Verbal and physical abuse against Jordanian nurses in the work environment

Violence against healthcare professionals in intensive care units: a systematic review and meta-analysis of frequency, risk factors, interventions, and preventive measures

BACKGROUND

To assess the frequency, risk factors, consequences, and prevention of violence against healthcare workers in intensive care units.

METHODS

PubMed, Scopus, Google Scholar, EMBASE, Cochrane, and Web of Science were searched for studies on violence against healthcare workers in adult intensive care units. Risk factors, patient characteristics, and implications for healthcare workers were collected. Study quality, bias, and level of evidence were assessed using established tools.

RESULTS

Seventy-five studies with 139,533 healthcare workers from 32 countries were included. The overall median frequency of violence was 51% (IQR 37-75%). Up to 97% of healthcare workers experienced verbal violence, and up to 82% were victims of physical violence. Meta-analysis of frequency revealed an average frequency of 31% (95% CI 22-41%) for physical violence, 57% for verbal violence (95% CI 48-66%), and 12% for sexual violence (95% CI 4-23%). Heterogeneity was high according to the I2 statistics. Patients were the most common perpetrators (median 56%), followed by visitors (median 22%). Twenty-two studies reported increased risk ratios of up to 2.3 or odds ratios of up to 22.9 for healthcare workers in the ICU compared to other healthcare workers. Risk factors for experiencing violence included young age, less work experience, and being a nurse. Patients who exhibited violent behavior were often male, older, and physically impaired by drugs. Violence was underreported in up to 80% of cases and associated with higher burnout rates, increased anxiety, and higher turnover intentions. Overall the level of evidence was low.

CONCLUSIONS

Workplace violence is frequent and underreported in intensive care units, with potential serious consequences for healthcare workers, calling for heightened awareness, screening, and preventive measures. The potential risk factors for violence should be further investigated.

SYSTEMATIC REVIEW REGISTRATION

The protocol for this review was registered with Prospero on January 15, 2023 (ID CRD42023388449).

Workplace aggressions on hospital workers: A current and prevalent problem with a high demand for training

BACKGROUND

Workplace aggressions on hospital workers is a very frequent and under-reported problem.

OBJECTIVE

The novel objective of our study was to analyze the number of workplace aggressions per hospital worker. Other objectives of the study were to analyze the management knowledge and interest in receiving training on aggressions by hospital workers.

METHODS

An anonymous survey was handed out among all professionals in a university hospital.

RESULTS

A total of 1118 anonymous surveys were collected. The responders declared that throughout their working life they had suffered some sort of verbal aggression in the hospital in 766 cases (68.5%) and physical aggression in 393 cases (35.2%). Multiple logistic regression analyses found higher risk of receiving physical and verbal aggression in the nursing category and in the Emergency, Critical Care or Psychiatry Units, and a higher risk of receiving physical aggression in women. The score on the level of personal knowledge regarding the legal, physical, and psychological management of aggressions (score 0-10 for each of the 3 aspects) was 2.91±2.68 in legal management, 2.97±2.77 in psychological management and 2.91±2.76 in physical management. The opinion about the interest of receiving training (score from 0 to 10) on the legal management of hospital aggressions was 8.90±1.72, on psychological management was 8.85±1.78 and on physical management was 8.88±1.78.

CONCLUSIONS

Workplace aggression on hospital workers mainly affects women, the nursing category and the Emergency, Critical Care or Psychiatry Units. Hospital workers showed little knowledge on the topic but a great interest in receiving training.

Physical workplace violence in the health sector in Saudi Arabia

Physical workplace violence (WPV) occurs worldwide, causing psychological and physical injuries. However, reports from Saudi Arabia investigating which specialty is the most exposed are scarce. This study aimed to determine the prevalence and circumstances related to physical WPV among all healthcare providers in Saudi Arabia in 12 months, as well as the consequences for both attackers and targets of physical WPV. This cross-sectional study included all healthcare providers registered with the Saudi Commission for Health Specialties who had worked for more than 1 year in the health sector in Saudi Arabia until May 2019. Researchers distributed the questionnaire to the participants via email. Descriptive statistics were used to describe the basic features of the data. Correlations between the categorically measured variables were explored using a chi-square test of independence. Overall, 7398 healthcare workers (HCWs) voluntarily participated in the study, 51.3% being men and 48.7% being women. The mean age was 40 ± 8.62 years), and most participants were of non-Saudi origin. Overall, 9.3% HCWs had encountered physical violence. Male HCWs, pharmacists, nurses, and HCWs of non-Saudi origin were significantly more exposed to physical violence. Furthermore, those with direct physical contact with patients and those working with male patients only were more exposed to physical violence. Physical WPV is an important issue faced by HCWs, particularly those who work night shifts or have direct contact with patients. Results showed that more support, specific strategies and policies to reduce violence occurrence, and protection for healthcare providers are required.

Workplace Violence against Health Care Providers in Emergency Departments of Public Hospitals in Jordan: A Cross-Sectional Study

Workplace violence (WPV) against healthcare providers is a serious problem that carries health, safety, and legal consequences. Healthcare providers working in emergency departments (ED) are more susceptible to WPV compared to other healthcare settings. This study aimed to assess the prevalence of physical and verbal violence against ED physicians and nurses in public hospitals in Amman, Jordan, and to explore the relationship between WPV and the socio-demographic characteristics of the participants. A quantitative descriptive cross-sectional study design was used to assess physical and verbal violence against ED physicians and nurses. A self-administered questionnaire was completed by 67 physicians and 96 nurses from three public hospitals in Amman. In the past year, 33% and 53% of the participants experienced physical and verbal violence, respectively. Compared to their female counterparts, males were more frequently physically (43.7% vs. 2.3%, p-value < 0.001) and verbally (61.3% vs. 29.5%, p-value < 0.001) abused. The main perpetrators of physical and verbal violence were the patients' relatives. Out of 53 physical and 86 verbal abuse incidents, only 15 cases (10.8%) were followed up with legal persecution. In conclusion, there is a widespread occurrence of physical and verbal violence against ED physicians and nurses in the public sector hospitals in Jordan. A collaborative effort by all stakeholders should be instituted to ensure the safety of the physicians and nurses and to improve the quality of the healthcare provided.

Verbal and Physical Abuse Against Nurses Working in Hospitals and Health Centers in Buraidah, Saudi Arabia

Background Hospital staff, especially nurses, face violence of various forms in the workplace. This study aimed to assess the burden of verbal/physical abuse against nurses and their attitude towards such events in Buraidah, Saudi Arabia. Methods A cross-sectional study was conducted among nurses working in three public sectors and two private sector hospitals, and five primary healthcare facilities in Buraidah. Data was collected using a structured online questionnaire, disseminated among nurses through nursing departments of participating facilities. Data were analyzed using SPSS version 21.0. Results A total of 369 nurses participated in the survey, with a mean age of 34 (±6.9) years. About two-thirds, 68% (250) of respondents, had experienced at least one verbal/physical abuse incident during one year. The most common perpetrators were patients (44.4%). Sixteen percent of participants reported taking no action against the incident. Those working in private facilities were 80% less likely to experience abuse than those in public facilities, adjusted OR 0.20 (95% CI: 0.08-0.47). Conclusions There was a high burden of verbal/physical abuse against nurses, and they, therefore, suffer from disturbing memories. However, a little more than half do not officially report it to the managers, with only a small fraction seeing some action taken. Occupational health practitioners should take action to improve the policy and procedures related to workplace violence (WPV) in healthcare facilities. Further research is needed to characterize incidents to understand the patterns and develop interventions for the prevention of such events.

Violence against healthcare workers during coronavirus (COVID-19) pandemic in Egypt: a cross-sectional study

Background

Healthcare workers are on the front lines of COVID-19 and are subject to risks. A rise in the cases of violence and aggressiveness against HCWs has been observed worldwide, adding to the already existing burnout. The purpose of this research is to determine the prevalence of workplace violence, its risk variables, and the pattern of violence directed towards healthcare workers in the context of COVID-19 pandemic. The research used a cross-sectional analytic design. Purposive sampling was utilized to identify research participants using an online survey. Form’s link was distributed to accessible social media groups such as Facebook and WhatsApp from July 2020 to the end of October 2020. A self-administered structured survey was adapted from the World Health Organization survey questionnaire about violence in healthcare settings. The Google Form’s link was distributed to the social media groups until the total sample of 405 was collected.

Results

During the COVID-19 pandemic, workplace violence against Egyptian healthcare workers was prevalent (63.2%). The most prevailing type of violence among the exposed participants was verbal violence (87.9%). Violence is more common in the (< 40 years old) age group (80.9% of exposed healthcare workers). Violence was more statistically significant against females (60.5% of the exposed healthcare workers) (p-value = 0.023). Regarding the work specialty, violence was more committed against physicians (84.3% of exposed healthcare workers) than nurses (12.8% of exposed healthcare workers). The primary perpetrators of violence were the patient’s family (74.6%). The majority of the exposed HCWs (96%) reported no physical injury from the violent event, and 71.5% deemed the violent incident preventable. The majority (90.6%) of HCWs exposed to violent incidents declared non-reporting.

Conclusions

Effective risk communication at all levels of society is critical for reducing fear, stigma, and ultimately workplace violence, as recent assaults on healthcare institutions demonstrate. To reduce violence and safeguard the safety of the medical profession, the government, health policymakers, media organizations, and community engagement groups must collaborate for healthcare workers’ safety.

The mediating effect of job satisfaction on the relationship between workplace bullying and organizational citizenship behavior in nurses

BACKGROUND: Establishing strategies for improving nursing shortages, which are labor challenges in the current health care industry. OBJECTIVE: This study aimed to examine the correlation between workplace bullying and organizational citizenship behavior (OCB) in nurses and the mediating effects of job satisfaction on this relationship. METHODS: A total of 164 valid samples were obtained. The Negative Acts Questionnaire-Revised, the Minnesota Satisfaction Questionnaire, and an OCB scale were measured. RESULTS: The results indicate that a significantly larger proportion of nurses working in operating rooms (Δ odds ratio, odds = 2.30, p = 0.043), the emergency room, and the ICU (Δ odds = 2.79, p = 0.019) had suffered workplace bullying compared with nurses working in patient wards. No experience of workplace bullying exerted a positive and significant effect on job satisfaction (p < 0.001), and job satisfaction exerted a positive and significant effect on overall OCB (p < 0.001). No experience of workplace bullying exerted a significant mediating effect on the influence of job satisfaction on overall OCB (p < 0.001). CONCLUSIONS: The department of service in which a nurse works influences the occurrence of workplace bullying, previous experience with bullying reduces job satisfaction, and greater job satisfaction promotes higher OCB performance. Based on the study results, we advise that nursing executives address and prevent workplace bullying to increase the job satisfaction of nurses so that nurses are willing to display OCB, apply their expertise, and expand the role and functions of nursing.

Patient and visitor aggression de-escalation training for nurses in a teaching hospital in Cairo, Egypt

BACKGROUND

Workplace violence (WPV) has been recognized as a major occupational hazard worldwide. Healthcare professions are particularly at a higher risk of WPV. Patients and their relatives are commonly the most common perpetrators for WPV against physicians. Trainings on the universal precautions of violence, how to effectively anticipate, recognize and manage potentially violent situation is recommended by OSHA as a part of a written, effective, comprehensive, and interactive WPV prevention program.

OBJECTIVE

To implement and evaluate the effectiveness of a training session delivered to nurses. The training session aimed to increase nurses' ability to identify potentially violent situations and to effectively manage these situations in a teaching hospital in Egypt.

METHODOLOGY

A total of 99 nurses attended the training sessions. Confidence in coping with aggressive patient scale, along with nurses' attitudes toward WPV, were used to assess the effectiveness of the training sessions.

RESULTS

Nurses' perceived confidence to deal with aggression increased after attending the training sessions. Nurses' attitudes toward WPV positively changed after attending the training session.

CONCLUSION AND RECOMMENDATIONS

Increasing awareness of the problem among healthcare professions as well as the public is warranted. Violence prevention program with a zero-tolerance policy is warranted.

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.

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.

Predictors of violence against health professionals during the COVID-19 pandemic in Brazil: A cross-sectional study

BACKGROUND

The increase in violence against health professionals in the COVID-19 pandemic makes it necessary to identify the predictors of violence, in order to prevent these events from happening.

OBJECTIVE

Evaluating the prevalence and analyzing the variables involved in the occurrence of violence against health professionals during the COVID-19 pandemic in Brazil.

METHOD

This is a cross-sectional study conducted online involving Brazilian health professionals during the COVID-19 pandemic. The data were collected through a structured questionnaire (Google Online Form) sent to health professionals on social networks and analyzed through logistic regression by using sociodemographic variables. The set of grouped variables was assigned to the final model when p <0.05. A network was built using the Mixed Graph Models (MGM) approach. A centrality measurement chart was constructed to determine which nodes have the greatest influence, strength and connectivity between the nodes around them.

RESULTS

The predictors of violence in the adjusted regression model were the following: being a nursing technician / assistant; having been working for less than 20 years; working for over 37 hours a week; having suffered violence before the pandemic; having been contaminated with COVID-19; working in direct contact with patients infected by the virus; and having family members who have suffered violence. The network created with professionals who suffered violence demonstrated that the aggressions occurred mainly in the workplace, with an indication of psycho-verbal violence. In cases in which the aggressors were close people, aggressions were non-verbal and happened both in public and private places. The assaults practiced by strangers occurred in public places.

CONCLUSIONS

Violence against health professionals occurs implicitly and explicitly, with consequences that can affect both their psychosocial well-being and the assistance given to their patients and families.

Verbal abuse among newly hired registered Jordanian nurses and its correlate with self-esteem and job outcomes

Purposes

1) identify the verbal abuse prevalence among newly hired registered nurses in Jordan; 2) examine the mean score of self-esteem, intent to stay, and job commitment 3) examine the relationships between the exposure to and the effects of verbal abuse, self-esteem, job commitment, and intent to stay in newly hired Jordanian registered nurses.

Background

Studies shows that verbal abuse in health care settings is a health-risk factor for both nurses and patients.

Design

A cross-sectional descriptive correlational study was conducted jn 2019.

Materials and methods

A convenient sample of 200 registered nurses were recruited from two large cities in the North of Jordan. Self-reported questionnaires were used to collect data.

Results

Verbal abuse is highly prevalent among newly hired registered nurses in Jordan 100%, the mean score of exposure to verbal abuse was M = 6.76, and the effect of verbal abuse scale was M = 28.35. The result of person r indicated that there is a significant negative correlation between verbal abuse affect/reactions and registered nurses' intention to stay p = ˂0.01, job commitment p = ˂0.01 and self-esteem p = ˂0.01. Also, the exposure to verbal abuse is negatively correlated with nurse's job commitment, (r = -.203, p = .004).

Conclusion

Verbal abuse is negatively correlated with nurses' self-esteem, intent to stay and job commitment.

Implications

Administrators and nurse managers should establish educational training programs and workplace safety protocols to protect nurses and to create a safe positive work environment with no tolerance to verbal abuse.

Workplace violence among nursing professionals

INTRODUCTION

The frequency of workplace violence has increased significantly across several countries, with short- and long-term effects on workers' health. Within the health care sector, nursing professionals are the most exposed to workplace violence, since they provide direct assistance to patients on a 24-hour basis.

OBJECTIVES

To identify the types of occupational violence experienced by nursing professionals.

METHODS

This was a descriptive, quantitative study of 55 nursing professionals in the emergency unit of a public hospital. Data were collected between April and June 2018 through the Questionnaire for Workplace Violence Experienced or Witnessed by Nursing Professionals. Categorical variables were presented as frequencies and percentages, while continuous variables were described using measures of central tendency and dispersion.

RESULTS

A total of 49 (88.9%) participants had experienced workplace violence, with 21 (38%) suffering verbal abuse; 14 (25.4%) experiencing mobbing; 6 (11%) reporting physical violence; 5 (9.1%) suffering sexual harassment; and 3 (5.4%) reporting racial discrimination. Furthermore, 44 (90%) of these individuals reported that the incidents of violence could have been prevented.

CONCLUSIONS

The types of violence observed included physical aggression, verbal abuse, sexual harassment and racial discrimination, with verbal abuse being the most commonly reported. These acts were perpetrated by patients and their families, as well as colleagues and supervisors. Violence prevention strategies should be implemented in institutions in order to provide a safe working environment.

Workplace violence in nursing: A concept analysis

OBJECTIVES

To clarify the concept of workplace violence in nursing and propose an operational definition of the concept.

METHODS

The review method used was Walker and Avant's eight-step method.

RESULTS

Identification of the key attributes, antecedents, consequences, and empirical referents of the concept resulted in an operational definition of the concept. The proposed operational definition identifies workplace violence experienced by nurses as any act or threat of verbal or physical violence, harassment, intimidation, or other threatening disruptive behavior that occurs at the worksite with the intention of abusing or injuring the target.

CONCLUSIONS

Developing insights into the concept will assist in the design of new research scales that can effectively measure the underlying issues, provide a framework that facilitates nursing interventions, and improve the validity of future studies.

Physical violence and verbal abuse against nurses working with risk stratification: characteristics, related factors, and consequences

OBJECTIVE

to analyze the characteristics, related factors, and consequences of physical violence and verbal abuse against nurses working with risk stratification.

METHODS

a cross-sectional, descriptive and quantitative study carried out with 80 nurses who work with risk stratification in emergency services. Data were collected using an adapted instrument and analyzed using (uni)bivariate inferential statistics.

RESULTS

companions were the main perpetrators of verbal abuse (86.1%); and patients inflicted physical violence (100%). Professionals with up to five years of experience are 74% less likely to suffer physical violence (p=0.029). Women suffer 5.83 times more verbal abuse than men (p=0.026). Sadness (15.8%) and fear of the aggressor (15.3%) were the main consequences of verbal abuse; and fear of the aggressor (22.2%) and stress (22.2%) were results of physical violence.

CONCLUSION

violence is influenced by institutional, professional and client aspects. Therefore, coping with it requires multidimensional strategies.

Verbal Abuse Among Nurses Working in a Nepalese Government Hospital

Verbal abuse among nurses is the most prevailing type of violence encountered by nurses. A cross-sectional research design was used to identify the characteristics of verbal abuse among nurses. A self-administered questionnaire was completed by 201 nurses working in a government hospital of Nepal. Nurses were exposed to verbal abuse and yelling or raising voice in an angry fashion was the most common forms experienced by 96.5% of the respondents. Patient's relatives were reported as the main source of verbal abuse. Frequent exposure to verbal abuse was found in Nepalese nurses, which makes nurses feel unsupported, increased stress levels, and decreased sense of relaxation/well-being in the job. There is an immediate need of monitoring and training among nursing staff in recognition and management of aggressive behavior.

Prevalence of Workplace Violence and Associated Factors Against Nurses Working in Public Health Facilities in Southern Ethiopia

Background

Workplace violence is an important challenge faced by healthcare providers, especially nurses, throughout the world. But this issue is neglected in developing countries, including Ethiopia. Therefore, the objective of this study was to assess the prevalence of workplace violence and associated factors against nurses working in public health facilities.

Methods

A cross-sectional study was conducted in public health facilities in Gamo Gofa zone from February to March 2018. A simple random sampling technique was used to select 354 study respondents from selected public health facilities. The data was collected using a self-administered, pre-tested, and structured questionnaire and analyzed by using SPSS version 21. Descriptive analysis was made and both bi-variable and multivariable logistic regression were applied to identify the factors associated with workplace violence against nurses.

Results

Out of the 348 participants, 150 (43.1%) nurses had experienced workplace violence. Among these, 47 (13.5%) had faced physical violence, 98 (28.2%) had verbal abuse, 36 (10.3%) were bullied/mobbed, and 25 (7.2%) faced sexual harassment at least once in the last 12 months. Patients’ relatives were the leading perpetrators in physical, verbal violence, and bullying, accounting 55.3%, 46.9%, and 36.1%, respectively. Female nurses (AOR=1.98; 95% CI=(1.21, 3.25), those who live without a spouse (AOR=1.98; 95% CI=(1.22, 3.22), those who drink alcohol (AOR=1.88; 95% CI=(1.03, 3.44), and those who chew chat (AOR=3.24; 95% CI=(1.25, 8.45) were more likely to suffer from workplace violence in public health facilities.

Conclusion

The prevalence of workplace violence against nurses was high. In addition, the characteristics of the occurrences of different types of violence are different beginning from the perpetrators’ characteristics to the measures taken by the nurses. In addition, sex, marital status, drinking alcohol, and chewing chat were found statistically significant factors influencing workplace violence against nurses.

Nurses' perspectives of violence in emergency departments: A metasynthesis

INTRODUCTION

Workplace violence against nurses in the Emergency Department (ED) is a significant issue worldwide and has received increased attention. Workplace violence against nurses in the ED has increased in recent years. With such a large number of nurses having experienced violence, it is important to understand and elucidate the nurses' perspective of violence in the ED.

METHOD

Qualitative studies that were published between 2010 and 2019. A metasynthesis of 6 qualitative studies was conducted using Noblit and Hare's metaethnographic methodology. The Critical Appraisal Skills Program (CASP) was used to evaluate the quality of the studies.

RESULTS

Four overarching themes emerged from the data: the inevitability of violence, invisible wounds and painful memories, post-violence repercussions, and double-sided: physical and verbal abuse.

DISCUSSION

Findings provide insight into policies actions related to perpetrators and developing violence protections guidelines to support ED nurses in managing workplace violence.

CONCLUSION

Violence in the ED is an inevitable experience for nurses. Organizations must take a realistic approach to implement violence reduction measures and training programs in the ED.

Verbal abuse and psychological disorders among nursing student interns in KSA

Objective

This study aimed to investigate the forms and frequency of verbal abuse (VA) among nursing student interns and determine the prevalence of psychological disorders (i.e. depression, stress, and anxiety) within this group.

Materials and methods

A cross-sectional study was conducted in an urban teaching hospital in KSA. Nursing student interns responded to the Verbal Abuse Questionnaire and Depression Anxiety Stress Scales.

Results

A total of 54 interns completed the questionnaires; 55% of them had been exposed to one type of VA at least once a year, and 5% of them had experienced VA several times a week. ‘Ignoring’ was the most frequently experienced form of VA (50.8%), and feeling overwhelmed was the most commonly experienced emotional reaction (51.1%) to VA. ‘Stop talking to the abusive person’ was the most frequently reported behavioural reaction to VA (57.9%). Most of them (59.3%) did not report a sign of depression, but 18.5% of them had severe to extremely severe depression. Most interns (70.4%) did not report a sign of anxiety, but approximately 11.1% of them had severe to extremely severe anxiety. A majority (70.4%) of the interns did not report a sign of stress, and only 5.6% of them reported experiencing severe stress.

Conclusion

VA is a major problem that is encountered in clinical settings, especially by future nurses. The present findings underscore the need to further examine the levels and forms of VA that are experienced by them and their reactions to such stress-inducing behaviours.

Medical vandalism: Awareness and opinions; beyond the clinician's window

Background and Aims:

Medical vandalism has become a major matter of concern in today's world. The number of violent mob attacks on doctors and other medical personnel is on the rise. This trend is having a negative impact on the proper functioning of healthcare system thus affecting the quality of care and treatment. The aim of this study is to assess the awareness and opinions of the stakeholders in healthcare facilities about vandalism in today's medical practice.

Methods:

A cross-sectional survey study was conducted in Acharya Vinoba Bhave Rural Hospital among 360 participants, comprising of nurses, patient's relatives, security personnel and non-medical staff in the Emergency Care Units and wards. A detailed questionnaire was prepared and used to assess the opinion of the subjects covering various aspects of medical vandalism such as prevalence of vandalism, experiences of vandalism at work, various factors causing medical vandalism, initiatives taken by the respondents to curb vandalism and awareness about various laws implemented by the government that help prevent vandalism.

Results:

Majority of the participants were of the opinion that medical vandalism was prevalent in India. Overcrowding of patients, inadequate skilled healthcare providers and occurrence of sudden death in casualty are among the major factors that trigger vandalism. This issue has been on the rise in both government and private setups, and nurses seem to be the major victims of such cruelness. 80% of the subjects admitted that verbal abuse was more common than physical abuse.

Conclusion:

Although violence against all healthcare professionals has been recorded since historical times, the current scenario of the country is disturbing. Immediate measures need to be taken to curb vandalism. Various laws need to be implemented to strictly punish those who create violence. Likewise, institutions must ensure the availability of adequate staff and facilities to reduce events that make the bystanders aggressive.

Mental health nurses' perspective of workplace violence in Jordanian mental health hospitals

PURPOSE

The purpose was to assess the mental health nurses' perspectives of workplace violence in mental health departments in Jordan.

DESIGN AND METHODS

A cross-sectional correlation study was utilized to address the study's purposes. Data were collected using self-reported questionnaires from nurses working in governmental mental health departments in Jordan.

FINDINGS

The findings indicated that 80% of the respondents were victims of at least one violent act in the last 2 years. Verbal abuse was the most indicated type of violence. Patients were considered the main source of violence.

PRACTICE IMPLICATIONS

Policies and legislations addressing workplace violence should be implemented, and nurses should be trained on using such policies. Hospital managers should create a safe work environment by enforcing effective security measures and maintaining adequate staffing.

Compassion fatigue and substance use among nurses

AIM

This study aimed to detect if there were differences in compassion fatigue (CF) among nurses based on substance use and demographic variables of gender, marital status, type of health institution and income.

BACKGROUND

Compassion fatigue is considered an outcome of poorly handled stressful situations in which nurses may respond with self-harming behaviours like substance use. Evidence in this area is critically lacking.

METHODS

This study used a descriptive design to survey differences in CF of 282 nurses. The participants completed a demographic survey and indicated whether they consume any of the following substances on a frequent basis: cigarettes, sleeping pills, power drinks, anti-depressant drugs, anti-anxiety drugs, coffee, analgesics, amphetamines and alcohol. Compassion Fatigue scores were surveyed using CF self-test 66 items developed by Stamm and Figely (Compassion satisfaction and fatigue test. http://www.isu.edu/~bhstamm/tests.htm, 1996).

RESULTS

There were significant differences in CF scores in favour of nurses who used cigarettes, sleeping pills, power drinks, anti-depressants and anti-anxiety drugs. While no significant differences in CF were found between nurses who used coffee, analgesics, amphetamines and alcohol, significant differences in nurses' CF were found in relation to type of institution, gender and marital status. But nurses' income did not bring differences to CF scores.

CONCLUSION

Nurses who might be lacking resilience cope negatively with CF using maladaptive negative behaviours such as substance use.

IMPLICATIONS FOR NURSING MANAGEMENT

Nursing management should be aware of the substance use drive among nurses and build organizational solutions to overcome compassion fatigue and potential substance use problems.

Violence in the workplace in Nursing: consequences overview

Objective:

to reflect on the consequences of workplace violence experienced by nursing professionals.

Methods:

this is a reflection paper based on recent publications related to the subject, particularly researches carried out in Brazil and in other countries.

Results:

exposure to workplace violence has been associated with health problems in nursing professionals, which may be physical damage, emotional manifestations, and psychic disorders. It also affects the employee performance, his or her family and social interactions.

Conclusion:

this phenomenon is potentially noxious and costly, for it leads to suffering, illness, absence from work, and even death. This reflection calls attention moreover to the importance of a safe and adequate health care work environment.

Employee reactions to the use of management control systems in hospitals: motivation vs. threat

OBJECTIVE

Management control systems (such as budgets or balanced scorecards) are formal procedures used by managers to promote employee behavior aligned with organisational objectives. Employees may react to these control systems by either becoming more motivated or perceiving them as a threat. The aim of this paper is to determine the extent to which hospital ownership (public or private), professional group (physician, nurse, pharmacist or administrative employee), type of contract (fixed or temporary), gender and tenure can condition employee reaction to management control systems.

METHODS

We conducted the study in the three largest hospitals in the State of Santa Catarina (Brazil), two public (federal and state-owned) and one private (non-profit organisation). Physicians, nurses, pharmacists and administrative employees received a questionnaire between October 2013 and January 2014 concerning their current perceptions. We obtained 100 valid responses and conducted an ANOVA variance analysis.

RESULTS

Our results show that the effect of management control systems on employees differs according to hospital ownership, professional group and type of contract. However, no significant evidence was found concerning gender or tenure.

CONCLUSIONS

The results obtained contribute to creating specific knowledge on the reactions of employees to the use of management control systems in hospitals. This information may be important in adapting management control systems to the characteristics of the hospital and its employees, which may in turn contribute to reducing dysfunctional worker behavior.

Prevalence and risk factors of workplace violence against health care workers in emergency department in Ismailia, Egypt

INTRODUCTION

Emergency department is one of the high-risk areas, where violence against health care workers (HCWs) is a prevalent and serious problem. Violence has negative effects on HCWs, and therefore on the quality of care provided in emergency department. This study aimed to determine the prevalence, types, sources and risk factors of violence reported by HCWs in emergency department.

METHODS

A cross-sectional study was conducted using a standardized questionnaire developed by the WHO. One hundred thirty four questionnaires were included in this study (94.4% response rate).

RESULTS

WPV was reported by 59.7% of HCWs. Verbal violence was the most reported (58.2%), compared to physical violence (15.7%). The most reported reasons for violence were waiting time and that patient and family expectations not being met. Only 29.5% of HCWs who experienced verbal violence and 23.8% of who experienced physical violence reported it to hospital authority. About 75% of HCW thought that work place violence could be prevented, and about 60% said that no action was taken against the attacker by hospital authority.

CONCLUSION

Violence against HCWs in emergency department is a significant issue that cannot be ignored. There are multiple reasons. The key point in dealing with the problem is to treat its specific causes.

Coping Strategies of Neurology Nurses Experiencing Abuse From Patients and Families

OBJECTIVE

The objectives of this study were to assess incidence of verbal and physical abuse of neurology nurses, identify their coping strategies, and explore relationships between demographic characteristics, incidence, and coping strategies.

BACKGROUND

A 2011 U.S. Department of Justice survey found that average annual rates of nonfatal violent crime against nurses were greater than all occupations and identified nurses as having the highest percentage of workplace violence.

METHODS

A descriptive, exploratory research design utilizing an online survey of 112 neurology nurses in the United States was used for this study.

RESULTS

Results identified the presence of verbal and physical abuse against neurology nurses, avoidance coping strategies utilized, and gender differences on types of violence and effects of abuse.

CONCLUSIONS

Administrative attention must address abuse of neurology nurses by patients and families and develop nursing practice that eliminates the use of avoidance as a way of dealing with this abuse.

Patient Aggression in Real Time on Geriatric Inpatient Units

This study focused on verbal and physical aggression against nursing staff, in real time, by elderly patients. The aggressive incidents were recorded at the end of each shift when they were more likely to be accurately remembered. Before beginning the study, nursing staff were taught how to use the Modified Overt Aggression Scale (MOAS) to identify aggressive acts. High rates of verbal and physical aggression among the elderly were observed by nurses, and data show that 75% of nursing staff experienced aggression on their shift. They either experienced aggression themselves or observed aggression on every single shift; that is at least five violent incidents in a work-week. Even if one is not the target of aggression, such observation is associated with elevated levels of stress.

The impact of training program on nurses' attitudes toward workplace violence in Jordan

BACKGROUND

Nurses' attitudes toward workplace violence are still inadequately explored, and possess an impact in preventing, and managing the violent incidents and the quality of nursing care. Creating a demand for an effective intervention program to improve nurses' knowledge of and attitudes toward workplace violence.

OBJECTIVE

To study the impact of the training program on nurses' attitudes toward workplace violence in a military hospital in Jordan.

METHODS

One group before-after design was employed. A stratified random sample of 100 nurses working in three shifts was recruited. Data were collected earlier and after the preparation program using the Attitudes Toward Patient Physical Assault Questionnaire. "The Framework Guidelines for addressing workplace violence in the health sector", was adopted in this work. The preparation sessions were for one day each week over five weeks. The post-test assessment was over five weeks using the same questionnaire.

RESULTS

A total of 97 nurses completed the survey. The outcomes demonstrated the significant impact of the training program on nurses' attitudes towards workplace violence (t=6. 62, df=96, p=0.000). The prevalence of verbal abuse by patients and visitors was 63.9% and for physical abuse, 7.2% were from patients and 3.1% of visitors. Most violent incidents occurred during day duty and during delivering nursing care (40.2% and 32%, respectively). Major source of emotional support for abused nurses was from the nursing team (88.7%), while the legal support was from nursing management (48.5%).

CONCLUSION

The study highlights a general concern among nursing staff about workplace violence. Confirming that violence prevention education for staff is a necessary step forward to deescalate the problem. A significant effect of the training program was evident in this study.

Challenges of hemodialysis in Vietnam: experience from the first standardized district dialysis unit in Ho Chi Minh City

Background

Hemodialysis is an increasingly common treatment in Vietnam as the diagnosis of end stage renal disease continues to rise. To provide appropriate hemodialysis treatment for end-stage renal disease patients, we conducted a 1-year cross-sectional study to measure the prevalence of bloodborne infection and factors associated with non-compliant behaviors in hemodialysis patients.

Methods

One hundred forty-two patients were tested for hepatitis B virus (HBV) surface antigen and hepatitis C virus (HCV) core antigen. They provided demographic, medical and dialysis information. Non-compliant behaviors were obtained from their medical records.

Results

Overall, 99 % of patients reused their dialyzers and 46 % had arteriovenous fistula on admission. Both HBV and HCV equally accounted for 8 % of patients and concurrent infection accounted for 1 %. Non-compliance rates of dietary and medication were 39 and 27 % respectively. 42 % of patients missed hemodialysis session, 8 % were verbally or physically abusive and 9 % were non-cooperative. Of the 54 % catheterized patients, 7 % improperly cared for their dialysis access. Dietary non-adherence was associated with male patients (p = 0.03) and medication non-adherence was associated with younger age (p = 0.05). Duration between diagnosis of chronic kidney disease and initiation of hemodialysis was associated with improper care of dialysis access (p = 0.04). Time on hemodialysis was associated with missed hemodialysis session (p = 0.007) and verbal or physical abuse (p = 0.01).

Conclusion

Health services need to provide safe practice for dialyzer reuse given the endemicity of hepatitis. We believe a national survey similar to ours about seroprevalence and infection control challenges would prepare Vietnam for providing safer satellite treatment units. Safe hemodialysis services should also comprise patient preparedness, education and counseling.

Workplace violence towards workers in the emergency departments of Palestinian hospitals: a cross-sectional study

BACKGROUND

Workplace violence (WPV) in hospital emergency departments (EDs) is a common problem. The objective of this study was to assess the characteristics (level and type), associated risk factors, causes, and consequences of WPV against workers in Palestinian EDs.

METHODS

A cross-sectional study was conducted in 14 out of the available 39 EDs in Palestine: 8 from the West Bank and 6 from the Gaza Strip. Data were collected using a self-administered questionnaire between July-September 2013. Multivariate logistic regression models were used to examine risk factors associated with exposure to WPV.

RESULTS

A total of 444 participants (response rate 74.5%): 161 (32.0%) nurses, 142 (32%) physicians, and 141 (31.7%) administrative personnel. The majority (76.1%) experienced a type of WPV in the past 12 months: 35.6% exposed to physical and 71.2% to non-physical assaults (69.8% verbal abuses, 48.4% threats, and 8.6% sexual harassments). Perpetrators of physical and non-physical violence were mainly patients' families/visitors (85.4% and 79.5%, respectively). Waiting time, lack of prevention measures, and unmet expectations of patients and their families are the main reasons for WPV. The multivariate regression analysis showed that younger personnel (OR = 2.29 CI 95% 1.309-4.036), clinicians (nurses and physicians) (OR = 1.65 CI 95% 0.979-2.797) comparing with administrative, and less experienced ED personnel (OR = 2.39 CI 95% 1.141-5.006) are significantly at higher risk of exposure to WPV (P < 0.05). Low level (40%) of violence reporting is evident, largely attributed to not enough actions being taken and fear of consequences. Violence has been shown to have considerable consequences for workers' well-being, patient care, and job retention.

CONCLUSIONS

Violence against workers in Palestinian EDs is highly common. The effects of violence are considerable. Multiple factors cause violence; however, EDs' internal-system-related factors are the most amenable to change. Attention should be given to strengthening violence prevention policy and measures and improving incident-reporting system.

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

BACKGROUND

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

METHODS

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

RESULTS

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

CONCLUSIONS

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

Patient and visitor violence towards staff on medical and psychiatric wards in India

BACKGROUND

Patient and visitor violence (PVV) towards staff is common across health settings. It has negative effects on staff and treatment provision. Little data is available from the developing world.

AIMS

To examine the prevalence of PVV in India and make comparisons with the existing data.

METHODS

We administered an abbreviated version of the Survey of Violence Experienced by Staff (SOVES-A) in English in Mysore on medical and psychiatric wards.

RESULTS

249 staff participated. 16% of staff in psychiatric wards were subjected to some form of PVV in the past 4 weeks which is lower than in the developed world. 57% of staff on medical wards experienced PVV which is similar to the developed world. Patients and Visitors were almost equal sources of this violence. Verbal abuse was more common than threats and physical assaults. Training in aggression management may be a protective factor.

CONCLUSION

PVV is a significant problem in India, especially on medical wards. Aggression management training may be a way to reduce the prevalence of PVV.

[Prevalence of anxiety disorders and depression among junior doctors and their links with their work]

The caregivers are exposed to several occupational hazards, including psychosocial risks. Among these occupational groups, junior doctors have been little studied. The aim of this study was to evaluate the prevalence of depression and anxiety among junior doctors and their links with their work.

METHODS

This is a prospective study using an anonymous online questionnaire between October 2011 and June 2012. Every junior doctor of Brest medical school was included without exclusion criteria. The questionnaire asked about demographic and health data. It included four validated scales: the Center for Epidemiologic Studies Depression Scale (CES-D), the Spielberger anxiety questionnaire, the Quality of Life Questionnaire of WHO (WHO-QOL) and the Job Content Questionnaire of Karasek.

RESULTS

One hundred and ninety-two junior doctors were included; 68.2 % of them were women. They were 13.0 % suffering from depression; 28.7 % from anxiety; 32.8 % of junior doctors were in job strain and 29.7 % in iso strain. Depression was correlated with high psychological demands and anxiety. The lack of organizational support from senior doctors and competition between junior doctors increased the junior doctors' anxiety.

CONCLUSION

A part of junior doctors is anxious and depressed, somehow due to the psychological demands of work and relationships with other junior doctors and with senior doctors.

Violence Against Nurses in Emergency Departments in Jordan

Violence against nurses in emergency departments (EDs) has become a widespread phenomenon affecting nurses’ job satisfaction and work performance. Literature is scarce regarding prevalence rates and causes of violence directed toward nurses in Jordan. The present study investigated violence experienced by Jordanian nurses in EDs and causes of violence from their perspectives. This descriptive study collected data from 174 Jordanian ED nurses. The majority of the participants (91.4%) reported experiencing violence (verbal 95.3% vs. physical 23.3%). According to participants, the most common causes of violence in the ED were crowding and workload (75.9%), and the least was care of patients with dementia or Alzheimer’s disease (35.6%). Violence is common in Jordanian EDs, giving rise to many heath and behavioral consequences. Health care administrators are obligated to protect nurses from violent incidents by providing adequate safety measures, beneficial administrative procedures, and sincere efforts to overcome the causes of this phenomenon.