were not attacked attributed external locus to situational factors such as waiting time, not receiving service, and the nature of the interaction between the attacker and the CBFP.
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10
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Cheng S, Dawson J, Thamby J, Liaw WR, King EB. How do aggression source, employee characteristics and organisational response impact the relationship between workplace aggression and work and health outcomes in healthcare employees? A cross-sectional analysis of the National Health Service staff survey in England. BMJ Open 2020; 10:e035957. [PMID: 32792432 PMCID: PMC7430410 DOI: 10.1136/bmjopen-2019-035957] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
OBJECTIVES To examine the prevalence of aggression in healthcare and its association with employees' turnover intentions, health and engagement, as well as how these effects differ based on aggression source (patients vs colleagues), employee characteristics (race, gender and occupation) and organisational response to the aggression. DESIGN Multilevel moderated regression analysis of 2010 National Health Service (NHS) survey. SETTING 147 acute NHS trusts in England. PARTICIPANTS 36 850 participants across three occupational groups (14% medical/dental, 61% nursing/midwifery, 25% allied health professionals or scientific and technical staff). MAIN OUTCOME MEASURES Employee turnover intentions, health and work engagement. RESULTS Both forms of aggression (from patients and colleagues) have significant and substantial effects on turnover intentions, health and work engagement; however, for all three outcome variables, the effect of aggression from colleagues is more than twice the size of the effect of aggression from patients. Organisational response was found to buffer the negative effects of aggression from patients for turnover intentions and the negative effects of aggression from patients and colleagues for employee health. The results also demonstrated that nurses/midwives, women and Black employees are more likely to experience aggression; however, no clear patterns emerged on how aggression differentially impacts employees of different races, genders and occupations with respect to the outcome variables. CONCLUSIONS Although aggression from patients and colleagues both have negative effects on healthcare employees' turnover intentions, health and work engagement, these negative effects are worse when it is aggression from colleagues. Having an effective organisational response can help ameliorate the negative effects of aggression on employees' health; however, it may not always buffer negative effects on turnover intentions and work engagement. Future research should examine other approaches, as well as how organisational responses and resources may need to differ based on aggression source.
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Affiliation(s)
- Shannon Cheng
- Department of Psychological Sciences, Rice University, Houston, Texas, USA
| | - Jeremy Dawson
- Sheffield University Management School and School of Health and Related Research, The University of Sheffield, Sheffield, UK
| | - Julie Thamby
- Department of Psychological Sciences, Rice University, Houston, Texas, USA
| | - Winston R Liaw
- Health Systems and Population Health Sciences, University of Houston College of Medicine, Houston, Texas, USA
| | - Eden B King
- Department of Psychological Sciences, Rice University, Houston, Texas, USA
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11
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Kracher SL, Currivan A, Guerrero M, Goebert D, Agapoff JR, Kuo B, Hishinuma E, Wong C, Fuimaono-Poe M. A Multidisciplinary Consultation-Liaison Team Approach to Reduce Enhanced Observer Usage. PSYCHOSOMATICS 2020; 61:707-712. [PMID: 32680691 DOI: 10.1016/j.psym.2020.04.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/19/2019] [Revised: 04/20/2020] [Accepted: 04/21/2020] [Indexed: 11/17/2022]
Abstract
BACKGROUND There are few evidence-informed guidelines and findings to show that the use of sitters improves patient safety; overall, it is a costly intervention to address patients with disruptive behaviors. OBJECTIVE The purpose of this article is to demonstrate that the creation of a multidisciplinary consultation-liaison (C-L) team, integrated with a psychiatric C-L team, together can decrease sitter use and improve outcomes using nonpharmacologic interventions. METHODS This retrospective study describes the planning, implementation, and data collection using in creating an multidisciplinary C-L team to collaborate with the psychiatric C-L team and outcomes to support the approach. The multidisciplinary C-L team was composed of advanced practice registered nurses and creative art therapists. The teams worked closely with the medical units to develop and monitor criteria for sitter use. The key outcomes of the intervention improved patient safety and reduced overall cost. RESULTS In the first year of implementation of a multidisciplinary C-L approach, sitter use decreased by 72%. Nonpharmacologic interventions improved patient outcomes by providing education to medical staff that enhanced the assessment and implementation of enhanced observer use across all the medical units. Subsequent data also reflect a sustained reduction in cost over the next 2-year period, saving the institution nearly $70K a month. CONCLUSION An multidisciplinary C-L and psychiatric C-L team collaborated on the need for psychiatric medications, or nonpharmacologic interventions to address behaviors and decrease the need for an enhanced observer. The teams worked together to make policy revisions and algorithms and provide education, the result of which was significant financial savings and improved patient safety.
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Affiliation(s)
- Stacy L Kracher
- Behavioral Health Services, The Queens Medical Center, Honolulu, HI.
| | - Andrew Currivan
- Behavioral Health Services, The Queens Medical Center, Honolulu, HI
| | - Maria Guerrero
- Behavioral Health Services, The Queens Medical Center, Honolulu, HI
| | - Deborah Goebert
- Behavioral Health Services, The Queens Medical Center, Honolulu, HI; Department Psychiatry, John Burns School of Medicine, University of Hawaii, Honolulu, HI
| | - James R Agapoff
- Behavioral Health Services, The Queens Medical Center, Honolulu, HI; Department Psychiatry, John Burns School of Medicine, University of Hawaii, Honolulu, HI
| | - Bradley Kuo
- Behavioral Health Services, The Queens Medical Center, Honolulu, HI
| | - Earl Hishinuma
- Behavioral Health Services, The Queens Medical Center, Honolulu, HI; Department Psychiatry, John Burns School of Medicine, University of Hawaii, Honolulu, HI
| | - Chelsea Wong
- Behavioral Health Services, The Queens Medical Center, Honolulu, HI
| | - Me Fuimaono-Poe
- Behavioral Health Services, The Queens Medical Center, Honolulu, HI
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12
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Goldblatt H, Freund A, Drach-Zahavy A, Enosh G, Peterfreund I, Edlis N. Providing Health Care in the Shadow of Violence: Does Emotion Regulation Vary Among Hospital Workers From Different Professions? JOURNAL OF INTERPERSONAL VIOLENCE 2020; 35:1908-1933. [PMID: 29294693 DOI: 10.1177/0886260517700620] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Research into violence against health care staff by patients and their families within the health care services shows a rising frequency of incidents. The potentially damaging effects on health care staff are extensive, including diverse negative psychological and physical symptoms. The aim of this qualitative study was to examine how hospital workers from different professions reacted to patients' and visitors' violence against them or their colleagues, and how they regulated their emotional reactions during those incidents. The research question was as follows: How do different types of hospital workers regulate the range of their emotional reactions during and after violent events? Participants were 34 hospital workers, representing several professional sectors. Data were collected through in-depth semistructured interviews, which were later transcribed and thematically content analyzed. Five themes were revealed, demonstrating several tactics that hospital workers used to regulate their emotions during incidents of violent outbursts by patients or visitors: (1) Inability to Manage Emotion Regulation, (2) Emotion Regulation by Distancing and Disengagement Tactics, (3) Emotion Regulation Using Rationalization and Splitting Tactics, (4) Emotion Regulation via the Use of Organizational Resources, and (5) Controlling Emotions by Suppression. Hospital workers who experienced dissonance between their professional expectations and their emotional reactions to patients' violence reported using various emotion regulation tactics, consequently managing to fulfill their duty competently. Workers who did not experience such dissonance felt in full control of their emotions and did not manifest responses of emotion regulation. Others, however, experienced intense emotional flooding and failed to regulate their emotions. We recommend developing health care staff's awareness of possible emotional implications of violent incidents, for themselves as people and for their intact functioning at work. In addition, we recommend further development of health care staff training programs for coping with violent patients and enhancement of formal and informal organizational support.
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13
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Demirci Ş, Uğurluoğlu Ö. An Evaluation of Verbal, Physical, and Sexual Violence Against Healthcare Workers in Ankara, Turkey. JOURNAL OF FORENSIC NURSING 2020; 16:E33-E41. [PMID: 32379250 DOI: 10.1097/jfn.0000000000000286] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
BACKGROUND Healthcare professionals work in high-stress, fast-paced settings where individuals from different professions work together and who are exposed to many types of violence. The phenomenon of violence has become a concern of utmost importance for healthcare professionals that should be addressed with due attention. OBJECTIVES The aim of this study was to evaluate the verbal, physical, and sexual workplace violence experienced by healthcare professionals. METHODS A survey was conducted in a public hospital in Ankara, Turkey, among 104 physicians, 93 nurses, and 150 other medical staff. RESULTS Of the participating healthcare workers, 96.2%, 95.7%, and 80.7% of the physicians, nurses, and other medical personnel, respectively, reported having been exposed to verbal violence at least once in their professional life. Physicians were identified as a source of violence among other healthcare professionals. A logistic regression analysis was performed to determine the effects of sociodemographic features on violence. The statistically significant results showed that nurses are exposed to sexual violence more than other medical personnel are (OR = 3.11, 95% CI [1.29, 7.49]). Nurses were more exposed to verbal (OR = 5.08, 95% CI [1.54, 16.75]) and physical (OR = 3.68, 95% CI [1.15, 11.80]) violence compared with other medical personnel working in the hospital. CONCLUSIONS This study shows that a great majority of healthcare professionals are subjected to violence ranging from verbal violence in particular to physical and sexual violence.
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Affiliation(s)
- Şenol Demirci
- Author Affiliations: Faculty of Economics & Administrative Science, Department of Health Management, Hacettepe University
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Honarvar B, Ghazanfari N, Raeisi Shahraki H, Rostami S, Lankarani KB. Violence against Nurses: A Neglected and Health-threatening Epidemic in the University Affiliated Public Hospitals in Shiraz, Iran. THE INTERNATIONAL JOURNAL OF OCCUPATIONAL AND ENVIRONMENTAL MEDICINE 2019; 10:111-123. [PMID: 31325294 PMCID: PMC6708406 DOI: 10.15171/ijoem.2019.1556] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/29/2018] [Accepted: 04/03/2019] [Indexed: 02/05/2023]
Abstract
Background:
Nurses are more likely to be exposed to violence at their workplace in comparison with other employees.
Objective:
To determine various aspects of violence against nurses in Shiraz public hospitals.
Methods:
This cross-sectional study was conducted from 2017 to 2018, using a multistage random sampling method. Violence including verbal threats, verbal abuse, physical and sexual abuse as well as ethnical types, violence from patients, patients' companions and coworkers, and causes of violence were investigated using a checklist.
Results:
405 nurses with a mean age of 30.2 (SD 7.1) years and female to male ratio of 4.2 were interviewed. 363 (89.6%) nurses had experienced at least one kind of violence; 68.4% suffered from more than one type of violence. Verbal abuse (83.9%), verbal threats (27.6%), physical violence (21.4%), sexual abuse (10.8%), and ethnical harassment (6.1%) were the most common types of violence experienced by the nurses. Patients' companions, patients, and physicians were reported as the sources of violence in 70.6%, 43.1%, and 4.1% of cases, respectively. Nurses with non-official employment status and non-Farsi ethnicity, having a disease, with non-evening shift work, and those with short or long employment period were more affected. Unrealistic expectations by patients' companions and long working hours were the most common attributing factors.
Conclusion:
Violence against nurses, as a strenuous and health-threatening crisis, has become epidemic in public hospitals in our region. Effective interventions are warranted to sort out these problems.
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Affiliation(s)
- Behnam Honarvar
- Health Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Nima Ghazanfari
- Health Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Hadi Raeisi Shahraki
- Department of Epidemiology and Biostatistics, School of Health, Shahrekord University of Medical Sciences, Shahrekord, Iran
| | - Sara Rostami
- Health Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Kamran Bagheri Lankarani
- Health Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran
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Toussaint M, Ramirez MR, Peek‐Asa C, Saftlas A, Casteel C. Workplace violence victimization in young workers: An analysis of the US National Crime Victimization Survey, 2008 to 2012. Am J Ind Med 2019; 62:691-700. [PMID: 31219632 PMCID: PMC10117365 DOI: 10.1002/ajim.22995] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/22/2019] [Indexed: 11/06/2022]
Abstract
BACKGROUND The aim of this study was to measure the frequency of workplace violence (WPV) victimization in 16 to 24-year olds in the United States and compare rates by occupation and demographics. METHODS As an open cohort, participants 12 years or older in the National Crime Victimization Survey were interviewed at 6-month intervals over a 3-year period from 2008 to 2012. WPV victimization rates were calculated. Weighted, multilevel Poisson regression was used to compare WPV victimization rates by occupation and demographics. RESULTS The rate of WPV victimization was 1.11 incidents per 1000 employed person-months (95% confidence interval: 0.95-1.27). The highest rates of WPV were in protective service occupations (5.24/1000 person-months), transportation (3.04/1000 person-months), and retail sales (2.29/1000 person-months). Compared with their respective counterparts, lower rates of WPV victimization were found among younger, black, and rural/suburban workers. CONCLUSIONS Findings identify occupations and target populations in need of future research and evidence-based interventions to improve the working conditions for young workers.
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Affiliation(s)
- Maisha Toussaint
- Department of Occupational and Environmental Health, College of Public HealthThe University of IowaIowa City Iowa
| | - Marizen R. Ramirez
- Department of Occupational and Environmental Health, College of Public HealthThe University of IowaIowa City Iowa
- Division of Environmental Health Sciences, School of Public HealthUniversity of MinnesotaMinneapolis Minnesota
| | - Corinne Peek‐Asa
- Department of Occupational and Environmental Health, College of Public HealthThe University of IowaIowa City Iowa
| | - Audrey Saftlas
- Department of Epidemiology, College of Public HealthThe University of IowaIowa City Iowa
| | - Carri Casteel
- Department of Occupational and Environmental Health, College of Public HealthThe University of IowaIowa City Iowa
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Campbell VLS, Foley HL, Vianna KW, Brunger F. Folie du système? Preventing Violence Against Nurses in In-patient Psychiatry. Psychiatr Q 2019; 90:413-420. [PMID: 31028509 DOI: 10.1007/s11126-019-09636-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Violence against psychiatric nurses is a difficult reality of work on in-patient psychiatry units. Health care providers and managers, nursing unions, and workplace protection agencies are looking for solutions to improve safety and quality of care. We are suggesting that simultaneous to this solution-seeking, there is also a need to critically reflect on the nature of violence itself within in-patient psychiatric settings. In this article we consider the gendered dynamics of power and violence within the in-patient psychiatric setting. The nursing profession is over 90% female. Given that violence in society often has a 'gendered' nature, and in light of a report from the Ontario Council of Hospital Unions which likened violence against nurses to domestic violence, we have put forth a view of the acute in-patient psychiatric milieu that considers gender and power in its analysis of violence against nurses. Intended to encourage enquiry into our pre-suppositions as health care providers, we use Foucauldian and feminist theories to up-end our notions of "anti-violence technologies", and to consider the unique and risky position that psychiatric nurses occupy as carers, care providers, and "anti-violence officers". We conclude by posing ethical questions which may be of interest for professional development, care planning, team building, and clinical ethics and education.
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Affiliation(s)
- Vashti L S Campbell
- Faculty of Medicine, Division of Community Health and Humanities, Memorial University, 300 Prince Philip Drive, St. John's, NL, A1B 3V6, Canada
| | - Holly L Foley
- Faculty of Medicine, Division of Community Health and Humanities, Memorial University, 300 Prince Philip Drive, St. John's, NL, A1B 3V6, Canada
| | - Kevin W Vianna
- Faculty of Medicine, Division of Community Health and Humanities, Memorial University, 300 Prince Philip Drive, St. John's, NL, A1B 3V6, Canada
| | - Fern Brunger
- Faculty of Medicine, Division of Community Health and Humanities, Memorial University, 300 Prince Philip Drive, St. John's, NL, A1B 3V6, Canada.
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Fino E, Di Campli S, Patrignani G, Mazzetti M. The modulating role of gender and aggression in emotional reactions of nursing students: A cross‐sectional study. J Adv Nurs 2019; 75:1462-1472. [DOI: 10.1111/jan.13936] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2018] [Revised: 10/22/2018] [Accepted: 11/22/2018] [Indexed: 01/28/2023]
Affiliation(s)
- Edita Fino
- Department of Experimental, Diagnostic and Specialty Medicine (DIMES) Alma Mater Studiorum ‐ University of Bologna Bologna Italy
| | - Serena Di Campli
- Dipartimento Cardio‐toraco‐vascolare Sant'Orsola‐Malpighi Polyclinic Bologna Italy
| | - Giulia Patrignani
- Dipartimento della Donna, del bambino e delle malattie urologiche Sant'Orsola‐Malpighi Polyclinic Bologna Italy
| | - Michela Mazzetti
- Department of Experimental, Diagnostic and Specialty Medicine (DIMES) Alma Mater Studiorum ‐ University of Bologna Bologna Italy
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Hassankhani H, Parizad N, Gacki-Smith J, Rahmani A, Mohammadi E. The consequences of violence against nurses working in the emergency department: A qualitative study. Int Emerg Nurs 2018; 39:20-25. [DOI: 10.1016/j.ienj.2017.07.007] [Citation(s) in RCA: 46] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2017] [Revised: 07/26/2017] [Accepted: 07/30/2017] [Indexed: 02/03/2023]
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Pihl-Thingvad J, Brandt LPA, Andersen LL. Consistent Use of Assistive Devices for Patient Transfer Is Associated With Less Patient-Initiated Violence: Cross-Sectional Study Among Health Care Workers at General Hospitals. Workplace Health Saf 2018; 66:453-461. [PMID: 29486660 DOI: 10.1177/2165079917752714] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This study investigated whether factors related to bodily contact between health care workers and patients were associated with patient-initiated violence. This cross-sectional study surveyed 496 Danish health care workers measuring patient-initiated violence, use of assistive devices, body mass index, physical exertion, frequency of patient transfers, psychosocial work environment, gender, age, and seniority. Associations were modeled using logistic regression analyses using patient-initiated violence as the outcome. Twenty-five percent of the respondents had experienced physical or verbal violence during the past year. Infrequent use of assistive devices, high physical strain, and severe obesity all significantly increased the risk of physical violence (risk ratio [RR] = 1.18, RR = 1.18, and RR = 1.16, respectively), whereas only the lack of assistive device use significantly increased the risk of verbal violence (RR = 1.13 and RR = 1.08). Consistent use of assistive devices appears to reduce the risk of patient-initiated violence. Managers should require the use of assistive devices when designing work processes for patient transfers.
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Affiliation(s)
| | | | - Lars L Andersen
- 3 National Research Centre for the Working Environment.,4 Aalborg University
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Groenewold MR, Sarmiento RF, Vanoli K, Raudabaugh W, Nowlin S, Gomaa A. Workplace violence injury in 106 US hospitals participating in the Occupational Health Safety Network (OHSN), 2012-2015. Am J Ind Med 2018; 61:157-166. [PMID: 29152784 DOI: 10.1002/ajim.22798] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/06/2017] [Indexed: 11/09/2022]
Abstract
BACKGROUND Workplace violence is a substantial occupational hazard for healthcare workers in the United States. METHODS We analyzed workplace violence injury surveillance data submitted by hospitals participating in the Occupational Health Safety Network (OHSN) from 2012 to 2015. RESULTS Data were frequently missing for several important variables. Nursing assistants (14.89, 95%CI 10.12-21.91) and nurses (8.05, 95%CI 6.14-10.55) had the highest crude workplace violence injury rates per 1000 full-time equivalent (FTE) workers. Nursing assistants' (IRR 2.82, 95%CI 2.36-3.36) and nurses' (IRR 1.70, 95%CI 1.45-1.99) adjusted workplace violence injury rates were significantly higher than those of non-patient care personnel. On average, the overall rate of workplace violence injury among OHSN-participating hospitals increased by 23% annually during the study period. CONCLUSION Improved data collection is needed for OHSN to realize its full potential. Workplace violence is a serious, increasingly common problem in OHSN-participating hospitals. Nursing assistants and nurses have the highest injury risk.
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Affiliation(s)
- Matthew R. Groenewold
- Alice Hamilton Laboratory, National Institute for Occupational Safety and Health, Division of Surveillance, Hazard Evaluations and Field Studies; Centers for Disease Control and Prevention; Cincinnati Ohio
| | - Raymond F.R. Sarmiento
- Alice Hamilton Laboratory, National Institute for Occupational Safety and Health, Division of Surveillance, Hazard Evaluations and Field Studies; Centers for Disease Control and Prevention; Cincinnati Ohio
| | - Kelly Vanoli
- Alice Hamilton Laboratory, National Institute for Occupational Safety and Health, Division of Surveillance, Hazard Evaluations and Field Studies; Centers for Disease Control and Prevention; Cincinnati Ohio
| | - William Raudabaugh
- Alice Hamilton Laboratory, National Institute for Occupational Safety and Health, Division of Surveillance, Hazard Evaluations and Field Studies; Centers for Disease Control and Prevention; Cincinnati Ohio
| | - Susan Nowlin
- Alice Hamilton Laboratory, National Institute for Occupational Safety and Health, Division of Surveillance, Hazard Evaluations and Field Studies; Centers for Disease Control and Prevention; Cincinnati Ohio
| | - Ahmed Gomaa
- Alice Hamilton Laboratory, National Institute for Occupational Safety and Health, Division of Surveillance, Hazard Evaluations and Field Studies; Centers for Disease Control and Prevention; Cincinnati Ohio
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Iennaco JD, Whittemore R, Dixon J. Aggressive Event Incidence using the Staff Observation of Aggression Scale-Revised (SOAS-R): A Longitudinal Study. Psychiatr Q 2017; 88:485-499. [PMID: 27562175 DOI: 10.1007/s11126-016-9462-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
The aim of this study was to identify aggressive event incidence rates in the inpatient psychiatric setting, describe characteristics of events and differences based on aggression target and type (verbal vs. physical). A longitudinal study was carried out of aggressive events identified by workers in four inpatient psychiatric units using the Staff Observation of Aggression Scale-Revised (SOAS-R) over 6 weeks. A total of 113 aggressive events were recorded resulting in a rate of 13.27 events per bed per year. Verbal aggression was demonstrated in 86 % and physical aggression in 57 % of events. Most events (70.8 %, n = 81) targeted a worker. Compared to other targets, workers were 3.4 times more likely to feel threatened (95 % CI 1.2-9.6, χ2 = 5.08, p = 0.0242), and less likely to have a visible injury (OR 0.15, 95 % CI 0.04-0.6; χ2 = 7.1, p = 0.0078). Event severity ranged from 0 to 21 with a mean of 9.5(SD = 5.1), with 20 % considered severe. Verbal events had lower mean severity of 6.5(SD = 3.8) versus physical events with a severity of 11.8(SD = 4.8; t = 6.5, df = 111, p < 0.0001). In 57.5 % of events there was no consequence to the victim. For most events (76 %) resolution included workers talking to the patient, while 54 % involved use of medication. Restrictive measures (physical hold, seclusion or physical restraint) were involved in 24.8 % of events. Aggression incidence was similar to incidence found in other studies. Workers were the target of most aggressive events and many were identified as having no understandable provocation. Further understanding of event characteristics will promote more effective prevention and management of aggressive events.
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Çelik AK, Oktay E, Çebi K. Analysing workplace violence towards health care staff in public hospitals using alternative ordered response models: the case of north-eastern Turkey. INTERNATIONAL JOURNAL OF OCCUPATIONAL SAFETY AND ERGONOMICS 2017; 23:328-339. [DOI: 10.1080/10803548.2017.1316612] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
| | - Erkan Oktay
- Department of Econometrics, Atatürk University, Turkey
| | - Kübranur Çebi
- Graduate School of Social Sciences, Atatürk University, Turkey
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Yragui NL, Demsky CA, Hammer LB, Van Dyck S, Neradilek MB. Linking Workplace Aggression to Employee Well-Being and Work: The Moderating Role of Family-Supportive Supervisor Behaviors (FSSB). JOURNAL OF BUSINESS AND PSYCHOLOGY 2017; 32:179-196. [PMID: 29563665 PMCID: PMC5858561 DOI: 10.1007/s10869-016-9443-z] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
PURPOSE The present study examined the moderating effects of family-supportive supervisor behaviors (FSSB) on the relationship between two types of workplace aggression (i.e., patient-initiated physical aggression and coworker-initiated psychological aggression) and employee well-being and work outcomes. METHODOLOGY Data were obtained from a field sample of 417 healthcare workers in two psychiatric hospitals. Hypotheses were tested using moderated multiple regression analyses. FINDINGS Psychiatric care providers' perceptions of FSSB moderated the relationship between patient-initiated physical aggression and physical symptoms, exhaustion and cynicism. In addition, FSSB moderated the relationship between coworker-initiated psychological aggression and physical symptoms and turnover intentions. IMPLICATIONS Based on our findings, family-supportive supervision is a plausible boundary condition for the relationship between workplace aggression and well-being and work outcomes. This study suggests that, in addition to directly addressing aggression prevention and reduction, family-supportive supervision is a trainable resource that healthcare organizations should facilitate to improve employee work and well-being in settings with high workplace aggression. ORIGINALITY This is the first study to examine the role of FSSB in influencing the relationship between two forms of workplace aggression: patient-initiated physical and coworker- initiated psychological aggression and employee outcomes.
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Affiliation(s)
- Nanette L Yragui
- Washington State Department of Labor & Industries, SHARP Program, 243 Israel Rd SE, Bldg 3, Olympia, WA 98501, USA
| | - Caitlin A Demsky
- Department of Psychology, Portland State University, Portland, OR, USA
| | - Leslie B Hammer
- Department of Psychology, Portland State University, Portland, OR, USA
| | - Sarah Van Dyck
- Department of Psychology, Portland State University, Portland, OR, USA
| | - Moni B Neradilek
- The Mountain-Whisper-Light Statistical Consulting, Seattle, WA, USA
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Aivazi AA, Menati W, Tavan H, Navkhasi S, Mehrdadi A. Patients' bill of rights and effective factors of workplace violence against female nurses on duty at Ilam teaching hospitals. J Inj Violence Res 2017; 9:779. [PMID: 28039684 PMCID: PMC5279987 DOI: 10.5249/jivr.v9i1.779] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2015] [Accepted: 07/06/2016] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Workplace violence against female nurses is an increasing problem. In addition, recognition the rights of patients can reduce such violence against female nurses. Therefore, the aim of the current study was to investigate workplace violence against female nurses in respect with patients' bill of rights at two public hospitals of Ilam in 2012. METHODS In a descriptive cross-sectional research, workplace violence against female nurses was studied. Data were gathered employing a researcher made questionnaire filled out by 106 female nurses. The questionnaire was on workplace, physical and verbal violence of patients and their attendants, and also the patient's rights as respected by nursing staff. Permission of university ethics committee was obtained. Data analyses were done by T-test and ANOVA in SPSS software. RESULTS Totally, 90.6 % and 15.1 % of the participants were subjected to verbal and physical assaults by patients, respectively during last year of the study. Further, 92.5% and 11.3% of nurses experienced verbal and physical assaults by the patients' attendants, respectively. Most of the nursing staff believed that reporting aggressive attacks to the concerned officials would not be useful. A negative significant correlation was found between the aggressions of patients with age as well as marital status of nurses, (P= 0.04). Furthermore, a significant association was seen between physical violence of patients and the nurses' recognition of the patients' bill of rights (P= 0.03). CONCLUSIONS Due to high rate of violence against female nurses, some proper and effective actions such as employing a trained security force along with legal punitive charges against violators through responsible officials are highly suggested.
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Affiliation(s)
| | | | - Hamed Tavan
- Department of Nursing, Psychosocial Injuries Research Center, Ilam University of Medical Sciences, Ilam, Iran.
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Pompeii LA, Schoenfisch A, Lipscomb HJ, Dement JM, Smith CD, Conway SH. Hospital workers bypass traditional occupational injury reporting systems when reporting patient and visitor perpetrated (type II) violence. Am J Ind Med 2016; 59:853-65. [PMID: 27409575 DOI: 10.1002/ajim.22629] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/23/2016] [Indexed: 01/04/2023]
Abstract
BACKGROUND Under-reporting of type II (patient/visitor-on-worker) violence by workers has been attributed to a lack of essential event details needed to inform prevention strategies. METHODS Mixed methods including surveys and focus groups were used to examine patterns of reporting type II violent events among ∼11,000 workers at six U.S. hospitals. RESULTS Of the 2,098 workers who experienced a type II violent event, 75% indicated they reported. Reporting patterns were disparate including reports to managers, co-workers, security, and patients' medical records-with only 9% reporting into occupational injury/safety reporting systems. Workers were unclear about when and where to report, and relied on their own "threshold" of when to report based on event circumstances. CONCLUSIONS Our findings contradict prior findings that workers significantly under-report violent events. Coordinated surveillance efforts across departments are needed to capture workers' reports, including the use of a designated violence reporting system that is supported by reporting policies. Am. J. Ind. Med. 59:853-865, 2016. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- Lisa A. Pompeii
- Division of Epidemiology, Human Genetics, Environmental Sciences, School of Public Health; University of Texas Medical Center; Houston Texas
| | - Ashley Schoenfisch
- Department of Occupational Medicine; Duke University Medical Center; Durham North Carolina
| | - Hester J. Lipscomb
- Department of Occupational Medicine; Duke University Medical Center; Durham North Carolina
| | - John M. Dement
- Department of Occupational Medicine; Duke University Medical Center; Durham North Carolina
| | | | - Sadie H. Conway
- Division of Epidemiology, Human Genetics, Environmental Sciences, School of Public Health; University of Texas Medical Center; Houston Texas
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Ferri P, Silvestri M, Artoni C, Di Lorenzo R. Workplace violence in different settings and among various health professionals in an Italian general hospital: a cross-sectional study. Psychol Res Behav Manag 2016; 9:263-275. [PMID: 27729818 PMCID: PMC5042196 DOI: 10.2147/prbm.s114870] [Citation(s) in RCA: 141] [Impact Index Per Article: 17.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Background Workplace violence (WPV) against health professionals is a global problem with an increasing incidence. The aims of this study were as follows: 1) to examine the frequency and characteristics of WPV in different settings and professionals of a general hospital and 2) to identify the clinical and organizational factors related to this phenomenon. Methods The study was cross-sectional. In a 1-month period, we administered the “Violent Incident Form” to 745 professionals (physicians, head nurses, nurses, nursing assistants), who worked in 15 wards of a general hospital in northern Italy. Results With a response rate of 56%, 45% of professionals reported WPV. The most frequently assaulted were nurses (67%), followed by nursing assistants (18%) and physicians (12%). The first two categories were correlated, in a statistically significant way, with the risk of WPV (P=0.005, P=0.004, multiple logistic regression). The violent incidents more frequently occurred in psychiatry department (86%), emergency department (71%), and in geriatric wards (57%). The assailants more frequently were males whereas assaulted professionals more often were females. Men committed physical violence more frequently than women, in a statistically significant way (P=0.034, chi-squared test). Verbal violence (51%) was often committed by people in a lucid and normal state of consciousness; physical violence (49%) was most often perpetrated by assailants affected by dementia, mental retardation, drug and substance abuse, or other psychiatric disorders. The variables positively related to WPV were “calling for help during the attack” and “physical injuries suffered in violent attack” (P=0.02, P=0.03, multiple logistic regression). Conclusion This study suggests that violence is a significant phenomenon and that all health workers, especially nurses, are at risk of suffering aggressive assaults. WPV presented specific characteristics related to the health care settings, where the aggression occurred. Prevention programs tailored to the different care needs are necessary to promote professional awareness for violence risk.
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Affiliation(s)
- Paola Ferri
- Department of Diagnostic, Clinical and Public Health Medicine, School of Nursing
| | - Monica Silvestri
- Department of Diagnostic, Clinical and Public Health Medicine, School of Nursing
| | | | - Rosaria Di Lorenzo
- Department of Mental Health, Service of Psychiatric Diagnosis and Treatment, Modena, Italy
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Al-Turki N, Afify AA, AlAteeq M. Violence against health workers in Family Medicine Centers. J Multidiscip Healthc 2016; 9:257-66. [PMID: 27330300 PMCID: PMC4898428 DOI: 10.2147/jmdh.s105407] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Health care violence is a significant worldwide problem with negative consequences on both the safety and well-being of health care workers as well as workplace activities. Reports examining health care violence in Saudi Arabia are limited and the results are conflicting. OBJECTIVE To estimate the prevalence and determine the demographic and occupational characteristics associated with workplace violence in primary care centers in Riyadh, Saudi Arabia. METHODS A cross-sectional study included 270 health care workers in 12 family medicine centers in Riyadh during November and December 2014. A structured self-administered questionnaire was used to estimate the frequency, timing, causes, reactions, and consequences of workplace violence plus participants' demographic and occupational data. RESULTS A total 123 health care workers (45.6%) experienced some kind of violence over 12 months prior to the study. These included physical (6.5%) and nonphysical violence (99.2%), including verbal violence (94.3%) and intimidation (22.0%). Offenders were patients (71.5%) in the majority of cases, companions (20.3%), or both (3.3%). Almost half (48.0%) of health care workers who experienced violence did nothing, 38.2% actively reported the event, and 13.8% consulted a colleague. A significant association of workplace violence was found with working multiple shifts, evening or night shift, and lack of an encouraging environment to report violence. CONCLUSION Workplace violence is still a significant problem in primary care centers. The high frequency of violence together with underreporting may indicate the inefficiency of the current safety program. More safety programs and training activities for health care workers, efficient reporting system, and zero tolerance policies need to be implemented to minimize workplace violence against health workers.
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Affiliation(s)
- Nouf Al-Turki
- Family Medicine Department, Prince Sultan Military Medical City, National Guard Health Affairs, Riyadh, Kingdom of Saudi Arabia
| | - Ayman Am Afify
- Family Medicine Department, Prince Sultan Military Medical City, National Guard Health Affairs, Riyadh, Kingdom of Saudi Arabia
| | - Mohammed AlAteeq
- Department of Family Medicine and PHC, King Abdul-Aziz Medical City, National Guard Health Affairs, Riyadh, Kingdom of Saudi Arabia
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Affiliation(s)
- James P Phillips
- From Harvard Medical School and the Department of Emergency Medicine, Beth Israel Deaconess Medical Center - both in Boston
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Hazif-Thomas C, Thomas P. [Empathy fatigue and psychiatric care of the elderly]. SOINS. GÉRONTOLOGIE 2015:33-6. [PMID: 26364820 DOI: 10.1016/j.sger.2015.07.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
Empathy is one of the qualities which enable caregivers to develop high quality care. The circumstances of professional practice such as pressure and lack of time can see this quality pushed to one side. The risk of burnout is all the greater as empathy alone does not protect caregivers from submitting themselves to their hierarchy. Compassion, on the other hand, enables caregivers to actively take on their responsibilities.
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Affiliation(s)
| | - Philippe Thomas
- CH Bohars, 29820 Bohars, CHRU Brest, UBO, EA 4686, 29200 Brest, France
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Physical Violence against General Practitioners and Nurses in Chinese Township Hospitals: A Cross-Sectional Survey. PLoS One 2015; 10:e0142954. [PMID: 26571388 PMCID: PMC4646672 DOI: 10.1371/journal.pone.0142954] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2015] [Accepted: 10/28/2015] [Indexed: 11/20/2022] Open
Abstract
Purpose The purpose of this study is to identify risk factors of physical violence in Chinese township hospitals. Methods A cross-sectional survey was used in a sample of 442 general practitioners and 398 general nurses from 90 township hospitals located in Heilongjiang province, China (response rate = 84.8%). Results A total of 106 of the 840 (12.6%) respondents reported being physically attacked in their workplace in the previous 12 months. Most perpetrators were the patients’ relatives (62.3%), followed by the patient (22.6%); 73.6% of perpetrators were aged between 20 and 40 years. Of the physical violence incidents, about 56.6% (n = 60) resulted in a physical injury, and 45.4% of respondents took two or three days of sick leave. Reporting workplace violence in hospitals to superiors or authorities was low (9.4%). Most respondents (62.8%) did not receive training on how to avoid workplace violence. Logistic regression analyses indicated that general nurses, aged 35 years or younger, and with a higher-level professional title were more likely to experience physical violence. Healthcare workers with direct physical contact (washing, turning, lifting) with patients had a higher risk of physical violence compared to other health care workers. Procedures for reporting workplace violence were a protective factor for physical violence; when in place, reporting after psychological violence (verbal abuse, bullying/mobbing, harassment, and threats) was more protective than waiting until an instance of physical violence (beating, kicking, slapping, stabbing, etc.). Conclusions Physical violence in Chinese township hospitals is an occupational hazard of rural public health concern. Policies, procedures, and intervention strategies should be undertaken to manage this issue.
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Wu JC, Tung TH, Chen PY, Chen YL, Lin YW, Chen FL. Determinants of workplace violence against clinical physicians in hospitals. J Occup Health 2015; 57:540-7. [PMID: 26423827 DOI: 10.1539/joh.15-0111-oa] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVES Workplace violence in the health sector is a worldwide concern. Physicians play an essential role in health-care teamwork; thus, understanding how organizational factors influence workplace violence against physicians is critical. METHODS A total of 189 physicians from three public hospitals and one private hospital in Northern Taiwan completed a survey, and the response rate was 47.1%. This study was approved by the institutional review board of each participating hospital. The 189 physicians were selected from the Taipei area, Taiwan. RESULTS The results showed that 41.5% of the respondents had received at least one workplace-related physical or verbal violent threat, and that 9.8% of the respondents had experienced at least one episode of sexual harassment in the 3 months before the survey. Logistic regression analysis revealed that physicians in psychiatry or emergency medicine departments received more violent threats and sexual harassment than physicians in other departments. Furthermore, physicians with a lower workplace safety climate (OR=0.89; 95% CI=0.81-0.98) and more job demands (OR=1.15; 95% CI=1.02-1.30) were more likely to receive violent threats. CONCLUSIONS This study found that workplace violence was associated with job demands and the workplace safety climate. Therefore, determining how to develop a workplace safety climate and ensure a safe job environment for physicians is a crucial management policy issue for health-care systems.
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Affiliation(s)
- Jeng-Cheng Wu
- Department of Urology, Taipei Medical University Hospital
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Liu H, Zhao S, Jiao M, Wang J, Peters DH, Qiao H, Zhao Y, Li Y, Song L, Xing K, Lu Y, Wu Q. Extent, Nature, and Risk Factors of Workplace Violence in Public Tertiary Hospitals in China: A Cross-Sectional Survey. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2015; 12:6801-17. [PMID: 26086703 PMCID: PMC4483731 DOI: 10.3390/ijerph120606801] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/27/2015] [Revised: 06/01/2015] [Accepted: 06/09/2015] [Indexed: 11/16/2022]
Abstract
Using a cross-sectional survey design from 11 public tertiary hospitals (a specialist hospital, four Chinese medicine hospitals, and six general hospitals) in the urban areas of Heilongjiang, we determined the nature of workplace violence that medical staff have encountered in Chinese hospitals and identified factors associated with those experiences of violence. A total of 1129 health workers participated. The specialist hospital had the highest prevalence of physical violence (35.4%), while the general hospitals had the highest prevalence of non-physical violence (76%). Inexperienced medical staff (p < 0.001) were more likely to suffer non-physical violence than physical violence in Chinese medicine hospitals compared to experienced staff. Medical units (p = 0.001) had a high risk of non-physical violence, while surgical units (p = 0.005) had a high risk of physical violence. In general hospitals, staff with higher levels of anxiety about workplace violence were more vulnerable to both physical violence (1.67, 95% CI 1.36–2.10) and non-physical violence (1.309, 95% CI 1.136–1.508) compared to those with lower levels of anxiety, while rotating shift workers had a higher odds of physical violence (2.2, 95% CI 1.21–4.17) and non-physical violence (1.65, 95% CI 1.13–2.41) compared to fixed day shift workers. Thus, prevention should focus not only on high-risk sections of hospitals, but also on the nature of the hospital itself.
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Affiliation(s)
- He Liu
- Department of Health Policy and Hospital Management, School of Public Health, Harbin Medical University, 157 Baojian Road, Nangang District, Harbin 150081, China.
| | - Siqi Zhao
- Department of Health Policy and Hospital Management, School of Public Health, Harbin Medical University, 157 Baojian Road, Nangang District, Harbin 150081, China.
| | - Mingli Jiao
- Department of Health Policy and Hospital Management, School of Public Health, Harbin Medical University, 157 Baojian Road, Nangang District, Harbin 150081, China.
- Institute of Quantitative &Technical Economics, Chinese Academy of Social Science, 5 Jian Guo Men Nei Road, Dongcheng District, Beijing 100000, China.
| | - Jingtao Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Harbin Medical University, 157 Baojian Road, Nangang District, Harbin 150081, China.
| | - David H Peters
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe St., Baltimore, MD 21205, USA.
| | - Hong Qiao
- Endocrine and Metabolic Diseases, The 2nd Affiliated Hospital of Harbin Medical University, 246 Xuefu Road, Nangang District, Harbin 150081, China.
| | - Yuchong Zhao
- Heilongjiang Nursing College, 209 Xuefu Road, Nangang District, Harbin 150081, China.
| | - Ye Li
- Department of Health Policy and Hospital Management, School of Public Health, Harbin Medical University, 157 Baojian Road, Nangang District, Harbin 150081, China.
| | - Lei Song
- Department of Social Medicine, School of Public Health, Harbin Medical University, 157 Baojian Road, Nangang District, Harbin 150081, China.
| | - Kai Xing
- Department of Health Policy and Hospital Management, School of Public Health, Harbin Medical University, 157 Baojian Road, Nangang District, Harbin 150081, China.
| | - Yan Lu
- School of Public Health, Jiamusi University, Jiamusi 154007, China.
| | - Qunhong Wu
- Department of Social Medicine, School of Public Health, Harbin Medical University, 157 Baojian Road, Nangang District, Harbin 150081, China.
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Workplace Violence: A Survey of Nationally Registered Emergency Medical Services Professionals. ACTA ACUST UNITED AC 2015. [DOI: 10.1155/2015/137246] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Previous studies on violence against prehospital personnel have mainly reported on “verbal” and “physical” violence. This study explored how provider demographic and work-related characteristics were associated with five different forms of workplace violence (being cursed or threatened; being punched, slapped, or scratched; being spat upon; being stabbed/stabbing attempt; and being shot/shooting attempt). A cohort of nationally registered United States Emergency Medical Services professionals was surveyed to determine the experience of each of these types of patient initiated violence by these providers and their partners. Multivariable logistic regression analyses indicated gender was significantly associated with both being cursed/threatened and being stabbed or experiencing a stabbing attempt (odds ratio (OR) = 0.65, CI = 0.44–0.96; OR = 0.27, CI = 0.09–0.75, resp.). Level of EMT practice was significantly associated with being cursed/threatened, being spat upon, and being punched, slapped, or scratched (OR = 0.17, CI = 0.11–0.27; OR = 0.30, CI = 0.21–0.43; OR = 0.31, CI = 0.22–0.44, resp.). Both community size and experience were significantly associated with all the types of violence investigated. EMS workplace violence research is at its infancy; thus this study adds to a limited but growing body of knowledge.
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Keyvanara M, Maracy MR, Ziari NB. A study conducted on the demographic factors of victims of violence in support and administrative departments of hospital in 2013. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2015; 4:35. [PMID: 26097849 PMCID: PMC4456864 DOI: 10.4103/2277-9531.157192] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
BACKGROUND Violence is now regarded as a serious problem and its complication causes heavy costs on the healthcare systems. The present study aimed to investigate the correlation between some demographic characteristics and confrontation with violence. Since there is no study on the prevalence of violence among the support and administration staff of hospitals in Iran, this study was conducted to investigate violence in these departments. MATERIALS AND METHODS This descriptive-analytical and correlation survey was carried out by census among the support and administrative staff interacting with patients and their companions in Al-Zahra University Hospital of Isfahan in 2013. Research tool was a researcher-made questionnaire including five domains: Personal information, workplace information, verbal violence, physical violence, and other violent acts. Its validity was evaluated by experts reviewing it and its reliability by test-retest (r =0.9). Finally, data were analyzed using descriptive statistical indicators and statistical tests such as Chi-square for sex, marital status, and work department and Mann-Whitney U test for age, level of education, work experience, and violence types by the statistical software SPSS version 20. RESULTS According to the results obtained, 81% of subjects had been abused at least once and the most reported violence was related to verbal violence (78.4%). There was significant correlation between sex and violence and men were the main victims of violence, but there was no relation between marital status, age, and violence. Work experience was correlated to physical violence and other violent acts conversely. There was also an inverse correlation between physical violence and education; also, security staff faced more violence than others. CONCLUSION As high prevalence of violence was found especially among the security staff and personnel with less education and work experience, it is suggested to take actions such as educating about patient accompaniment and visiting condition, holding training workshops on confronting with violence and appropriate communication with patients and families, using experienced and patient staff to interact with clients.
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Affiliation(s)
- Mahmoud Keyvanara
- Department of Health Services Management, School of Management and Medical Information, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mohammad Reza Maracy
- Department of Epidemiology and Biostatistics, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Najmeh Bahman Ziari
- Department of Health Economics and Management, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
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Azar M, Badr LK, Samaha H, Dee V. Does administrative support negate the consequences of nurse abuse? J Nurs Manag 2015; 24:E32-43. [DOI: 10.1111/jonm.12286] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/10/2014] [Indexed: 11/27/2022]
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Aivazi AA, Tavan H. Prevalence of conceived violence against nurses at educational hospitals of Ilam, Iran, 2012. INTERNATIONAL JOURNAL OF AFRICA NURSING SCIENCES 2015. [DOI: 10.1016/j.ijans.2015.04.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
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Dement JM, Lipscomb HJ, Schoenfisch AL, Pompeii LA. Impact of hospital type II violent events: use of psychotropic drugs and mental health services. Am J Ind Med 2014; 57:627-39. [PMID: 24526348 DOI: 10.1002/ajim.22306] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/17/2014] [Indexed: 11/07/2022]
Abstract
BACKGROUND While violence can adversely affect mental health of victims, repercussions of violence against workers is not as well characterized. MATERIALS AND METHODS We explored relationships between workplace violent events perpetrated by patients or visitors (Type II) against hospital employees and the employee use of psychotropic medications or mental health services using a data system that linked violent events with health claims. RESULTS Significant associations were observed between reported Type II workplace violent events and employee prescription claims for anti-depressants and anxiolytics combined (RR = 1.45, 95% CI = 1.01-2.33) and anti-depressants alone (RR = 1.65, 95% CI = 1.10-2.48). No significant association between reported violent events and health claims for treatment of depression or anxiety was observed. CONCLUSIONS Type II violence experienced by hospital workers may lead to increased use of psychotropic drugs, particularly anti-depressants but also anxiolytics. Our results suggest an important role of employee assistance programs in mitigating the psychological consequences of workplace violent events.
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Affiliation(s)
- John M. Dement
- Division of Occupational and Environmental Medicine; Duke University Medical Center; Durham North Carolina
| | - Hester J. Lipscomb
- Division of Occupational and Environmental Medicine; Duke University Medical Center; Durham North Carolina
| | - Ashley L. Schoenfisch
- Division of Occupational and Environmental Medicine; Duke University Medical Center; Durham North Carolina
| | - Lisa A. Pompeii
- The University of Texas; School of Public Health; Houston Texas
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Sabbath EL, Hurtado DA, Okechukwu CA, Tamers SL, Nelson C, Kim SS, Wagner G, Sorenson G. Occupational injury among hospital patient-care workers: what is the association with workplace verbal abuse? Am J Ind Med 2014; 57:222-32. [PMID: 24151093 DOI: 10.1002/ajim.22271] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/23/2013] [Indexed: 01/03/2023]
Abstract
OBJECTIVE To test the association between workplace abuse exposure and injury risk among hospital workers. We hypothesized that exposed workers would have higher injury rates than unexposed workers. METHODS Survey of direct-care workers (n = 1,497) in two hospitals. Exposure to workplace abuse was assessed through self-report; occupational injury reports were extracted from employee records. We tested associations between non-physical workplace violence and injury using log-binomial regression and multilevel modeling. RESULTS Adjusted prevalence ratio (PR) for injury associated with being yelled at was 1.52 (95% CI 1.19, 1.95); for experiencing hostile/offensive gestures 1.43 (1.11, 1.82); and for being sworn at 1.41 (1.09, 1.81). In analyses by injury subtypes, musculoskeletal injuries were more strongly associated with abuse than were acute traumatic injuries. Associations operated on group and individual levels and were most consistently associated with abuse perpetrated by patients. CONCLUSION Exposure to workplace abuse may be a risk factor for injuries among hospital workers.
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Affiliation(s)
- Erika L. Sabbath
- Harvard Center for Population and Development Studies; Cambridge Massachusetts
| | - David A. Hurtado
- Department of Social and Behavioral Sciences; Harvard School of Public Health; Boston Massachusetts
| | - Cassandra A. Okechukwu
- Department of Social and Behavioral Sciences; Harvard School of Public Health; Boston Massachusetts
| | - Sara L. Tamers
- Department of Social and Behavioral Sciences; Harvard School of Public Health; Boston Massachusetts
- Center for Community-Based Research; Dana-Farber Cancer Institute; Boston Massachusetts
| | - Candace Nelson
- Department of Environmental Health; Harvard School of Public Health; Boston Massachusetts
| | - Seung-Sup Kim
- Department of Healthcare Management; Korea University; Seoul Republic of Korea
- Department of Environmental and Occupational Health; The George Washington University School of Public Health and Health Services; Washington District of Columbia
| | - Gregory Wagner
- Department of Environmental Health; Harvard School of Public Health; Boston Massachusetts
- National Institute for Occupational Safety and Health; Washington District of Columbia
| | - Glorian Sorenson
- Department of Social and Behavioral Sciences; Harvard School of Public Health; Boston Massachusetts
- Center for Community-Based Research; Dana-Farber Cancer Institute; Boston Massachusetts
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Wada K, Suehiro Y. Violence chain surrounding patient-to-staff violence in Japanese hospitals. ARCHIVES OF ENVIRONMENTAL & OCCUPATIONAL HEALTH 2014; 69:121-124. [PMID: 24205964 DOI: 10.1080/19338244.2012.750587] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
The aim of this study was to determine if patient-to-staff violence is associated with staff-to-staff violence and patient-to-patient violence among nurses and patient service clerks. A survey was conducted using an anonymous questionnaire for attendees of a lecture on antiviolence in health care institutions. Patient-to-staff verbal violence was associated with staff-to-staff verbal violence (odds ratio [OR] = 1.43; 95% confidence interval [CI]: 1.16-1.66). Patient-to-staff physical violence was associated with staff-to-staff physical violence (OR = 7.80; 95% CI: 1.86-13.5) and patient-to-patient verbal violence (OR = 2.69; 95% CI: 1.18-5.42). Patient-to-staff sexual harassment was associated with staff-to-staff sexual harassment (OR = 6.55; 95% CI: 3.59-8.91) and patient-to-patient verbal violence (OR = 2.96; 95% CI: 1.44-5.17). Staff who had experienced patient-to-staff violence were likely to have experienced violence by other staff and to have witnessed or reported violence among patients.
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Affiliation(s)
- Koji Wada
- a National Center for Global Health and Medicine , Tokyo , Japan
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Ünsal Atan S, Baysan Arabaci L, Sirin A, Isler A, Donmez S, Unsal Guler M, Oflaz U, Yalcinkaya Ozdemir G, Yazar Tasbasi F. Violence experienced by nurses at six university hospitals in Turkey. J Psychiatr Ment Health Nurs 2013; 20:882-9. [PMID: 23216948 DOI: 10.1111/jpm.12027] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/08/2012] [Indexed: 11/30/2022]
Abstract
This research was conducted to analyse the violence experienced by nurses employed at six university hospitals. A descriptive and cross-sectional study was conducted. The research sample consisted of 441 nurses who worked in the emergency, intensive care and psychiatry units of six university hospitals in Turkey between June 2008 and June 2009 and who voluntarily agreed to participate. It was found that 60.8% of the nurses were subjected to verbal violence and/or physical violence from patients, visitors or health staff. Of the nurses who were subjected to workplace violence, 42.9% stated that their experience of verbal and/or physical violence had a negative impact on their physical and/or psychological health, and 42.9% stated that their work performance was negatively affected. Of these nurses, 1.8% stated that they received professional help, 13.6% stated that a report was made and 9.5% stated that they contacted the hospital police in some way. According to the findings of this research, similar to the situation worldwide, nurses in Turkey are subjected to verbal and/or physical violence from patients, visitors and health staff.
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Pompeii L, Dement J, Schoenfisch A, Lavery A, Souder M, Smith C, Lipscomb H. Perpetrator, worker and workplace characteristics associated with patient and visitor perpetrated violence (Type II) on hospital workers: a review of the literature and existing occupational injury data. JOURNAL OF SAFETY RESEARCH 2013; 44:57-64. [PMID: 23398706 DOI: 10.1016/j.jsr.2012.09.004] [Citation(s) in RCA: 72] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/09/2012] [Revised: 09/21/2012] [Accepted: 09/24/2012] [Indexed: 06/01/2023]
Abstract
PROBLEM Non-fatal type II violence experienced by hospital workers (patient/visitor-on-worker violence) is not well described. METHODS Hospital administration data (2004-2009) were examined for purposes of calculating rates of type II violent events experienced by workers. We also conducted a review of the hospital-based literature (2000-2010) and summarized findings associated with type II violence. RESULTS 484 physical assaults were identified in the data, with a rate of 1.75 events/100 full-time equivalents. Only few details about events were captured, while non-physical events were not captured. The literature yielded 17 studies, with a range proportion of verbal abuse (22%-90%), physical threats (12%-64%) and assaults (2%-32%) reported. The literature lacked rigorous methods for examining incidence and circumstances surrounding events or rates of events over time. DISCUSSION For purposes of examining the impact of type II violence on worker safety, satisfaction and retention, rigorous surveillance efforts by hospital employers and researchers are warranted.
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Affiliation(s)
- Lisa Pompeii
- The University of Texas, School of Public Health, 1200 Herman Pressler, RAS E617, Houston, Texas 77030, USA
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Lamont S, Brunero S, Bailey A, Woods K. Breakaway technique training as a means of increasing confidence in managing aggression in neuroscience nursing. AUST HEALTH REV 2012; 36:313-9. [PMID: 22935124 DOI: 10.1071/ah11001] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2011] [Accepted: 11/03/2011] [Indexed: 11/23/2022]
Abstract
OBJECTIVE The objective of this paper was to evaluate breakaway technique training with neuroscience nursing staff as a measure of increased confidence and safety in managing aggression. METHODS A quasi experimental design was used in a sample of neuroscience nursing staff (n=31), participating in 2×1h breakaway technique workshops. The workshops consisted of supervised skills training in safe breakaway techniques. A pre- and postintervention-matched questionnaire measuring confidence and safety around managing aggressive patients, and exposure to and confidence in dealing with breakaways, was self administered. RESULTS Statistically significant increases in confidence and safety in working with aggressive patients, and confidence levels for safe breakaways were reported. Qualitative comments demonstrated a desire for ongoing skills workshops. CONCLUSIONS This study provides early evidence of the importance of incorporating breakaway training into existing training programs which aim to minimise and manage aggression and violence in generalist settings.
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Affiliation(s)
- Scott Lamont
- Mental Health Liaison Nursing, Prince of Wales Hospital, Barker St, Randwick, NSW 2031, Australia.
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Gascon S, Leiter MP, Andrés E, Santed MA, Pereira JP, Cunha MJ, Albesa A, Montero-Marín J, García-Campayo J, Martínez-Jarreta B. The role of aggressions suffered by healthcare workers as predictors of burnout. J Clin Nurs 2012; 22:3120-9. [PMID: 22978353 DOI: 10.1111/j.1365-2702.2012.04255.x] [Citation(s) in RCA: 64] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
AIMS AND OBJECTIVES To examine the prevalence of aggression against healthcare professionals and to determine the possible impact that violent episodes have on healthcare professionals in terms of loss of enthusiasm and involvement towards work. The objective was to analyse the percentage of occupational assault against professionals' aggression in different types of healthcare services, differentiating between physical and verbal aggression as a possible variable in detecting burnout in doctors and nursing professionals. BACKGROUND Leiter and Maslach have explored a double process model of burnout not only based on exhaustion by overload, but also based on personal and organisational value conflicts (community, rewards or values). Moreover, Whittington has obtained conclusive results about the possible relationship between violence and burnout in mental health nurses. DESIGN A retrospective study was performed in three hospitals and 22 primary care centres in Spain (n = 1·826). METHODS Through different questionnaires, we have explored the relationship between aggression suffered by healthcare workers and burnout. RESULTS Eleven percent of respondents had been physically assaulted on at least one occasion, whilst 34·4% had suffered threats and intimidation on at least one occasion and 36·6% had been subjected to insults. Both forms of violence, physical and non-physical aggression, showed significant correlations with symptoms of burnout (emotional exhaustion, depersonalisation and inefficacy). CONCLUSIONS The survey showed evidence of a double process: (1) by which excess workload helps predict burnout, and (2) by which a mismatch in the congruence of values, or interpersonal conflict, contributes in a meaningful way to each of the dimensions of burnout, adding overhead to the process of exhaustion-cynicism-lack of realisation. Relevance to clinical practice. Studies indicate that health professionals are some of the most exposed to disorders steaming from psychosocial risks and a high comorbidity: anxiety, depression, etc. There is a clear need for accurate instruments of evaluation to detect not only the burnout but also the areas that cause it. Professional exhaustion caused by aggression or other factors can reflect a deterioration in the healthcare relationship.
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Affiliation(s)
- Santiago Gascon
- Authors: Santiago Gascon, PhD, Assistant Professor, Department of Psychology, Zaragoza University, Teruel, Spain; Michael P Leiter, PhD, Professor, Centre for Organisational and Development Research, Acadia University, Wolfville, NS, Canada; Joao P Pereira, PhD, Assistant Professor, Instituto Superior de Maia, Castelo da Maia; María J Cunha, PhD, Assistant Professor, Instituto Superior de Maia, Castelo da Maia, Portugal; Agustín Albesa, PhD Student, Psychologist and Lawyer, Department of Psychology, Zaragoza University, Zaragoza; Jesus Montero-Marín, PhD, Assistant Professor, Zaragoza University, Zaragoza; Javier García-Campayo, PhD, Professor, Department of Psychiatry Zaragoza University, Zaragoza, Spain
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Kim IH, Noh S, Muntaner C. Emotional demands and the risks of depression among homecare workers in the USA. Int Arch Occup Environ Health 2012; 86:635-44. [PMID: 22777396 DOI: 10.1007/s00420-012-0789-x] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2011] [Accepted: 06/11/2012] [Indexed: 11/27/2022]
Abstract
PURPOSE Homecare workers' diversity of emotional demands and their relation to mental health problems have not yet been fully explored. The purpose of this study is to investigate the types of emotional demands on homecare workers and the association of these demands with depression. METHOD Data were collected from two surveys of a random sample of 1,599 homecare workers (June 2003-September 2003 and December 2003-February 2004). Depression was assessed using a 20-item RCES-D screening scale. RESULTS Homecare workers appeared to have a variety of emotional demands: unfair treatment, client's family abuse, unmet care needs, client health, and emotional suppression. In general, homecare workers were more likely to be exposed to their client health and emotional suppression (mean scores = 1.46-3.07) than to be exposed to unmet care needs, unfair treatment, and client's family abuse (mean scores = 1.02-1.38). After adjusting for potential confounders, four emotional-demand factors (excluding the client health factor) were significantly associated with a high risk of subthreshold depression at Wave 1. In particular, the factor "unmet care needs" was an essential predictor of 6-month subthreshold depression at Wave 2. CONCLUSION This study illustrated the diversity of emotional demands among homecare workers and their association with depression. Our mixed findings regarding the cross-sectional and longitudinal analyses suggested that further research should refine the measurement of emotional demands and their relationship with mental health among homecare workers.
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Affiliation(s)
- Il-Ho Kim
- Social and Epidemiological Research, Centre for Addiction and Mental Health, Toronto, ON, Canada
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Clarke CM, Kane DJ, Rajacich DL, Lafreniere KD. Bullying in Undergraduate Clinical Nursing Education. J Nurs Educ 2012; 51:269-76. [DOI: 10.3928/01484834-20120409-01] [Citation(s) in RCA: 92] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2011] [Accepted: 02/22/2012] [Indexed: 11/20/2022]
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Arnetz JE, Aranyos D, Ager J, Upfal MJ. Development and application of a population-based system for workplace violence surveillance in hospitals. Am J Ind Med 2011; 54:925-34. [PMID: 21739469 DOI: 10.1002/ajim.20984] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/01/2011] [Indexed: 11/07/2022]
Abstract
BACKGROUND A unique and comprehensive reporting and population-based violence surveillance system in a multi-site hospital system is presented. METHODS Incidence rates and rate ratios (RR) were calculated by year, hospital, violence type, and job category in six hospitals, 2003-2008. RESULTS Incidence rates per hospital for the 6-year period ranged from a low of 1.52 to a high of 10.89 incidents/100 full-time equivalents (FTEs), with the highest risk at a hospital with an outpatient mental health facility (RR = 7.16, 95%CI = 5.17-10.26). Rates for worker-on-worker violence exceeded rates for patient-to-worker violence from 2004 to 2008. Mental health technicians (RR = 13.82, 95%CI = 1.13-17.29) and security personnel (RR = 2.25, CI = 1.68-3.00) were at greatest risk for violence. CONCLUSIONS This surveillance system provides ongoing information on professional groups and hospital departments at risk and trends in violence reporting over time. It can be used to determine where appropriate violence prevention efforts are most needed, and to evaluate violence interventions.
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Affiliation(s)
- Judith E Arnetz
- Department of Family Medicine and Public Health Sciences, Wayne State University, Detroit, Michigan 48201, USA.
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Leino TM, Selin R, Summala H, Virtanen M. Violence and psychological distress among police officers and security guards. Occup Med (Lond) 2011; 61:400-6. [DOI: 10.1093/occmed/kqr080] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Miranda H, Punnett L, Gore R, Boyer J. Violence at the workplace increases the risk of musculoskeletal pain among nursing home workers. Occup Environ Med 2011; 68:52-7. [PMID: 20876554 PMCID: PMC5884081 DOI: 10.1136/oem.2009.051474] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND Despite the high prevalences of workplace physical violence and musculoskeletal symptoms among health care workers, very few studies have examined the relationship between these two phenomena. METHODS We surveyed 920 clinical nursing home workers by questionnaire regarding musculoskeletal pain in the low back, shoulders, wrists or hands, and knees. Information was also collected on exposure to physical assaults at work during the preceding 3 months, other workplace safety features, physical workload and psychosocial work environment. Log-binomial regression was used to estimate the prevalence ratios (PR) with 95% CIs. RESULTS Almost one-half of respondents reported being assaulted at least once during the preceding 3 months by a resident or resident's visitor. The prevalence of low back pain increased from 40% among non-assaulted workers to 70% among those assaulted three or more times. The highest risk was found for widespread pain (three or more areas), with an adjusted PR of 2.7 (95% CI 1.8 to 3.9) for workers assaulted three or more times. Good workplace safety buffered the effects, so that violence increased the risk of most pains considerably less in a work environment perceived to be safe. CONCLUSIONS To our knowledge, this is the first study to show a dose-response association between physical assaults and musculoskeletal pain in a health care setting where violence is a frequent occurrence. This emphasises the need to address violence as a workplace hazard through practical measures for prevention as well as in future aetiological research on musculoskeletal disorders.
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Affiliation(s)
- Helena Miranda
- Department of Work Environment, University of Massachusetts Lowell, Lowell, Massachusetts, USA
- Centre of Expertise in Health and Work Ability, Finnish Institute of Occupational Health, Helsinki, Finland
| | - Laura Punnett
- Department of Work Environment, University of Massachusetts Lowell, Lowell, Massachusetts, USA
| | - Rebecca Gore
- Department of Work Environment, University of Massachusetts Lowell, Lowell, Massachusetts, USA
| | - Jon Boyer
- Department of Work Environment, University of Massachusetts Lowell, Lowell, Massachusetts, USA
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Leino T, Selin R, Summala H, Virtanen M. Work-related violence against security guards--who is most at risk? INDUSTRIAL HEALTH 2010; 49:143-150. [PMID: 21173537 DOI: 10.2486/indhealth.ms1208] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
Studies on violence in the work of security guards are largely lacking. This study is unique in that it focuses on security guards (n=1,010) in Finland, and assesses the different forms, prevalence, and risk factors of the work-related violence they often face. Information to a survey instrument was obtained by first interviewing 30 volunteers. Then we made a cross-sectional mailed survey that was sent to a randomized group of 2,000 security guards. The response rate was 52. We found the prevalence of verbal aggression, threats of assault, and physical acts against security guards at least once a month to be 39%, 19%, and 15% respectively. As regards risk factors and who is most at risk, our results show that male gender, young age, low work experience, late working hours, and time pressure were associated with all three forms of work-related violence. Unlike other forms of violence, verbal aggression was highly prevalent outside the metropolitan area and directed towards both more and less experienced security guards. In prevention policies for violence, it is important to identify high-risk groups such as those who have less work experience.
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Affiliation(s)
- Tuula Leino
- Finnish Institute of Occupational Health, Work Organizations, Topeliuksenkatu 41 a A, 00250 Helsinki, Finland.
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Estrada F, Nilsson A, Jerre K, Wikman S. Violence at Work—The Emergence of a Social Problem. ACTA ACUST UNITED AC 2010. [DOI: 10.1080/14043851003703846] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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