Workplace violence towards nurses in Hong Kong: prevalence and correlates

Interventions to prevent or manage workplace violence against student nurses during clinical placement: a systematic review protocol

OBJECTIVES

The objective of this review is to investigate the effectiveness of workplace violence management or prevention interventions, including strategies, protocols, and policies, to address violence against, and provide support to, registered nursing students (RNS) following incidents of violence during clinical placement.

INTRODUCTION

Workplace violence is a global issue that affects victims' physical and mental health. RNS are especially vulnerable to workplace violence because of their limited work experience and confidence. These students often feel shocked and unprepared when experiencing workplace violence due to limited education and support provided by educational institutions or clinical sites. Workplace violence can lead to anxiety, decreased confidence, and professional attrition. There is a need to systematically synthesize the evidence on workplace violence management and prevention to support nursing students during clinical placement.

INCLUSION CRITERIA

The review will consider studies assessing the effectiveness of interventions to address workplace violence or improve support for RNS. Studies that report on educational interventions or pre-clinical placement strategies and measure the preparedness of students will also be considered. Study designs will be limited to quantitative methods that evaluate intervention effectiveness.

METHODS

Databases to be searched include MEDLINE (Ovid), CINAHL (EBSCOhost), Web of Science Core Collection, Scopus, Embase (Ovid), Cochrane Central, ERIC (ProQuest), ProQuest Central, ProQuest Social Science Premium Collection, and ProQuest Dissertations and Theses Global. Two independent reviewers will screen, review, appraise, and extract data from eligible articles. For data synthesis, studies will be pooled using JBI SUMARI. The GRADE approach for grading the certainty of evidence will be followed and a Summary of Findings will be created.

REVIEW REGISTRATION

PROSPERO CRD42022377318.

Association of quality of nursing care with violence load, burnout, and listening climate

BACKGROUND

Violence against nurses is common. Previous research has recommended further development of the measurement of violence against nurses and integration of the individual and ward-related factors that contribute to violence against hospital nurses. This study was designed to address these issues by investigating the associations between violence, the listening climate of hospital wards, professional burnout, and perceived quality of care. For this purpose, we used a new operationalization of the violence concept.

METHODS

We sought nurses to participate in the study through social media which yielded 765 nurses working in various healthcare systems across Israel who volunteered to complete a self-administered online questionnaire. 80% of the sample were hospital nurses, and 84.7% were female. The questionnaire included validated measures of burnout, listening climate, and quality of care. Instead of using the traditional binary measure of exposure to violence to capture the occurrence and comprehensive impact of violence, this study measured the incremental load of violence to which nurses are subjected.

RESULTS

There were significant correlations between violence load and perceived quality of care and between constructive and destructive listening climates and quality of care. Violence load contributed 14% to the variance of burnout and 13% to the variance of perceived quality of care. The ward listening climate moderated the relationship between burnout and quality of care.

CONCLUSIONS

The results of this study highlight the impact of violence load among nurses and the ward listening climate on the development of burnout and on providing quality care. The findings call upon policymakers to monitor violence load and allocate resources to foster supportive work environments to enhance nurse well-being and improve patient care outcomes.

A Scoping Review of Assertiveness Therapy for Reducing Bullying Behavior and Its Impacts Among Adolescents

Bullying is a global problem in adolescents which has increased every year. One of the factors in the occurrence of bullying is the ability of interpersonal skills. This ability can build good relationships with assertive between adolescents and can prevent bullying. The purpose of this study is to describe assertiveness therapy for reducing bullying behavior and its impacts among adolescents. The method used in this study is scoping review. The search strategy used is PRISMA Extension for Scoping Reviews through three databases namely PubMed, CINAHL, and Scopus. The authors used inclusion criteria and exclusion criteria in the selection of articles. The major keywords used in the article search were bullying, assertiveness therapy, and adolescents. Data analysis used descriptive qualitative. The results showed that there were 10 articles that discussed assertive therapy. All articles show that assertiveness therapy can reduce bullying behavior and its impact significantly, such as reducing the impact of anxiety and increasing self-esteem. Assertiveness therapy methods carried out in the form of education, games, and role play. Education is carried out online and offline. Educational media is provided directly and through media such as educational videos which can be accessed at any time. Gender and cultural approaches are important aspects in the implementation of assertive therapy. Assertive therapy can improve interpersonal skills, social skills, empathy and assertiveness so that it can reduce bullying behavior and its impacts in adolescents. Then, this data becomes the basis for nurses to carry out assertive therapy as an effort to prevent and reduce bullying behavior in adolescents.

Recoverability and estimation of causal effects under typical multivariable missingness mechanisms

In the context of missing data, the identifiability or "recoverability" of the average causal effect (ACE) depends not only on the usual causal assumptions but also on missingness assumptions that can be depicted by adding variable-specific missingness indicators to causal diagrams, creating missingness directed acyclic graphs (m-DAGs). Previous research described canonical m-DAGs, representing typical multivariable missingness mechanisms in epidemiological studies, and examined mathematically the recoverability of the ACE in each case. However, this work assumed no effect modification and did not investigate methods for estimation across such scenarios. Here, we extend this research by determining the recoverability of the ACE in settings with effect modification and conducting a simulation study to evaluate the performance of widely used missing data methods when estimating the ACE using correctly specified g-computation. Methods assessed were complete case analysis (CCA) and various implementations of multiple imputation (MI) with varying degrees of compatibility with the outcome model used in g-computation. Simulations were based on an example from the Victorian Adolescent Health Cohort Study (VAHCS), where interest was in estimating the ACE of adolescent cannabis use on mental health in young adulthood. We found that the ACE is recoverable when no incomplete variable (exposure, outcome, or confounder) causes its own missingness, and nonrecoverable otherwise, in simplified versions of 10 canonical m-DAGs that excluded unmeasured common causes of missingness indicators. Despite this nonrecoverability, simulations showed that MI approaches that are compatible with the outcome model in g-computation may enable approximately unbiased estimation across all canonical m-DAGs considered, except when the outcome causes its own missingness or causes the missingness of a variable that causes its own missingness. In the latter settings, researchers may need to consider sensitivity analysis methods incorporating external information (e.g., delta-adjustment methods). The VAHCS case study illustrates the practical implications of these findings.

The Relationship between Patients' Demands and Workplace Violence among Healthcare Workers: A Multilevel Look Focusing on the Moderating Role of Psychosocial Working Conditions

Workplace violence against healthcare workers is a widespread phenomenon with very severe consequences for the individuals affected and their organizations. The role played by psychosocial working conditions in healthcare workers' experiences of violence from patients and their family members has received relatively scant attention. In the present study, we investigated the idea that psychosocial working conditions (workload, job control, supervisor support, and team integration), by affecting the well-being and job performance of healthcare workers, play a critical role in the relationship between patients' demands and the escalation of workplace violence. Specifically, we tested the hypothesis that psychosocial working conditions moderate the relationship between patients' demands and workplace violence. Participants were 681 healthcare workers distributed in 55 work groups of three public healthcare facilities in Italy. Multilevel analysis showed significant interactions between patients' demands and each of the investigated psychosocial factors on workplace violence, which in all the cases were in the expected direction. The results suggest that improving the quality of the psychosocial work environment in which healthcare workers operate may be a critical aspect in the prevention of workplace violence.

A Qualitative Systematic Review of Healthcare Practitioners' Experience of Workplace Violence

Healthcare practitioners face significant risks of workplace violence due to various reasons such as hospital congestion, miscommunication, and aggressive behaviours of patients and relatives. Exposure to workplace violence may disrupt the workflow process and compromise patient care in healthcare facilities, ultimately affecting job performance, reducing job satisfaction, and negatively affecting the physical and mental health of healthcare practitioners. This study aimed to review all the published studies conducted on the experiences of workplace violence among healthcare practitioners. This study is a systematic review of qualitative studies. Data were collected through online databases including ScienceDirect, PubMed, MEDLINE and JSTOR were searched from the year 2015-2021. The inclusion criteria were: qualitative methods and mixed methods of data collection and analysis; studies that were carried out among healthcare practitioners who have been experience on workplace violence; scope of the primary studies included experience of workplace violence; and published in English/Malay in academic journal between 2015 and 2021. A total of 15 papers were included in the final analysis. The overall quality of the included papers was high. Of the 15 papers, 12 studies fully met the CASP criteria. The results of the 15 included studies were organised into the thematic groups of: i) verbal violence as the common workplace violence; ii) perceived causes of workplace violence and iii) seeking help. Across different countries, verbal violence was the most common type of workplace violence reported by healthcare practitioners. This review also identified that a lack of information, failure to meet patient expectations, and delayed treatment were the main contributing factors to workplace violence.

Psychological distress as a mediator between workplace violence and turnover intention with caring for patients with COVID-19

The Coronavirus Disease 2019 (COVID-19) outbreak exacerbated workplace violence and turnover intention among nurses, particularly affecting greater levels of psychological distress. This study aimed to examine psychological distress as a mediator of the relationship between workplace violence and turnover intention among clinical nurses, and to investigate whether caring for patients with COVID-19 moderates this relationship through the lens of the affective events theory. We conducted an online survey of 325 Korean registered nurses (mean age = 30.75; female = 92.6%) who work in clinical settings between August and October 2021 using the convenience sampling method. Psychological distress was measured using the 21-item Depression Anxiety Stress Scale and workplace violence using one dichotomous item adopted from the Workplace violence questionnaire. We measured turnover intention using the six-item Anticipated Turnover Scale. Caring for patients with COVID-19 was determined using one dichotomous item. The research hypotheses assume that the relationship between workplace violence and turnover intention could be mediated by psychological distress and moderated by caring for patients with COVID-19 among Korean nurses. We performed a moderated mediation analysis with workplace violence as the independent variable, turnover intention as the dependent variable, psychological distress as a potential mediator, and caring for patients with COVID-19 as a potential moderator. The analysis revealed that nurses' psychological distress among 308 nurses had a statistically significant mediating effect on the relationship between workplace violence and turnover intention. Furthermore, caring for patients with COVID-19 had a significant further moderating effect on this relationship. These findings highlight the need for psychological support services for clinical nurses at institutional and organizational levels amidst the ongoing COVID-19 pandemic. It is hoped that these findings can contribute to the development of tailored interventions for nurses caring for patients with COVID-19 to attenuate their psychological distress in a timely and effective manner.

Overall Description and Predictors of Disruptive Behavior Toward Nurses in the Perioperative Arena

PURPOSE

To investigate the prevalence, characteristics, causes, consequences, and predictors of and responses to disruptive behavior toward nurses in the perioperative arena.

DESIGN

A cross-sectional design using a network questionnaire platform.

METHODS

Nurses in the perioperative arena were recruited online in March 2020. Data on disruptive behavior toward nurses in the past 6 months and nurses' sociodemographic and environmental factors were collected.

FINDINGS

Nurses (N = 496) responded validly to the survey. In total, 82.1% of participants experienced disruptive behavior. Assignment of overwhelming workloads and verbal aggression were the most common behaviors, and surgeons were the major perpetrators. Perpetrators' intrapersonal issues were the most commonly perceived causes. A positive strategy was the most common strategy adopted by participants. Further, 80.8% of participants recounted their negative experiences, and more than half of respondents (59.9%) talked with their nursing colleagues. Nearly half of respondents (45.9%) did not report disruptive behavior. Negative emotions as an immediate effect were reported by 53.1% of the participants, and the most common long-term impact was decreased passion for work. Middle age, job position, practice environment, and system help were risk factors for experiencing disruptive behavior.

CONCLUSIONS

The prevalence of disruptive behavior toward nurses in the perioperative arena is high, and its ramifications should not be ignored. Health care institutions should urgently implement intervention strategies to reduce disruptive behavior toward nurses.

Emergency Department Violence: A Growing Challenge for Healthcare Workers in Saudi Arabia

Background Workplace violence in healthcare settings, particularly in emergency departments (EDs), is a critical issue affecting healthcare providers and the quality of patient care. This study's primary aim was to determine the prevalence and types of workplace violence experienced by healthcare workers in Saudi Arabian EDs, assess the physical and psychological consequences of such violence, and explore the factors contributing to its occurrence. Methods Employing a descriptive, cross-sectional research design, the study was conducted in two phases at three hospitals in the Eastern Region of Saudi Arabia. It targeted ED healthcare workers, including physicians, nurses, and support staff. Data were collected via a questionnaire disseminated through social media, addressing incidents of violence, their nature, and subsequent responses. Results The findings indicate a significant incidence of workplace violence in EDs, predominantly involving verbal abuse and physical aggression, mostly initiated by patients' companions. The majority of these incidents occurred prior to patient-physician interaction, with nurses frequently being the primary victims. Although incidents were more often formally reported than informally, a substantial number remained unreported. There was no significant correlation between the experienced violence and variables like working hours or hospital governance. Conclusion The research highlights the urgent need for effective policies and strategies to mitigate workplace violence in healthcare settings in Saudi Arabia. It emphasizes the necessity of implementing comprehensive violence prevention and intervention programs to ensure a safer working environment for healthcare professionals.

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

BACKGROUND

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

METHODS

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

RESULTS

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

CONCLUSION

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

Improvement of violence management among nurses in Iran: The best practice implementation project in a health promoting hospital

BACKGROUND

This project aimed to assess compliance with evidence-based criteria' for the prevention and management of workplace violence against nursing staff in Shahid-Beheshti hospital, Maragheh, Iran. Workplace violence is a managerial and workplace occupational health and safety issue that can affect the performance of an institution. Further, it might turn the work environment into an insecure and hostile one which can influence the performance of employees and their professional relationships negatively. Nevertheless, staff have their own legal rights, and their organizations are legally and ethically in charge of providing them with safe work environments.

METHODS

Following the JBI Practical Application of Clinical Evidence System and Getting Research into Practice audit and feedback tool with three phases of activities, this project utilized an implementation framework incorporating quality improvement. Furthermore, the audit tool was used to establish the project and set up the measurement and evaluation of three evidence-based criteria.

RESULTS

The post-implementation audit results indicated a significant improvement in violence management and prevention. The compliance rate on the first criterion, i.e. aggression management training, increased from 49% at baseline to 81% at the end. The second criterion, i.e. timely support and assistance following an incident, exhibited greater increase from eight to 73%. Finally, an increased compliance was noted on the third criterion, i.e. policy for risk management and safe environment, from 22 to 77%.

CONCLUSIONS

The current project successfully implements evidence-based violence management in Shahid-Beheshti hospital. It reveals significant results on compliance and the increasing knowledge of nurses on evidence-based stress management, communication skills and self-companion.

Registered nurses' exposure to workplace aggression in Norway: 12-month prevalence rates, perpetrators, and current turnover intention

BACKGROUND

Identifying occupational health hazards among Registered Nurses (RNs) and other health personnel and implementing effective preventive measures are crucial to the long-term sustainability of health services. The objectives of this study were (1) to assess the 12-month prevalence rates of exposure to workplace aggression, including physical violence, threats of violence, sexual harassment, and bullying; (2) to identify whether the perpetrators were colleagues, managers, subordinates, or patients and their relatives; (3) to determine whether previous exposure to these hazards was associated with RNs' current turnover intention; and (4) to frame workplace aggression from an occupational health and safety perspective.

METHODS

The third version of the Copenhagen Psychosocial Questionnaire (COPSOQ III) was used to assess RNs' exposure to workplace aggression and turnover intention. A national sample of 8,800 RNs in Norway, representative of the entire population of registered nurses in terms of gender and geography, was analysed. Binary and ordinal logistic regression analyses were conducted, and odds for exposure and intention to leave are presented, with and without controls for RNs' gender, age, and the type of health service they work in.

RESULTS

The 12-month prevalence rates for exposure were 17.0% for physical violence, 32.5% for threats of violence, 12.6% for sexual harassment, and 10.5% for bullying. In total, 42.6% of the RNs had experienced at least one of these types of exposure during the past 12 months, and exposure to more than one of these hazards was common. Most perpetrators who committed physical acts and sexual harassment were patients, while bullying was usually committed by colleagues. There was a strong statistical association between exposure to all types of workplace aggression and RNs' intention to leave. The strongest association was for bullying, which greatly increased the odds of looking for work elsewhere.

CONCLUSIONS

Efforts to prevent exposure to workplace aggression should be emphasised to retain health personnel and to secure the supply of skilled healthcare workers. The results indicate a need for improvements. To ensure the sustainability of health services, labour and health authorities should join forces to develop effective workplace measures to strengthen prevention, mitigation, and preparedness regarding incidents of workplace aggression in health services and the response and recovery regarding incidents that could not be prevented.

The relationship between workplace violence, emotional exhaustion, job satisfaction and turnover intention among nurses during the COVID-19 pandemic

Objectives

Workplace violence is a major issue in society, business and healthcare settings. It adversely affects both employee safety and their ability to provide healthcare services.

Aim

This study examined the association between workplace violence, emotional exhaustion, job satisfaction and turnover intention among nurses during the COVID-19 pandemic.

Methods

We collected data from 513 nurses. We conducted 'Process Macro' analysis. Firstly, we included three mediators in the model: job satisfaction, workplace violence and emotional exhaustion. Secondly, we used work hours and anxiety as moderators of the relationship between workplace violence and turnover intention.

Results

The findings revealed statistical significance that job satisfaction and workplace violence mediated the relationship between emotional exhaustion and nurse turnover intentions. Work hours and anxiety also moderated the relationship between workplace violence and nurses' turnover intention.

Conclusion

Respondents indicated that they were most affected by verbal violence during this time. Workplace violence is a negative factor that affects nurses' work, affecting them physically and psychologically. This occupational risk should be considered when evaluating nurses exposed to violence, as it affects job satisfaction and turnover intentions. The main theoretical contribution of this research is the identification of the association between workplace violence, emotional exhaustion, job satisfaction and turnover intention among nurses during the COVID-19 pandemic. It is clear that the research findings will be useful for healthcare professionals. The findings may have practical implications for healthcare administrators and their staff.

What are ambulance personnel experiences of sexual harassment and sexual assault in the workplace? A rapid evidence review

INTRODUCTION

Sexual assault and harassment of ambulance personnel in the workplace is widespread. Prevention via body worn cameras and legal efforts have been positive, however improvement is still needed to ensure the protection of staff from the negative impact of sexual violence at work.

METHODS

A rapid evidence review was conducted following the Cochrane Rapid Review guidance. MEDLINE and CINAHL Complete were searched from inception to February 2023. Screening and data extraction was conducted by one author and verified by the other. Included studies were appraised using a variety of critical appraisal checklists and a narrative synthesis was conducted.

RESULTS

From 46 articles screened, 7 were included in the review representing 3994 ambulance personnel from Australia, Canada, the United States, the United Kingdom and South Korea. Seven themes were identified, including a need for more training, education and resources regarding sexual assault and harassment, differences in perpetrators, poor experiences with organisations, effects on victims outside the workplace, effects on victims within the workplace, barriers to reporting, and increased prevalence of sexual assault and harassment against women.

CONCLUSION

The effect of sexual assault and harassment has far-reaching negative impact on victims' lives. More training and resources are recommended.

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

BACKGROUND

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

METHODS

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

RESULTS

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

CONCLUSIONS

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

Violence toward staff in the inpatient psychiatric setting: Nurses' perspectives: A qualitative study

BACKGROUND

Workplace violence is a universal phenomenon faced by employees in all industries but more so by employees working in sectors that require interpersonal contact, especially with individuals who may be violent, distressed, or vulnerable. Globally, healthcare professionals working in the emergency and psychiatric sectors are at the highest risk of workplace violence. In fact, healthcare professionals in the psychiatric setting have a higher risk rate of facing workplace violence opposed to other healthcare settings. Workplace violence can lead to adverse physical and psychological outcomes and impact the quality of care provided to patients.

OBJECTIVE

This study aims to explore nurses' experiences with workplace violence and the impact of violence on nurses. Whereas the objectives of this study are to explore and analyze mental health nurses' experiences with workplace violence in Brunei Darussalam, identify and explore the impact of violence on mental health nurses, and discuss nurses' coping mechanisms following a workplace violence experience.

DESIGN

Qualitative explorative study.

SETTING(S)

Mental Health Unit Kiarong of Raja Isteri Pengiran Anak Saleha Hospital, Brunei Darussalam.

PARTICIPANTS

Nurses (n = 12).

METHODS

Data was collected by conducting individual via online platforms. The interviews were carried out in English and/or Malay, the verbatim transcripts produced were transcribed in their source languages and only relevant excerpts were translated into English for the write-up. The data were analyzed utilizing thematic analysis by the researcher independently.

RESULTS

This study identified three themes: Violence as a norm in the psychiatric setting, perceived impact of workplace violence, and "Talk, Report and Accept" as Coping mechanisms.

CONCLUSIONS

In conclusion, it is apparent that globally workplace violence is normalized in the nursing industry, especially in the psychiatric setting. Workplace violence yields a plethora of negative long-term and short-term impacts on nurses. Despite this, workplace violence often goes unreported for numerous reasons but mainly due to the lack of changes after reporting. Nurses should be encouraged to report all instances of workplace violence by demonstrating effective changes and providing hazard pay. The management should actively attempt to reduce the risk of workplace violence by preemptively equipping nurses with the necessary training including identification of potential risks of workplace violence, effective de-escalation methods, and proper control and restraint methods.

Workplace bullying and violence in health sector in Saudi Arabia

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

Violence against women and associated factors among female construction workers in Addis Ababa, Ethiopia

BACKGROUND

Violence against Women (VAW) is a global public health problem; almost one in three global women experienced one form of violence. Violence free environment is the one that everyone cherishes. However, millions of women worldwide suffer from violence. In Ethiopia, VAW is very common and considered a private matter though it has serious consequences for girls and women. Studies pointed out that it varies by workplace, and hence important to assess it among female construction workers in Addis Ababa.

OBJECTIVE

To assess the prevalence and factors contributing to gender-based violence on female construction workers in Addis Ababa, Ethiopia, 2021.

METHODS

A cross-sectional study design with a multistage cluster sampling technique was used to select 827 study participants and a face-to-face interview was held from February 24 to April 24, 2021. Data entry was done using Epi info-7 and exported to SPSS version 26 for analysis. Both bivariable and multivariable binary logistics regression analysis were employed.

RESULTS

A total of 827 female workers were interviewed in this study. The mean age of the respondents was 24.97 years with SD of ± 5.6. The magnitude of violence against female in the workplace was 70.9% (95% CI: 67.7, 73.9). This study found that females in the age group 15-19 years (AOR = 2.37, 95%CI: 1.26, 4.45), females who live in Addis Ababa for less than 3 years (AOR = 3.02, 95%CI: 1.59, 5.73) and for 3-7 years (AOR = 2.14, 95% CI: 1.14, 4.00) and females who have no formal education (AOR = 3.16, 95%CI: 1.80, 5.54) had higher odds of violence at their workplace.

CONCLUSION

The magnitude of overall VAW among female construction workers in Addis Ababa was high compared to other workplaces. Age and the number of years lived in Addis Ababa were found to be significant factors of violence among female construction workers. Hence, emphasis shall be given for female construction workers in Addis Ababa.

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

BACKGROUND

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

METHODS

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

RESULTS

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

CONCLUSIONS

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

Nurse-to-nurse horizontal violence during the covid-19 pandemic and its impact on turnover intention: A cross-sectional study

BACKGROUND

Nurse-to-nurse (N2N) horizontal violence has been documented among the main determinants of nurses' turnover intention. Even with its utmost importance, inadequate attention has been thus far drawn to the way crisis-induced pressure added to work environments, such as the coronavirus disease 2019 (COVID-19) pandemic, can impact horizontal violence, and then give rise to turnover intention.

AIM

The present study was to investigate the relationship between N2N horizontal violence along with its dimensions and turnover intention among clinical nurses.

METHODS

A cross-sectional survey was conducted utilizing the Turnover Intention Questionnaire (TIQ), developed by Kim et al. (2007), and the Negative Acts Questionnaire-Revised (NAQ-R; Einarsen, Hoel, & Notelaers, 2009). The participants, recruited by random sampling, included 295 clinical nurses working in referral hospitals for COVID-19. The data were also analysed using the SPSS software package (ver. 19), via descriptive and inferential statistics, Pearson correlation test and multiple linear regression.

RESULTS

The study participants obtained the mean scores of 52.50 ± 11.85 and 45.38 ± 13.24 for turnover intention and horizontal violence, respectively. Among the dimensions of horizontal violence, the highest value belonged to "work-related bullying," with the mean score of 51.04 ± 15.23, and the lowest was associated with the "physically intimidating bullying" dimension, with the mean value of 15.90 ± 5.96. The Pearson correlation test results correspondingly showed that turnover intention was positively correlated with work-related bullying (r = 0.73), person-oriented bullying (r = 0.72), physically intimidating bullying (r = 0.53) and overall horizontal violence (r = 0.74). The regression analysis outcomes additionally demonstrated that the work-related and person-oriented bullying dimensions of N2N horizontal violence could predict turnover intention in nurses (F = 184.66, p < 0.001).

IMPLICATIONS

The study findings help nursing managers and policymakers to immediately formulate sound measures and guidelines to prevent or at least manage the problems, viz., N2N horizontal violence and turnover intention. These measures can be thus in the form of training programs focused on communication, stress reduction and conflict resolution techniques, especially during crises, together with obvious procedures for reporting the incidents of horizontal violence.

Suicide, self-harm, and suicide ideation in nurses and midwives: A systematic review of prevalence, contributory factors, and interventions

BACKGROUND

Nurses have been identified as an occupational group at increased risk of suicide. This systematic review examines the prevalence of, and factors influencing, suicide and related behaviours among nurses and midwives (PROSPERO pre-registration CRD42021270297).

METHODS

MEDLINE, PsycINFO, and CINAHL were searched. Articles published from 1996 onwards exploring suicidal thoughts and behaviours among nurses and midwives were included. Quality of included studies was assessed. Articles were subjected to narrative synthesis informed by suicide data examined, study design, and quality. PRISMA guidelines were followed.

RESULTS

A total of 100 studies were eligible for inclusion in the review. Articles examining suicide exclusively among midwives were absent from the literature. Several studies confirmed that nursing professionals, especially female, are at increased risk of suicide, particularly by self-poisoning. Factors contributing to risk include psychiatric disorders, alcohol and substance misuse, physical health problems, and occupational and interpersonal difficulties. In studies of non-fatal suicidal behaviours, including during the COVID-19 pandemic, psychiatric, psychological, physical and occupational factors were contributory. There has been little investigation of interventions for prevention of suicide in nurses.

LIMITATIONS

Only articles published in English language were reviewed.

CONCLUSIONS

The findings highlight the risk of suicide in nurses. They also show a combination of factors contribute to suicide and non-fatal suicidal behaviour in nurses, with psychiatric, psychological, physical health, occupational and substance misuse (especially alcohol) problems being particularly important. The limited evidence regarding prevention measures indicates a major need to develop primary and secondary interventions for this at-risk occupational group, for example, education regarding enhancing wellbeing and safe alcohol use, alongside accessible psychological support.

Perception and Practice of Workplace Violence Prevention and Its Associated Factors among Employers at Healthcare Facilities in Melaka, Malaysia

Workplace violence (WPV) is a major public health concern, especially among healthcare workers. There is a negative perception and poor practice of healthcare employers towards WPV prevention. This study aims to determine the perception and practice towards WPV prevention and its associated factors among healthcare employers in Melaka, Malaysia. A cross-sectional study was conducted by recruiting 162 healthcare employers, using a validated questionnaire and utilised linear regression analysis. The participants had a mean percentage of 67.2% for perception and 80% for practice towards WPV prevention. The perception towards WPV prevention is associated with the following characteristics: female (adjusted ß = -3.95; 95% CI: -7.81, -0.09; p = 0.045), Indian ethnicity (adjusted ß = 16.04; 95% CI: 2.34, 29.74; p = 0.022), other ethnicities (adjusted ß = 25.71; 95% CI: 8.94, 42.47; p = 0.003), degree holder (adjusted ß = 4.35; 95% CI: 0.15, 8.54; p = 0.042), masters holder (adjusted ß = 7.63; 95% CI: 1.11, 14.14; p = 0.022), and enough funds (adjusted ß = -5.46; 95% CI: -9.25, -1.67; p = 0.005). Meanwhile, the practice towards WPV prevention is significantly associated with Chinese ethnicity (adjusted ß = -9.25; 95% CI: -18.36, -0.14; p = 0.047), Indian ethnicity (adjusted ß = -14.97; 95% CI: -29.48, -0.46; p = 0.043), other ethnicities (adjusted ß = 23.55; 95% CI: 5.59, 41.51; p = 0.011), degree holder (adjusted ß = -4.41; 95% CI: -8.67, -0.14; p = 0.043), and availability of standard operating procedure for reporting WPV (adjusted ß = 6.07; 95% CI: 1.58, 10.57; p = 0.008). The high perception and practice towards WPV prevention and its associated factors among healthcare employers provide evidence-based input to improve the existing measures for WPV prevention.

Frequency and Impacts of Verbal Abuse on Healthcare Workers in a Secondary Healthcare Structure in Greece

BACKGROUND

Threatening and aggressive behaviors in healthcare settings constitute a significant problem that can affect not only the physical and mental integrity of staff but also patient safety and the quality of healthcare. Literature highlights verbal abuse as the most common form of non-physical violence and is estimated from 51.8% to 63.4% worldwide.

PURPOSE

The purpose of the study was the investigation of verbal abuse incidence toward physicians and nurses and the differences noted between them in a regional hospital.

METHODS

The study took place in a public regional hospital in southern Greece. A number of 185 nurses and 60 physicians completed the verbal abuse scale (VAS) for assessing verbal violence in the work environment; selected socio-demographic and occupational characteristics were also recorded.

RESULTS

Physicians have undergone verbal abuse once a week at a percentage of 38.3%, while at the same frequency; nurses record a percentage of 12.4%. Regarding the relationship between the victim of verbal abuse and the abuser, 26.7% of the physicians answered that the abuser was another senior member of the staff, while the percentage for nurses is higher and reaches 31.9%. According to VAS items, accusing and blaming (mean±SD=3.00±0.96) is noted as the most common form of verbal abuse for physicians, judging and criticizing stands out as the most frequent (3.17±1.11) and the most stressful action (3.25±1.11) form for nurses. The most frequent behavior by the physicians is to put the verbal abuse situation in a humorous context (2.78±1.14). In contrast, nurses are trying to clarify any misunderstanding that may occur (3.10±1.00).

CONCLUSIONS

Verbal abuse incidents are experienced by both physicians and nurses. They are stressful for the victims and can significantly affect work relationships and job satisfaction.

Aggression in mental health care: Opportunities for the future-A qualitative study on the challenges when defining and managing aggression across inpatient disciplines

WHAT IS KNOWN ON THE SUBJECT?: Aggression towards caregivers is a global phenomenon in mental health care. Although attempts have been made to define aggression, there is no globally accepted definition. Discrepancies in defining aggression can lead to differences in judgement and a sub-par management of aggression. The fact that different disciplines work together in mental health care makes it an even more pressing matter as no research was found regarding a multidisciplinary definition of aggression. Currently, coercive measures, such as isolation, sedation or restraints, are the most common ways of managing aggression. WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE?: Mental healthcare nurses and psychologists defined aggression by previous experiences, and they also agree that there are no alternatives in managing aggression when non-coercive techniques do not work. Several opportunities and examples of best practice were given by the participants, but the consensus was that caregivers are in need of alternatives when they are face to face with acute aggression. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: It is vital for residential units to agree on a definition of aggression and acute aggression. It is our belief that this can aid them in preventing and de-escalating aggression as well as diminishing the use of coercive measures. Further primary research exploring the opportunities of non-coercive techniques, a multidisciplinary approach and the relationship between a workplace culture normalizing aggression and the mental well-being of healthcare workers is also needed.

ABSTRACT

INTRODUCTION: Aggression by patients against healthcare workers is a global recurring phenomenon in mental health care. Discrepancies in defining aggression can lead to differences in judgement, which in turn causes difficulties in managing aggression. The multidisciplinary nature of mental healthcare makes a standardized definition an even more pressing matter. No studies, however, were found exploring the way different disciplines approach the definition of aggression. Although traditional methods of managing aggression rely on coercive methods, current research favours the use of non-coercive measures.

AIM

The aim of this study was to explore the different ways mental healthcare nurses and psychologists define and manage aggression in a residential unit.

METHOD

A qualitative research design was used, consisting of interviews and focus groups. Transcripts were analysed using a reflexive thematic approach.

RESULTS

Three major themes were found: (1) approaches towards defining aggression, (2) experiencing aggression and (3) managing aggression: the need for alternatives.

DISCUSSION

In this study, aggression is defined by how aggression has been experienced, both mental health nurses and psychologists agree that there are no alternatives in managing aggression when non-coercive techniques do not work. Aggression is considered an integral part of the job indicating an "aggression-tolerating" workplace.

IMPLICATIONS FOR PRACTICE

Three implications for practice were identified: (1) It is vital for residential units to agree on a broad-based definition of aggression, (2) further primary research exploring the opportunities of non-coercive techniques and a multidisciplinary approach is crucial and (3) the relationship between a workplace culture normalizing aggression and the mental well-being of healthcare workers also needs further study.

Job security among healthcare workers in Guangdong, China

Objective

The objective of this study was to explore the sense of job security and its influencing factors among healthcare workers in Guangdong, China.

Methods

This cross-sectional study used stratified random sampling to enroll healthcare workers employed by hospitals across Guangdong province between September 2020 and October 2020.

Results

A total of 4,173 questionnaires were distributed, and 4,076 were returned for an effective recovery rate of 97.68%. The overall score for the sense of security was 64.85 ± 20.09, and the item means score was 2.95 ± 0.91. Multiple-linear regression analysis showed that work experience (years), education level, job position, specialty unit, employment type, marital status, job satisfaction, WPV frequency, daily sleep duration, weekly overtime hours, average monthly earnings (RMB), hospital level, and region were significantly associated with senses of poor security among healthcare workers (all P < 0.05).

Conclusions

Hospital workers in Guangdong reported relatively low levels of job security. Levels of job security were significantly associated with multiple factors which could be addressed by hospital practices to improve the sense of job security among healthcare workers.

Triggers of Workplace Violence in Emergency Departments: A Qualitative Study

Background: Workplace violence has become an alarming phenomenon facing healthcare systems worldwide. Emergency nurses were the most victimized from workplace violence incidents. There is a crucial need for conducting qualitative research addressing the unique contextual factors associated with workplace violence against emergency nurses in Jordan.Purpose: This study aimed to explore circumstances that Jordanian emergency nurses, who were victims of workplace violence from clients and/or their relatives, perceive as provocative for workplace violence events.Methods: A qualitative phenomenological method was used. Purposive sampling was utilized to recruit participants (n=15), who were victims of workplace violence, and working in eight emergency departments distributed over all regions of Jordan. Semi-structured face-to-face interviews were conducted. All interviews were recorded and transcribed into Arabic. The Interpretive Phenomenological Analysis (IPA) was used to manually analyse the gathered data. Member checking, prolonged engagement with data, stepwise replication, and personal journaling were used to enhance the rigor of the study.Results: Findings of this study resulted in four superordinate themes that represents the main individual, social, and organisational factors contributing to workplace violence in Jordanian emergency departments. These themes include aggressors’ misconceptions and misbehaviours with four subordinate themes, inappropriate Jordanian social customs with two subordinate themes, organisational circumstances of emergency department with two subordinate themes, and escalator nurses with three subordinate themes.Conclusion: This study highlighted how specific social, cultural, legal, and administrative aspects of Jordanian society were inappropriately employed so as to lead to spread of the workplace violence. This study has provided insight into the need for change at personal level of emergency nurses, social level of Jordanian public, and organizational level of hospital administration and environment in order to mitigate workplace violence incidence in emergency departments.

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

BACKGROUND

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

PURPOSE

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

METHODS

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

RESULTS

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

CONCLUSION

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

Workplace violence against nurses working in the public hospitals in Giresun, Turkey: Prevalence, risk factors, and quality of life consequences

PURPOSE

The aim of this study is to determine the prevalence and risk factors of workplace violence (WPV) against nurses working in public hospitals and to evaluate for associations between WPV with the quality of life (QOL).

DESIGN AND METHODS

A cross-sectional study design was carried out from April to May 2021. The study population consisted of 890 nurses working in public hospitals in Giresun, Turkey.

FINDINGS

The prevalence of WPV was found to be 54.8%, consisting of verbal abuse (38.4%), followed by bullying/mobbing (37.5%), physical violence (6.2%), and sexual harassment (1.7%). Moreover, the WPV was found to be related to poor QOL among the nurses.

PRACTICE IMPLICATIONS

Violence prevention, preparedness, and response arrangements should be established and maintained in all hospitals.

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

AIM

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

BACKGROUND

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

EVALUATION

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

KEY ISSUES

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

CONCLUSION

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

IMPLICATIONS FOR NURSING MANAGEMENT

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

Predictors of events of violence or aggression against nurses in the workplace: A scoping review

AIM

To identify predictors and consequences of violence or aggression events against nurses and nursing students in different work contexts.

BACKGROUND

Workplace violence against nurses and nursing students is a very common and widespread phenomenon. Actions to manage or prevent violent events could be implemented knowing the risk factors and consequences. However, there is a lack of systematic reviews that summarize knowledge on the predictors and consequences of workplace violence.

EVALUATION

A scoping review was conducted using electronic databases including APA PsycInfo, CINAHL, Cochrane, Ovid Medline, PubMed and Scopus.

KEY ISSUES

After full text analysis, 87 papers were included in the current scoping review. Risk factors of horizontal violence were grouped into 'personal' and 'Environmental and organizational', and for violence perpetrated by patients into 'personal', 'Environmental and organizational' and 'Characteristics of the perpetrators'.

CONCLUSIONS

The results of this scoping review uncover problems that often remain unaddressed, especially where these episodes are very frequent. Workplace violence prevention and management programmes are essential to counter it.

IMPLICATIONS FOR NURSING MANAGEMENT

The predictors and the consequents identified constitute the body of knowledge necessary for nurse managers to develop and implement policy and system actions to effectively manage or prevent violent events.

How workplace violence correlates turnover intention among Chinese health care workers in COVID-19 context: The mediating role of perceived social support and mental health

AIM

To elucidate the effects of workplace violence on turnover intention among Chinese health care workers, and to identify the potential mediators in this relationship.

BACKGROUND

Workplace violence has emerged as a crucial determinant of turnover intention for health care workers.

METHODS

A cross-sectional survey was conducted among Chinese health care workers (N = 1,063) between 13 and 20 February 2020. Mediation effects were tested using structural equation modelling with weighted least squares mean and variance adjusted (WLSMV) estimator.

RESULTS

Workplace violence had both direct and indirect effects on turnover intention among Chinese health care workers. Specifically, perceived social support, mental health and perceived social support together with mental health partially mediated the relationship between workplace violence and turnover intention.

CONCLUSIONS

Chinese health care workers experiencing violence during the COVID-19 outbreak were more likely to report turnover intention. Enhancing social support and reducing mental health problems would be beneficial in decreasing the detrimental effects of workplace violence on turnover intention.

IMPLICATIONS FOR NURSING MANAGEMENT

Ensuring health care workers' health and safety is vital in reducing turnover intention, which in turn ascertains continuity of health care delivery. Health care managers should develop targeted interventions to improve social support and prevent post-violence mental health problems.

Prevalence and Risk Factors of Workplace Violence Against Emergency Department Nurses in China

Objectives: We aim to find out the prevalence, characteristics, and predictors of workplace violence (WPV) against current Chinese emergency department (ED) nurses.

Methods: A cross-sectional survey of 20,136 ED nurses was conducted in 31 provinces in China between July and September 2019. Descriptive analyses were used to examine the prevalence and characteristics of WPV. Chi-square analysis and Binary logistic regression analysis were used to identify the predictors of WPV.

Results: During the past 12 months, there are 79.39% of ED nurses exposed to any type of WPV, including 78.38% and 39.65% exposed to nonphysical and physical violence, respectively. Binary logistic regression analysis shows that ED nurses who were male, had bachelor’s degrees, had average monthly salary between 5,001 and 12,000, worked in central China, had higher professional titles, were more experienced, arranging shift work, and had higher work stress were more likely to experience WPV.

Conclusion: A relatively high prevalence of WPV against Chinese ED nurses has been revealed in this study. The characteristics and predictors of WPV remind us to take positive measures to reduce WPV.

Distress, support and psychological resilience of psychiatric nurses as second victims after violence: A cross-sectional study

AIM

The aim is to explore the impact of violence and psychological resilience on psychiatric nurses as second victims.

BACKGROUND

Workplace violence is a public health concern, seriously influencing medical staff's physical and mental health. However, few pieces of research have concentrated on psychiatric nurses as second victims.

METHOD

The socio-demographic data, violence-related data, psychological resilience scale, the Chinese version of the Second Victim Experience and Support Tool were applied to conduct a cross-sectional survey on nurses from psychiatric hospitals. The multiple linear regression model identified significant variables associated with violence-related injury and resilience.

RESULTS

A total of 683 nurses completed the survey, of whom 88.3% were women. The average scores of the second victims' experience and support, support and distress were 3.45 ± 0.43, 3.71 ± 0.57 and 3.19 ± 0.67, respectively. Physical violence, psychological violence, psychological influence and nursing work environment were positively correlated with the experience and support of the second victims, and innocuous violence was a negative factor, which explains 20.6% of the variation. Moreover, physical injury, nursing work environment, resilience restructuring, physical violence, psychological violence, psychological impact and disagreement about the existence of violence explained 14.8% of the distress. The innocuous violence, psychological violence and nursing work environment explained 46.2% of the support.

CONCLUSIONS

Our findings suggest that nurses who are second victims after the violence mainly suffer from severe psychological distress and receive the least support for the same.

IMPLICATION FOR NURSING MANAGEMENT

The study provides clues to help nursing managers' emphasis on the distress and support of second victims and provides targeted intervention based on the relevant factors and these results. The article is a cross-sectional study of psychiatric nurses, which has been approved by the ethics committee of the hospital before the survey. All the nurses who participated in the survey have been informed and agreed.

Workplace violence toward emergency medicine physicians in the hospitals of Taif city, Saudi Arabia: a cross-sectional survey

Background

Workplace violence against health care workers is an emerging concern in various global health settings and the documentation of physical and verbal attacks against physicians in tertiary hospitals in Saudi Arabia is uncommon. This study aimed to determine the incidence of workplace violence against physicians in the emergency department of selected tertiary hospitals in Taif City, Saudi Arabia from June to July 2021. Associations between the incidence of violence and interventions and type of physicians and years of experience were also investigated.

Methodology

Using a cross-sectional design, a total of 96 physicians were recruited to answer the World Health Organization Questionnaire on Violence against Health Care Workers last June to July 2021.

Results

It was found out that 75 physicians (78.1%) experienced verbal violence while 14 physicians (14.6%) experienced physical violence. Most of the workplace violence happened within hospital premises (84.4%). Despite having an experience of verbal and physical violence, only 44.8% of the respondents reported the incidents. The most common instigators were patients (55.21%), their relatives (78.00%), external colleagues (9.37%) and staff members (6.25%). Most respondents took no action, or reported the incidence to the police or senior staff member. The incidence of workplace violence and type of physician showed significant association. The number of years of practice in emergency medicine also exhibited statistically significant association with the incidence of verbal attack, frequency of violence, and location of incident.

Conclusion

There is high incidence of workplace violence among physicians in tertiary hospitals, and younger physicians with less experience in emergency medicine were the most susceptible to both verbal and physical violence. There is a need to strengthen policies to protect physicians against workplace violence.

Prevalence of lateral violence in nurse workplace: a systematic review and meta-analysis

BACKGROUND

The prevalence of inter-nurse lateral violence (LV) reported in current studies is inconsistent, ranging from 7% to 83%. The purpose of this study is to quantify the prevalence of LV in nurses' workplaces.

METHODS

Systematic review and meta-analysis. Cochrane, PubMed, Embase, CINAHL, CNKI and Wanfang databases were searched for relevant studies (up to 27 January 2021). We included cross-sectional, case-control or cohort studies in which both abusers and victims were nurses. Studies that did not provide specific data on abusers were excluded. Stata V.16.0 was used for statistical analysis. Fixed-effect or random-effect model was adopted according to heterogeneity, which was evaluated by Cochran's Q and I² values. The main indicator was LV prevalence. Sensitivity analysis, subgroup analysis and meta-regression were performed to investigate the sources of heterogeneity.

RESULTS

A total of 14 studies with 6124 nurses were included. Further, 13 articles with 5745 nurses were included in the meta-analysis, and the pooled prevalence of LV among nurses was 33.08% (95% CI: 23.41% to 42.75%, p<0.05; I²=99.0%). The remaining one study containing 370 samples reported that the prevalence of inter-nurse LV was 7.92%. Subgroup analysis showed that region, sample size, sampling, study's quality, response rate and publication time might not be the sources of heterogeneity. Meta-regression indicated that sample size had the main influence on model heterogeneity. Egger's test showed the existence of publication bias (p=0.03).

DISCUSSION

The prevalence of inter-nurse LV is high in nurse workplace. It is suggested that scholars pay more attention to the cultural differences of inter-nurse LV between regions in the future. This study has the following limitations: there is a lack of studies on LV prevalence in many countries; lack of standard assessment tools; no grey literature was searched.

Formally reporting incidents of workplace violence among nurses: A scoping review

AIM

To describe and synthesise the scientific literature on nurses' formal reporting of workplace violence.

BACKGROUND

Research on reporting workplace violence among nurses is increasing annually, but the evidence from such reports has not been summarised or analysed.

EVALUATION

A scoping review was conducted using electronic databases including PubMed, Web of Science, Scopus, CINAHL and Ovid-Embase.

KEY ISSUES

Forty-nine studies were included in this review, and four significant issues pertinent to reporting of workplace violence was identified: (1) the reporting rate is generally low, and oral report is the most popular medium (2) nurses are often not satisfied with how the organisation handles their report, (3) the reasons affecting reporting are complex and diverse, (4) few studies have proposed countermeasures to promote reporting formally.

CONCLUSION

Scholars are paying increasing attention to workplace violence, however, the reporting of workplace violence in real world situations is not being facilitated to inform improvements in managing violence in the workplace. Therefore, more countermeasures conducive to reporting urgently need to be put forward.

IMPLICATIONS FOR NURSING MANAGEMENT

Nurse managers are in a pivotal position to encourage reporting by their staff, respond pro-actively and advocate for more streamlined and accessible processes. The findings of this review can provide a basis for nursing managers to better manage workplace violence and improve the reporting rate among nurses.

Incivility toward nurses: a systematic review and meta-analysis

One important part of a nurse’s job is to create and help maintain a safe work environment. Evidence shows that negative behaviors such as incivility are not uncommon in the nursing profession. This systematic review and meta-analysis aimed to examine the prevalence of incivility toward nurses. For this purpose, all observational studies that primarily investigated the rate of incivility toward nurses were selected. The electronic databases PubMed, Embase, Web of Sciences, Magiran, IranDoc, and Scopus were searched for studies published during the period of January 1, 1996 to December 31, 2019. The quality of studies was assessed using Hoy’s Critical Assessment Checklist. The study was undertaken using the random effects model, and data were analyzed using STATA14. Data on 60 articles, including data on 30801 individuals, published between 1997 and 2019, entered the study. The findings showed the prevalence of incivility to be 55.10% (95%, CI: 48.05, 62.06).

Due to the high prevalence of uncivil behavior, especially of the verbal type, nursing managers should identify risk factors in the workplace. Planners should develop programs to increase workplace safety, especially in centers that are most exposed to these behaviors. It is also recommended that future studies focus on implementation of effective evidence-based interventions based on organizational culture.

Exploring Experiences of Workplace Violence and Attempts to Address Violence Among Mental Health Nurses in the Kingdom of Saudi Arabia

INTRODUCTION

Workplace violence has emerged as a global phenomenon requiring immediate attention. The nursing profession is primarily affected, and the unique vulnerability of nurses to workplace violence is particularly evident in the field of mental health nursing.

AIMS

This study explores the experiences of mental health nurses with work-related violence and attempts to combat this violence in the context of inpatient mental health facilities in Saudi Arabia.

METHODS

This research comprises a qualitative exploratory study consisting of semistructured interviews with 16 participants using open-ended questions. The participants are psychiatric/mental health nurses with experience in the field, so this methodological approach facilitates a detailed investigation of their encounters with workplace violence.

RESULTS

This study reveals that nurses experience violence in accordance with two main themes and subthemes: experiences of workplace violence, the influence of violence on work settings, and efforts required to combat violence. Data show that these participants consider of prime importance access to training to increase safety through knowledge, improved communication, and protective skills, along with adequate staffing and a safe built environment.

CONCLUSION

The research findings confirm the urgency of addressing the needs of mental health nurses in inpatient psychiatric hospitals. Policymakers in the healthcare field must be aware of the inpatient psychiatric care climate and the need for support from those who staff these areas of practice. Training in specialized knowledge and skills is required to ensure a safe work environment as well as appropriate staffing levels, and a safe built environment. These conditions may be required to recruit and retain mental health nurses capable of providing best-practice care.

The Seniority Swoop: Young Nurse Burnout, Violence, and Turnover Intention in an 11-Hospital Sample

We sought to understand whether nurses aged 20 to 29 years burnout and intend to turnover in higher proportions than more senior nurses, and if so, why. Guided by Maslow's hierarchy, we used brief inventories to assess hospital-based bedside nurses at 11 hospitals in Pennsylvania and Rhode Island (n = 3549/9520) prior to the pandemic. In a second study, we compared scheduling policies, bargaining, and Magnet status to see whether these variables predicted worsened burnout rates in young nurses. In a pattern that appears like a swooping line when graphed, nurses aged 20 to 29 years reported higher burnout and intention to leave than more senior nurses. They also reported being punched, bitten, spit on, kicked, or otherwise physically struck more often, worked more long shifts, worked more nights, and reported more dehydration and poorer sleep. Notably, age alone was not a strong predictor of turnover until burnout was added to the model, indicating that there is no inherent millennial trait resulting in higher turnover. Instead, preventing and addressing burnout is key to retention. When comparing hospital characteristics, only scheduling perks for senior nurses predicted the seniority swoop pattern. We offer 9 recommendations to reduce burnout and turnover in young nurses.

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

Background

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

Methods

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

Results

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

Conclusions

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

Development and Validation of a Comprehensive Questionnaire to Assess Interpersonal Discord (Bullying, Harassment, and Discrimination) at the Workplace in a Healthcare Setting

Objective

This study was conducted to develop and validate a comprehensive questionnaire to assess bullying, discrimination, and harassment in healthcare settings.

Methodology

A mixed-method study design was used to develop and validate the questionnaire. In phase I, qualitative approaches were used for the development, which included literature search, focus group discussions (FGDs), following which the construct was developed. In phase II, face validity and construct validity were established using quantitative approaches.

Results

The final questionnaire consists of 25 items divided into five sections addressing the burden, impact, reasons for underreporting, risk factors, and mitigation strategies. The questionnaire has very good consistency with a Cronbach’s alpha score of 0.86.

Conclusion

This is a comprehensive tool with appropriate psychometric properties with potential use for evaluating the problem of interpersonal discord in the form of bullying, harassment, and discrimination in a healthcare setting.

Workplace violence among healthcare workers during COVID-19 pandemic in a Jordanian governmental hospital: the tip of the iceberg

During the COVID-19 pandemic, significant cases of violence, intimidation, or stigmatization were targeted at healthcare workers (HCWs), patients, and medical infrastructure. These occurrences were most likely just the "tip of the iceberg," with much more remaining unnoticed. The present study's purpose was to assess the frequency, characteristics, effects, and contributing factors of workplace violence (WPV) committed against HCWs in AlKarak Governmental Hospital (KGH), South Jordan, during the COVID-19 pandemic. A cross-sectional study was conducted among 382 HCWs (170 physicians and 212 nurses) working in the KGH, Jordan, during January and February 2021, using a semi-structured questionnaire. The current study showed that most participants (65.5%) reported exposure to WPV, mainly verbal violence (52.0%), and patients' relatives were the principal perpetrators in most incidents. The regular reporting of these incidents is deficient. The victims suffered psychological and physical effects. These assaults on healthcare facilities highlight the importance of effective risk communication at all levels of society to minimize anxiety, stigma, and, eventually, WPV. The way we communicate about COVID-19 is vital in motivating people to take proactive steps to fight the disease and safeguard healthcare.

A Systematic Review of Negative Work Behavior: Toward an Integrated Definition

The objective of this systematic review was to identify the overlapping and unique aspects of the operationalizations of negative work behaviors (NWBs) to specify a new integrative definition of NWB. More specifically, we examined (1) how many operationalizations and conceptualizations of NWB can be identified, (2) whether these operationalizations can be categorized into facets, i. e., the nature of NWB, harm, actor types, and roles, with subcategories, (3) what the meaningful overlap in these operationalizations was, (4) whether the operationalizations tapped unique and meaningful elements, i.e., positive labels and dynamic processes, and (5) how the overlapping and unique elements of the operationalizations could be integrated into a new theory-based research model for NWB for future research. In the literature search based on the Prisma framework, Pubmed, PsycINFO, and Google Scholar, we identified k = 489 studies that met the inclusion criteria of our review. The results of these studies revealed 16 frequently studied NWB labels, e.g., bullying and aggression. Many of these could be categorized in the same way, namely, in terms of the type of behavior, type of harm, and type of actor involved in the NWB. In our new definition of NWB, we integrated the content of the overlapping and meaningful unique elements of the 16 labels.

Working in labor and delivery unit increases the odds of work place violence in Amhara region referral hospitals: Cross-sectional study

BACKGROUND

Workplace violence is any act of negative behavior that causes, physically and psychologically harm to health professionals face in the workplace. The prevalence of workplace violence becomes a challenging occupational issue with increasing nature worldwide. In spite of the seriousness and the impact of the problem, little is known about its magnitude and determinants in the study area and even in Ethiopia.

OBJECTIVE

The study aimed to assess the magnitude of workplace violence and its associated factors among health care providers working for the last one year at Obstetrics and gynecology department in Amhara Regional State Referral Hospitals, Ethiopia 2019.

METHODS

Institutional based cross-sectional study was conducted from October 1st to 30th, 2019. 503 study participants were incorporated in the study. A pre-tested structured questionnaire was used to collect the data. Data were entered into EPI info version 7.2.3.1 and analyzed using SPSS version 23. Binary Logistic regression model was fitted to identify factors associated with workplace violence considering the association to be significant p- value <0.05.

RESULT

This study revealed that 44.5%of the health care providers had reported workplace violence (95% CI: 40.2-48.7). Of this majority of the Victims were experienced a verbal type of violence 200 (88.1%), followed by physical 14 (6.2%), sexual 11 (4.8%), and racial two (0.8%). Factors of workplace violence in this research with statically significant, were: working in labor ward (AOR = 7.4,95% CI: 2.9-18.7), Female sex of participant (AOR = 2.4, 95% CI:1.4-4), work experience less than 5 years(AOR 8.5, 95%CI:7.3-33.3) and numbers of staff less than5 in a shift (AOR = 5.3 95% CI:3.8-39.8) and 5-10 staff in a shift (AOR = 3.3, 95% CI:2.7-25).

CONCLUSION AND RECOMMENDATIONS

The prevalence of workplace violence among obstetrics and gynecology department health professionals in Amhara regional state referral hospitals was high. Developing an incident resolution protocol and legislations to encourage health professionals to prompt report violent acts and judicial punishment of perpetrators will be useful to combat workplace violence at obstetrics and gynecology department.

Prevalence and determinants of workplace violence among nurses in the South-East Asian and Western Pacific Regions: a systematic review and meta-analysis

BACKGROUND

Workplace violence (WPV) includes verbal abuse, physical violence, bullying or mobbing, assault and sexual harassment. The area has been well researched in the developed and high-income countries among nurses and healthcare professionals, but in the case of the low and upper-middle-income countries, there remains a paucity of comprehensive data on the prevalence of WPV and its contributing factors.

AIMS

To estimate the prevalence and determinants of WPV among nurses working in the South-East Asian Region and Western Pacific Regions.

DESIGN

Systematic review and Meta-analysis.

METHOD

A comprehensive search was done to retrieve articles based on a PRISMA compliant protocol registered in PROSPERO: CRD 42020223605. Study selection, quality assessment and data abstraction were independently done by the team members and discrepancies addressed through mutual consensus. Random-effect meta-analysis, I2 statistics and subgroup analysis were done.

RESULTS

The review included 41 studies conducted among 42,222 nurses from 13 countries. The pooled prevalence of WPV, verbal abuse, physical violence, threatening behaviour, physical assault, sexual harassment and bullying/mobbing were 58% (CI 51%-64%), 64% (CI 59%-70%), 23% (CI 14%-34%), 30(CI-11%-52%), 21% (CI 8%-38%), 12% (CI 7%-17%) and 25% (17%-33%), respectively. The various determinants of WPV included attributes related to the patient, nurses and organisation. Moreover, the impact of WPV included physical, psychological repercussions on nurses and the various measures used to manage it.

CONCLUSION

Nurses encounter a high level of WPV especially verbal abuse in their workplace settings. Nursing councils and professional nursing organisations should put in their effort towards the formulation and implementation of occupational safety legislation in their respective countries through appropriate political lobbying.

RELEVANCE TO CLINICAL PRACTICE

Our review highlights the emerging need to focus on the prevention of WPV among nurses working in lower, middle and upper-middle-income countries. Legislation changes and organisational commitment are vital for ensuring effective policies to combat WPV.

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

BACKGROUND

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

METHODS

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

FINDINGS

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

CONCLUSIONS/APPLICATIONS TO PRACTICE

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

Psychological Workplace Violence and Health Outcomes in South Korean Nurses

BACKGROUND

Workplace violence (WPV) and its health consequences should continue to be investigated to foster a healthy and safe working environment, which may reduce nurse staff turnover and improve nurse staff shortages. This study aimed to address the gap in understanding WPV in non-western nurses by examining the relationship between psychological WPV experience, psychological well-being, subjective job stress, and presenteeism among South Korean nurses.

METHODS

This cross-sectional study used data from the fifth Korean Working Conditions Survey (KWCS), and 477 nurses were analyzed. For the analysis, selected variables were extracted from the KWCS through a review of the existing literature. In the analysis, we included psychological WPV experiences, such as verbal abuse, unwanted sexual attention, threats, and/or humiliating behaviors over the past 1 month. We measured health outcomes including nurses' psychological well-being, subjective job stress, and presenteeism.

FINDINGS

Psychological WPV within the previous month was experienced by 11.1% of the participants. Experience with verbal abuse, threats, or humiliating behaviors was associated with more job stress, higher presenteeism, and poor psychological well-being.

CONCLUSION/APPLICATION TO PRACTICE

Study findings suggest that a comprehensive WPV prevention program accompanied by interventions aiming to reduce job stress and improve the well-being of nurses should be actively implemented. To prevent psychological WPV and improve the health of nurses, evidence-based efforts, such as establishment of WPV prevention procedures and education/training of workers at the national, organizational, and individual levels are needed.

"You Need to Get Over the Difficulties and Stand Up Again"-A Qualitative Inquiry into Young Nurses' Coping with Lateral Violence from the Feminist Perspective

Previous studies have reported lateral violence (LV) styles among nurses and the adverse impacts of LV on nurses and nursing. Young nurses, including nursing students and novice nurses, are often victims of LV. A large qualitative research study that contained three sub-studies exploring professional identity development in different professional stages was conducted by a research team in Macau, Special Administrative Region of China. Semi-structured interviews with nursing students and clinical nurses were carried out; among the 58 participants in the three sub-studies, 20 described some forms of LV and their ways of dealing with them. Framed by the feminist perspective, the researchers explored young nurses’ coping strategies in dealing with LV perpetrated by senior colleagues. Two themes were developed reflecting the coping strategies for LV: “making extra efforts” and “soothing emotional distress”. Three sub-themes were under the theme of “making extra efforts”: “catching up knowledge”, “making the most use of learning resources”, “adjusting communication manner”; another batch of sub-themes was under the theme of “soothing emotional distress”: “seeking support from schoolmates”, “living with family but crying alone”, and “adjusting lifestyle”. The study implied that young nurses exerted their agency in coping with LV in clinical practices. Nursing managers and educators should support young nurses’ efforts in overcoming power-based LV and incivility.

Knowledge, Attitudes, and Social Responsiveness Toward Corona Virus Disease 2019 (COVID-19) Among Chinese Medical Students-Thoughts on Medical Education

Purpose: To assess knowledge, attitudes, and social responsiveness toward COVID-19 among Chinese medical students.

Methods: Self-administered questionnaires were used to collect data from 889 medical students in three well-known Chinese medical universities. The questionnaire was comprised of three domains which consisted of demographic characteristic collection, seven items for knowledge, and eight items for attitudes and social responsiveness toward COVID-19. Data from different universities were lumped together and were divided into different groups to compare the differences, including (1) students at the clinical learning stage (Group A) or those at the basic-medicine stage (Group B) and (2) students who have graduated and worked (Group C) or those newly enrolled (Group D).

Results: Medical students at group B had a weaker knowledge toward COVID-19 than did students at group A, especially in the question of clinical manifestations (p < 0.001). The percentage of totally correct answers of COVID-19 knowledge in group C was higher than that in Group D (p < 0.001). There were significant differences between groups C and D in the attitudes and social responsiveness toward COVID-19. Surprisingly, we found that the idea of newly enrolled medical students could be easily affected by interventions.

Conclusions: In light of this information, medical education should pay attention not only to the cultivation of professional knowledge and clinical skills but also to the positive interventions to better the comprehensive qualities including communicative abilities and empathy.