Safety climate and workplace violence prevention in state-run residential addiction treatment centers

Mental Health Problems in Chinese Healthcare Workers Exposed to Workplace Violence During the COVID-19 Outbreak: A Cross-Sectional Study Using Propensity Score Matching Analysis

OBJECTIVE

This study aimed at examining the effect of medical workplace violence (MWV) on the mental health of Chinese healthcare workers during the outbreak of coronavirus disease 2019 (COVID-19).

METHODS

An anonymous online survey was issued to Chinese healthcare workers (N=1063) from 31 provinces and autonomous regions between February 13th and February 20th. Mental health was measured by the Chinese Depression Anxiety Stress Scales-21 (DASS-21). Medical workplace violence was measured using a single item, whether any type of workplace violence was experienced during the COVID-19 outbreak. Propensity score matching was used to assess the impact of MWV on mental health.

RESULTS

Out of 1063, 217 (20.4%) reported experiencing MWV during the COVID-19 outbreak. Before matching, MWV was correlated with elevated mental health problems (b=8.248, p<0.001), after adjusting for other variables. After matching, Chinese healthcare workers who experienced MWV were more likely to suffer from mental health problems than those who did not.

CONCLUSION

MWV exerts a detrimental effect on mental health among Chinese healthcare workers during the COVID-19 outbreak. It is necessary to create a more supportive and safer work environment for healthcare workers at this special context of the COVID-19 outbreak.

Patient safety in inpatient mental health settings: a systematic review

OBJECTIVES

Patients in inpatient mental health settings face similar risks (eg, medication errors) to those in other areas of healthcare. In addition, some unsafe behaviours associated with serious mental health problems (eg, self-harm), and the measures taken to address these (eg, restraint), may result in further risks to patient safety. The objective of this review is to identify and synthesise the literature on patient safety within inpatient mental health settings using robust systematic methodology.

DESIGN

Systematic review and meta-synthesis. Embase, Cumulative Index to Nursing and Allied Health Literature, Health Management Information Consortium, MEDLINE, PsycINFO and Web of Science were systematically searched from 1999 to 2019. Search terms were related to 'mental health', 'patient safety', 'inpatient setting' and 'research'. Study quality was assessed using the Hawker checklist. Data were extracted and grouped based on study focus and outcome. Safety incidents were meta-analysed where possible using a random-effects model.

RESULTS

Of the 57 637 article titles and abstracts, 364 met inclusion criteria. Included publications came from 31 countries and included data from over 150 000 participants. Study quality varied and statistical heterogeneity was high. Ten research categories were identified: interpersonal violence, coercive interventions, safety culture, harm to self, safety of the physical environment, medication safety, unauthorised leave, clinical decision making, falls and infection prevention and control.

CONCLUSIONS

Patient safety in inpatient mental health settings is under-researched in comparison to other non-mental health inpatient settings. Findings demonstrate that inpatient mental health settings pose unique challenges for patient safety, which require investment in research, policy development, and translation into clinical practice.

PROSPERO REGISTRATION NUMBER

CRD42016034057.

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

BACKGROUND

Workplace safety is a key issue in health care. However, workplace violence represents a serious threat to workplace safety and has become a global public health problem. Workplace violence may also lead to the psychological depletion of healthcare workers. Previous studies, although cross-sectional, did not use methods such as propensity score matching to assess the potential causality of workplace violence on mental health.

OBJECTIVES

To investigate the effects of workplace violence on depression and anxiety symptoms by propensity score matching, and to explore the prevalence of depression and anxiety symptoms in physicians and nurses.

DESIGN

A cross-sectional study.

SETTINGS AND PARTICIPANTS

A cross-sectional survey was conducted among 3000 physicians and nurses in 15 public hospitals in Heilongjiang and Beijing provinces using a purposive sampling method.

METHODS

Individual baseline characteristics and outcomes were compared across workplace violence and non-workplace violence groups using Pearson's Chi-squared tests for categorical variables and Mann-Whitney U tests for all non-parametric continuous variables. Propensity score matching was used to compare depression and anxiety symptoms in physicians and nurses who had experienced workplace violence with the symptoms of those who had not. Binary logistic regression analysis was used to analyse the associated factors of depression and anxiety symptoms.

RESULTS

A total of 2637 participants were involved in this study: 1264 (47.9%) were assigned to the exposed group, and 1373 (52.1%) to the non-exposed group. The prevalence of workplace violence among physicians and nurses in the past year was 47.9% (1264/2637). Before matching, the prevalence of depression and anxiety symptoms in physicians and nurses was 58.8% and 39.7%, respectively. Participants who experienced physical and non-physical violence were more likely to suffer from depression symptoms (odds ratios 1.999, 95% confidence interval: 1.497-2.670), and anxiety symptoms (odds ratios 1.999, 95% confidence interval: 1.497-2.670) than those who had not. Participants' age, education levels, and occupation types were common influencing factors of depression and anxiety symptoms. The results also showed that nurses are more likely to suffer from anxiety and depression symptoms than physicians.

CONCLUSIONS

It is necessary to develop effective control strategies at the individual, hospital and national levels to protect health care workers from workplace violence. When healthcare workers experience workplace violence, it is important to pay attention to their emotional reactions and to provide them with support in order to avoid adverse impacts on mental health. Further practices and research initiatives to examine the longitudinal relation among workplace violence, anxiety, and depression are recommended.

Occupational violence among female workers in an Iranian industrial area

Few studies have examined violence against female workers in the industrial sector. This study explored the prevalence of various types of violence and associated factors among female workers in the industrial sector. This descriptive survey was conducted in eleven industrial sites in Kashan, Iran, from April through September 2014. We used a 78-item questionnaire to obtain data from 817 female workers. More than half of the participants reported having experienced at least one type of violence. The prevalence rates of verbal aggression, sexual harassment, and physical violence were 52.5%, 12% and 11.5%, respectively. Single female workers (adjusted odds ratio [AOR] = 2.06, 95% CI = 1.09-4.27), and age older than 35 years were (AOR = 2.37, 95% CI = 1.26-2.93) each significantly related to increased odds of verbal violence. Short duration of employment (≤ five years) was the most strongly associated factor for sexual harassment (AOR = 2.82, 95% CI = 1.7-2.94). Working the night shift was significantly associated with encountering verbal violence (AOR = 2.79, 95% CI = 1.69-3.06). The high prevalence of violence suggests that management in industrial workplaces should invest time and resources in addressing violence. Developing a reporting procedure and training programs are recommended in dealing with workplace violence risk.

Employees exposed to work-related threats and violence in human services sectors: Are any employees members particularly exposed to violence and threats and what role do supervisors play?

BACKGROUND

The frequency of being exposed to work-related violence and threats is high in employees working in the human service sector. The question is whether certain employees are particularly exposed to violence and threats than others.

OBJECTIVE

This study examined whether particular employees were especially exposed to work-related violence and threats due to personal characteristics, coping styles, attitudes or participating in violence prevention training. We also examined the role played by supervisors.

METHODS

Questionnaire data were collected in 2010 and 2011. In all, 3584 employees from special schools, psychiatric wards, eldercare and the Prison and Probation Service participated. We used multivariate logistic regression analyses.

RESULTS

We found persons high on the extroversion and introversion scales were associated with statistical significant increased risk for work-related threats. Furthermore, accepting attitudes concerning work-related violence were also statistical significant associated with increased the risk for both work-related threats and violence. Associations between coping styles and work-related threats and violence were very small and statistically non-significant and we found no effect of violence prevention training. The risk for work-related threats for persons high on the extroversion scale was decreased if supervisor violence prevention behaviour was high. Furthermore, if supervisor prevention behaviour was high, prevention training decreased the risk for work-related violence. However, these associations weren't statistically significant.

CONCLUSION

The results stress that effective prevention requires involvement of both employees and supervisors.

Effects of Violence Prevention Behavior on Exposure to Workplace Violence and Threats: A Follow-Up Study

This longitudinal study investigates the relationship between prevention behaviors, that is, enacted violence prevention policies, and exposure to workplace violence and threats across four different high risk work sectors: psychiatry, special schools, eldercare, and the prison and probation services. Logistic regression analysis of a 1-year follow-up sample of 3.016 employees from these four sectors shows that prevention behaviors are significantly and negatively associated with self-reported exposure to workplace violence and threats-in the prison and probation services, eldercare, and in psychiatry, while no significant associations are found for special schools. The results therefore show clear sector differences with regard to the preventive effect of violence prevention behaviors. Furthermore, this multisector comparison suggests that prevention behaviors are more effective in relation to a moderate frequency of violence and threats, and that only top management prevention behavior can prevent very frequent incidents (odds ratio [ OR] = 0.58). This study contributes to the literature by use of a longitudinal design and acceptable response rates, while also simultaneously investigating several high risk sectors. The results imply that when managing workplace violence in high risk areas of human service work, there should be emphasis on the use of violence prevention behaviors from top management, supervisor, and among coworkers. However, type of sector and the frequency of workplace violence should be analyzed to evaluate the potential impact of prevention behaviors.

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.

Patient Violence Towards Counselors in Substance Use Disorder Treatment Programs: Prevalence, Predictors, and Responses

Workplace violence disproportionately impacts healthcare and social service providers. Given that substance use and abuse are documented risk factors for the perpetration of violence, SUD treatment personnel are at risk for patient-initiated violence. However, little research has addressed SUD treatment settings. Using data nationally representative of the U. S., the present study explores SUD counselors' experiences of violent behaviors perpetrated by patients. More than half (53%) of counselors personally experienced violence, 44% witnessed violence, and 61% had knowledge of violence directed at a colleague. Counselors reported that exposure to violence led to an increased concern for personal safety (29%), impacted their treatment of patients (15%), and impaired job performance (12%). In terms of organizational responses to patient violence, 70% of organizations increased training on de-escalation of violent situations, and 58% increased security measures. Exposure to verbal assault was associated with age, minority, tenure, recovery status, 12-step philosophy, training in MI/MET, and higher caseloads of patients with co-occurring disorders. Exposure to physical threats was associated with age gender, minority, tenure, recovery status, and higher caseloads of patients with co-occurring disorders. Exposure to physical assault was associated with age, gender, and sample. Implications of these findings for organizations and individuals are discussed.