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Aderinto N, Olatunji G, Olaniyi P, Afolabi S, Ajagbe K, Yusuf IA, Ojo D, Olatunji S, Awodun A, Toritseju T, Olamide KA, Ijitade G, Jegede OS. Prevalence, pattern, and predictors of WPV against medical interns in Southwest Nigeria: a cross-sectional study. Ann Med 2025; 57:2470955. [PMID: 39999850 PMCID: PMC11863999 DOI: 10.1080/07853890.2025.2470955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Revised: 12/05/2024] [Accepted: 01/21/2025] [Indexed: 02/27/2025] Open
Abstract
BACKGROUND Workplace violence (WPV) is a significant occupational hazard threatening the safety and well-being of medical interns in Nigeria. Despite its critical impact, there is a notable research gap regarding the prevalence, patterns, and influencing factors of WPV among medical interns in Southwest Nigeria. This study aims to fill this gap by investigating these aspects. METHODS This cross-sectional study utilized online questionnaires to collect data from 379 medical interns at ten hospitals in Southwest Nigeria. The data were analyzed using descriptive statistics and logistic regression. RESULTS The study found that 62.5% of medical interns had experienced WPV. Verbal abuse was the most common type of violence (63.3%), followed by threats (50.4%), physical assault (24.3%), verbal sexual harassment (13.2%), and physical sexual abuse (2.6%). The primary perpetrators were patients' relatives (81.9%) and patients (61.2%). WPV predominantly occurred in the afternoon (68.8%) and in emergency rooms (70.5%). The primary triggers were long waiting times (64.6%) and unmet patient needs (54.9%). Female interns had higher odds of experiencing WPV, with an adjusted odds ratio of 3.01 (95% CI: 0.82-11.03, p = 0.01) than their male counterparts. CONCLUSION WPV is prevalent among medical interns in Southwest Nigeria, with patients as the main perpetrators. Healthcare organizations must implement measures such as promoting a culture of respect, establishing zero-tolerance policies, training interns to recognize and address WPV, and providing support for victims.
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Affiliation(s)
- Nicholas Aderinto
- Department of Medicine and Surgery, Ladoke Akintola University of Technology, Ogbomoso, Nigeria
| | - Gbolahan Olatunji
- Department of Medicine and Surgery, University of Ilorin, Ilorin, Nigeria
| | - Peter Olaniyi
- Department of Medicine and Surgery, Ladoke Akintola University of Technology, Ogbomoso, Nigeria
| | - Samson Afolabi
- Department of Medicine and Surgery, Ladoke Akintola University of Technology, Ogbomoso, Nigeria
| | - Kamil Ajagbe
- Department of Medicine and Surgery, Ladoke Akintola University of Technology, Ogbomoso, Nigeria
| | | | - Deborah Ojo
- Department of Medicine and Surgery, University of Ilorin, Ilorin, Nigeria
| | - Samuel Olatunji
- Department of Medicine and Surgery, University of Ilorin, Ilorin, Nigeria
| | | | | | - Kadiri A. Olamide
- Department of Medicine and Surgery, University of Ilorin, Ilorin, Nigeria
| | - Grace Ijitade
- Department of Biostatistics and Epidemiology, College of Public Health, East Tennessee State University, Johnson City, TN, USA
| | - Oluwatosin Samson Jegede
- The Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, San Diego, CA, USA
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Tan Y, Zhou J, Zhang H, Lan L, Chen X, Yu X, Zhong L, Zhu L, Gao Y. Effects of effort-reward imbalance on emergency nurses' health: a mediating and moderating role of emotional exhaustion and work-family conflict. Front Public Health 2025; 13:1580501. [PMID: 40492008 PMCID: PMC12146345 DOI: 10.3389/fpubh.2025.1580501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2025] [Accepted: 05/13/2025] [Indexed: 06/11/2025] Open
Abstract
Background Effort-reward imbalance (ERI) is a prevalent issue in the healthcare sector, particularly in the high-intensity, high-risk, and high-stress environment of the emergency department. This results in emergency department nurses bearing heavier workloads, responsibilities, and time commitments compared to their counterparts in other departments. ERI poses significant risks to their physical, psychological, and sleep quality. Therefore, it is essential to explore the mechanisms through which ERI influences the health of emergency department nurses. Objective The aim of this investigation is to analyze if work-family conflict moderates the mediating influence emotional exhaustion has on the association between ERI and somatic symptoms and sleep disorders. Design A cross-sectional study. Settings The emergency nurses (N = 1,540) were included from 30 tertiary hospitals in 20 provinces or autonomous regions (Northeast, North, East, Central, South, Southwest, and Northwest China) of mainland China between December 26, 2023, and January 18, 2024. Methods Participants were recruited using stratified cluster sampling, obtaining data through web-based questionnaires. The study investigated the mediating and moderating effects using the PROCESS macro for SPSS. The mediation effect is tested by the bias correction Bootstrap sample size was set to 5,000. Result Considering emotional exhaustion as a mediating variable, the direct predictive influence of ERI on somatic symptoms and sleep disorders continues to be statistically significant (β = 0.271, 0.137, p < 0.01). Compared to the high-level work-family conflict group, the positive moderating effect of low-level work-family conflict on the relationship between ERI and emotional exhaustion was more pronounced (simple slope = 0.479, 0.757, p < 0.01). The moderated mediation effects of emotional exhaustion on somatic symptoms and sleep disorders are -0.063 (95%CI: -0.077 ~ -0.050) and -0.044 (95%CI: -0.056 ~ -0.033) respectively. Conclusion The study findings indicate that ERI was correlated with heightened emotional exhaustion, somatic symptoms, and sleep disorders among emergency department nurses. As a result, interventions should be implemented to improve ERI, alleviate emotional exhaustion among nurses, monitor work-family conflict levels, and mitigate the effects of these factors on nurses' overall well-being.
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Affiliation(s)
- Yuanyuan Tan
- Department of Health Management Center, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, University of Electronic Science and Technology of China, Chengdu, China
| | - Jing Zhou
- Department of Emergency Medicine, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, China
- Institute of Disaster Medicine, Sichuan University, Chengdu, China
- Nursing Key Laboratory of Sichuan Province, Chengdu, China
| | - Hao Zhang
- Department of Emergency Medicine, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, China
- Institute of Disaster Medicine, Sichuan University, Chengdu, China
- Nursing Key Laboratory of Sichuan Province, Chengdu, China
| | - Lin Lan
- Department of Emergency Medicine, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, China
- Institute of Disaster Medicine, Sichuan University, Chengdu, China
- Nursing Key Laboratory of Sichuan Province, Chengdu, China
| | - Xiaoli Chen
- Department of Emergency Medicine, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, China
- Institute of Disaster Medicine, Sichuan University, Chengdu, China
- Nursing Key Laboratory of Sichuan Province, Chengdu, China
| | - Xiaomin Yu
- Department of Emergency Medicine, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, China
- Institute of Disaster Medicine, Sichuan University, Chengdu, China
- Nursing Key Laboratory of Sichuan Province, Chengdu, China
| | - Luying Zhong
- Department of Emergency Medicine, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, China
- Institute of Disaster Medicine, Sichuan University, Chengdu, China
- Nursing Key Laboratory of Sichuan Province, Chengdu, China
| | - Ling Zhu
- Department of Emergency Medicine, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, China
- Institute of Disaster Medicine, Sichuan University, Chengdu, China
- Nursing Key Laboratory of Sichuan Province, Chengdu, China
| | - Yongli Gao
- Department of Emergency Medicine, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, China
- Institute of Disaster Medicine, Sichuan University, Chengdu, China
- Nursing Key Laboratory of Sichuan Province, Chengdu, China
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Elsharkawy NB, Alruwaili AN, Elsayed Ramadan OM, Alruwaili MM, Alhaiti A, Abdelaziz EM. Barriers to reporting workplace violence: a qualitative study of nurses' perceptions in tertiary care settings. BMC Nurs 2025; 24:395. [PMID: 40200356 PMCID: PMC11980070 DOI: 10.1186/s12912-025-03039-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2025] [Accepted: 03/26/2025] [Indexed: 04/10/2025] Open
Abstract
BACKGROUND Workplace violence (WPV) remains a formidable concern among nurses worldwide, with up to 60% in Saudi Arabia reportedly experiencing some form of aggression. In tertiary care hospitals, robust hierarchies and cultural norms intensify underreporting, thwarting evidence-based prevention and obscuring vital data. AIM This qualitative study investigated the perceived barriers to WPV reporting among nurses in tertiary care settings in the Aljouf region of Saudi Arabia, specifically addressing how organizational and cultural factors converge to discourage formal incident reporting. METHODS A qualitative descriptive design was employed, guided by Ajzen's Theory of Planned Behavior and the Social Ecological Model. Thirty-six registered nurses, purposively sampled from three tertiary hospitals, participated in six semi-structured focus groups conducted in Arabic or English, depending on participant preference. Data were thematically analyzed in NVivo, with methodological rigor ensured through triangulation and inter-coder reliability. RESULTS Three principal themes emerged: (1) Emotional and Psychological Barriers (78%), encompassing distress, anxiety, and fears of professional blame; (2) Organizational Ineffectiveness (65%), marked by convoluted reporting processes and perceived managerial indifference; and (3) Cultural and Hierarchical Influences (57%), reflecting deference to authority and normalization of violence. These themes illustrate how attitudes, subjective norms, and perceived behavioral control shaped by socio-cultural dynamics collectively contribute to persistent underreporting. CONCLUSIONS Mitigating WPV underreporting in Saudi tertiary care hospitals requires streamlined, user-friendly reporting channels, leadership accountability, and holistic psychosocial support. Implementing interprofessional education aimed at dismantling hierarchical imbalances can foster a zero-tolerance ethos toward violence. Longitudinal and comparative research should further examine evolving reporting behaviors to refine context-specific, culturally attuned strategies for addressing WPV. CLINICAL TRIAL NUMBER Not applicable.
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Affiliation(s)
- Nadia Bassuoni Elsharkawy
- Department of Maternity and Pediatric Health Nursing, College of Nursing, Jouf University, Sakaka, 72388, Saudi Arabia
| | - Abeer Nuwayfi Alruwaili
- Department of Nursing Administration and Education, College of Nursing, Jouf University, Sakaka, 72388, Saudi Arabia.
| | - Osama Mohamed Elsayed Ramadan
- Department of Maternity and Pediatric Health Nursing, College of Nursing, Jouf University, Sakaka, 72388, Saudi Arabia.
| | - Majed Mowanes Alruwaili
- Department of Nursing Administration and Education, College of Nursing, Jouf University, Sakaka, 72388, Saudi Arabia
| | - Ali Alhaiti
- Department of Nursing, College of Applied Sciences, Almaarefa University, Diriyah, Riyadh, 13713, Saudi Arabia
| | - Enas Mahrous Abdelaziz
- Department of Psychiatric Mental Health Nursing, College of Nursing, Jouf University, Sakaka, Jouf, 72388, Saudi Arabia
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Chen M, Liao X, Xie H. Cross-sectional study of workplace violence on work engagement among Chinese nurses: the mediating role of psychological resilience. BMJ Open 2025; 15:e086006. [PMID: 39819951 PMCID: PMC11752032 DOI: 10.1136/bmjopen-2024-086006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2024] [Accepted: 10/25/2024] [Indexed: 01/19/2025] Open
Abstract
OBJECTIVES This study aimed to investigate the status of workplace violence, psychological resilience and work engagement, and explore the potential mediating role of psychological resilience in the relationship between workplace violence and work engagement among Chinese nurses. DESIGN A cross-sectional survey was conducted among a convenience sample of clinical registered nurses. SETTING A convenience sample of clinical registered nurses was recruited from affiliated hospitals of Hunan University of Chinese Medicine. PARTICIPANTS A total of 1725 questionnaires were received, of which 1571 were deemed valid, resulting in an effective response rate of 91.07%. The final sample consisted of 1571 clinical registered nurses with a mean age of 31.65±7.16 years. OUTCOME MEASURES Data were collected through an online questionnaire comprising a general information form, the Workplace Violence Scale (WVS), Connor-Davidson Resilience Scale (CD-RS) and Utrecht Work Engagement Scale (UWES). Descriptive analysis, correlation analysis, and mediation analysis were performed using IBM SPSS Statistics software. RESULTS This cross-sectional investigation recruited a convenience sample of 1571 clinical registered nurses, who encountered multiple types of workplace violence in the past year. Pearson correlation analysis indicated negative associations between workplace violence and work engagement (r=-0.505, p<0.01), as well as between workplace violence and psychological resilience (r=-0.523, p<0.01). Mediation analysis revealed that psychological resilience partially mediated the relationship between workplace violence and work engagement, with the mediation effect accounting for 66.67% of the total effect. CONCLUSIONS Nurses exposed to workplace violence demonstrated decreased work engagement, while psychological resilience acted as a protective factor to mitigate the adverse impacts of workplace violence on work engagement. These findings provide a theoretical basis for interventions that equip nurses with resilience to combat workplace violence and improve work engagement.
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Affiliation(s)
- Miao Chen
- The First Hospital of Hunan University of Chinese Medicine, Changsha, Hunan, China
| | - Xiaoli Liao
- School of Nursing, Sun Yat-Sen University, Guangzhou, Guangdong, China
| | - Hao Xie
- The Third Xiangya Hospital, Central South University, Changsha, Hunan, China
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Nkadimeng M, Engelbrecht A, Rajan S. Workplace violence in three public sector emergency departments, Gauteng, South Africa: A cross-sectional survey. Afr J Emerg Med 2024; 14:252-257. [PMID: 39291136 PMCID: PMC11407051 DOI: 10.1016/j.afjem.2024.08.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2024] [Revised: 08/15/2024] [Accepted: 08/16/2024] [Indexed: 09/19/2024] Open
Abstract
Introduction Workplace violence against healthcareworkers in Emergency Departments (EDs) is a global concern. The purpose of this study was to determine the prevalence and types of workplace violence in EDs. Methods a cross-sectional survey was conducted in three public sector hospital EDs in Gauteng, South Africa. A self-administered, standardised online questionnaire developed by the World Health organization was used to collect data between March and November 2022. A total of 65 healthcareworkers which consisted of nurses (24) and doctors (41) participated in the study. Results The prevalence of workplace violence was 73.8 % with verbal abuse being the most common type at 66 %. Eighty-two percent of the victims did not report the incident. Poor communication and lack of mutual respect among staff and healthcare users contributed to both physical and non-physical workplace violence. Conclusion Workplace violence appears to be a common occurrence in EDs in the hospitals surveyed in Gauteng. It is regarded as a typical incident by respondents, and it is underreported. It has a direct negative impact on healthcareworkers and their working environment and indirectly on patients. Urgent attention from all stakeholders is needed to minimize the prevalence of these incidents.
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Affiliation(s)
- Mahlako Nkadimeng
- Division of Family Medicine, School of Medicine, Faculty of Health Sciences, University of Pretoria, Arcadia, South Africa
| | - Andreas Engelbrecht
- Division of Family Medicine, School of Medicine, Faculty of Health Sciences, University of Pretoria, Arcadia, South Africa
| | - Suma Rajan
- Division of Family Medicine, School of Medicine, Faculty of Health Sciences, University of Pretoria, Arcadia, South Africa
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Ayaz B, Dozois G, Baumann AL, Fuseini A, Nelson S. Perpetrators of gender-based workplace violence amongst nurses and physicians-A scoping review of the literature. PLOS GLOBAL PUBLIC HEALTH 2024; 4:e0003646. [PMID: 39240832 PMCID: PMC11379169 DOI: 10.1371/journal.pgph.0003646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/22/2024] [Accepted: 08/02/2024] [Indexed: 09/08/2024]
Abstract
In healthcare settings worldwide, workplace violence (WPV) has been extensively studied. However, significantly less is known about gender-based WPV and the characteristics of perpetrators. We conducted a comprehensive scoping review on Type II (directed by consumers) and Type III (perpetuated by healthcare workers) gender based-WPV among nurses and physicians globally. For the review, we followed the Preferred Reporting Items for Systematic and Meta Analyses extension for Scoping Review (PRISMA-ScR). The protocol for the comprehensive review was registered on the Open Science Framework on January 14, 2022, at https://osf.io/t4pfb/. A systematic search in five health and social science databases yielded 178 relevant studies that indicated types of perpetrators, with only 34 providing descriptive data for perpetrators' gender. Across both types of WPV, men (65.1%) were more frequently responsible for perpetuating WPV compared to women (28.2%) and both genders (6.7%). Type II WPV, demonstrated a higher incidence of violence against women; linked to the gendered roles, stereotypes, and societal expectations that allocate specific responsibilities based on gender. Type III WPV was further categorized into Type III-A (horizontal) and Type III-B (vertical). With Type III WPV, gendered power structures and stereotypes contributed to a permissive environment for violence by men and women that victimized more women. These revelations emphasize the pressing need for gender-sensitive strategies for addressing WPV within the healthcare sector. Policymakers must prioritize the security of healthcare workers, especially women, through reforms and zero-tolerance policies. Promoting gender equality and empowerment within the workforce and leadership is pivotal. Additionally, creating a culture of inclusivity, support, and respect, led by senior leadership, acknowledging WPV as a structural issue and enabling an open dialogue across all levels are essential for combating this pervasive problem.
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Affiliation(s)
- Basnama Ayaz
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada
| | | | - Andrea L. Baumann
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada
| | - Adam Fuseini
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada
| | - Sioban Nelson
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada
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Do SM, Nguyen NT, Mai ATL, Vu MTT. Nurses' Perspectives on Risk Factors and Strategies to Control Workplace Violence: A National Survey in Vietnam. IRANIAN JOURNAL OF PUBLIC HEALTH 2024; 53:1805-1814. [PMID: 39415871 PMCID: PMC11475177 DOI: 10.18502/ijph.v53i8.16286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Accepted: 09/18/2023] [Indexed: 10/19/2024]
Abstract
Background We aimed to describe nurses' perspectives on risk factors and strategies to control workplace violence. Methods To accomplish the study objectives, an online cross-sectional questionnaire-based investigation was conducted. The scales were developed in accordance with the guidelines provided by reputable organizations such as the International Labour Office (ILO), International Council of Nurses (ICN), WHO, and Public Services International (PSI), as well as previous scholarly works. Prior to implementation, the validity and reliability of the Likert scales were rigorously tested. The survey, conducted from March to May 2022, encompassed 163 public hospitals in Vietnam and was completed by 2,280 nurses employed in these institutions. Results According to nurses' perceptions, several key risk factors contribute to workplace violence (WPV). These include low socio-cultural awareness among patients and their family members, overcrowding in hospitals, non-compliance with hospital regulations, unrealistic expectations regarding treatment outcomes, communication issues among staff members. To effectively control WPV, nurses propose a range of strategies. These include enhancing the quality of hospital services and the hospital environment, fostering a positive workplace culture, establishing a comprehensive system for reporting and responding to incidents of WPV and developing patient care protocols. These strategies are believed to mitigate the occurrence and impact of WPV, ensuring a safer and more secure work environment for nurses. Conclusion Workplace violence in healthcare settings is influenced by organizational, clinical, and environmental risk factors. Nurses adopt a multi-component approach to manage workplace violence. This study provides valuable insights for developing effective strategies to combat workplace violence in Vietnam.
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Affiliation(s)
- Sinh Minh Do
- Department of Public Health, Nam Dinh University of Nursing, Nam Dinh, Vietnam
| | - Nguyet Thi Nguyen
- Department of Nursing, University of Medicine and Pharmacy, Vietnam National University Hanoi, Hanoi, Vietnam
| | - Anh Thi Lan Mai
- Preclinical Practice Center, Nam Dinh University of Nursing, Nam Dinh, Vietnam
| | - Mai Thi Thuy Vu
- Department of Public Health, Nam Dinh University of Nursing, Nam Dinh, Vietnam
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Nelson S, Ayaz B, Baumann AL, Dozois G. A gender-based review of workplace violence amongst the global health workforce-A scoping review of the literature. PLOS GLOBAL PUBLIC HEALTH 2024; 4:e0003336. [PMID: 38954697 PMCID: PMC11218983 DOI: 10.1371/journal.pgph.0003336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/26/2023] [Accepted: 05/20/2024] [Indexed: 07/04/2024]
Abstract
Workplace violence (WPV) impacts all levels of the health workforce, including the individual provider, organization, and society. While there is a substantial body of literature on various aspects of WPV against the health workforce, gender-based WPV (GB-WPV) has received less attention. Violence in both the workplace and broader society is rooted in gendered socio-economic, cultural, and institutional factors. Developing a robust understanding of GB-WPV is crucial to explore the differing experiences, responses, and outcomes of GB-WPV with respect to gender. We conducted a scoping review and report on the prevalence and risk factors of GB-WPV in healthcare settings globally. The review followed the Preferred Reporting Items for Systematic and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). We registered the scoping review protocol on the Open Science Framework on January 14, 2022, at https://osf.io/t4pfb/. A systematic search was conducted of empirical literature in five health and social science databases. Of 13667, 226 studies were included in the analysis. Across the studies, more women than men experienced non-physical violence, including verbal abuse, sexual harassment, and bullying. Men experienced more physical violence compared to women. Younger age, less experience, shifting duties, specific clinical settings, lower professional status, organizational hierarchy, and minority status were found to be sensitive to gender, reflecting women's structural disadvantages in the workplace. Given the high prevalence and impact of GB-WPV on women, we provided recommendations to address systemic issues in clinical practice, academia, policy, and research.
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Affiliation(s)
- Sioban Nelson
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada
| | - Basnama Ayaz
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada
| | - Andrea L. Baumann
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada
| | - Graham Dozois
- Princess Margaret Cancer Centre, Toronto, Ontario, Canada
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O'Brien CJ, van Zundert AA, Barach PR. The growing burden of workplace violence against healthcare workers: trends in prevalence, risk factors, consequences, and prevention - a narrative review. EClinicalMedicine 2024; 72:102641. [PMID: 38840669 PMCID: PMC11152903 DOI: 10.1016/j.eclinm.2024.102641] [Citation(s) in RCA: 14] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2024] [Revised: 04/25/2024] [Accepted: 04/29/2024] [Indexed: 06/07/2024] Open
Abstract
Workplace violence (WPV) against healthcare workers (HCW) is a globally growing problem in healthcare systems. Despite decades of research and interventions violent incidents are rising in their severity and frequency. A structured review of PubMed and Scopus databases and supplementary internet searches, resulted in a synthesis of evidence covering multiple countries and healthcare worker populations. High rates of WPV are increasingly common due to unmet patient expectations, poor communication, long wait times and organizational factors such as resourcing and infrastructure. We highlight links between WPV and poor worker health outcomes, staff turnover, reduced patient safety and medical errors. Few prevention and mitigation activities have shown sustained effects, highlighting the challenges in understanding and addressing the complex interplay of factors that drive violence against HCWs. The rapidly rising incidence of WPV requires special consideration and action from multiple stakeholders including patients and visitors, healthcare providers, law enforcement, media and policy makers.
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Affiliation(s)
- Conor J. O'Brien
- The Department of Anaesthesia and Perioperative Medicine, Royal Brisbane and Women's Hospital, Herston Campus, Brisbane, QLD, Australia
- The University of Queensland, Faculty of Medicine, Herston, QLD 4006, Australia
| | - André A.J. van Zundert
- The Department of Anaesthesia and Perioperative Medicine, Royal Brisbane and Women's Hospital, Herston Campus, Brisbane, QLD, Australia
- The University of Queensland, Faculty of Medicine, Herston, QLD 4006, Australia
| | - Paul R. Barach
- The University of Queensland, Faculty of Medicine, Herston, QLD 4006, Australia
- Thomas Jefferson University, Philadelphia, PA, United States
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Yosep I, Suryani S, Mediani HS, Mardhiyah A, Maulana I, Hernawaty T, Hazmi H. A Scoping Review of Assertiveness Therapy for Reducing Bullying Behavior and Its Impacts Among Adolescents. J Multidiscip Healthc 2024; 17:1777-1790. [PMID: 38680879 PMCID: PMC11048288 DOI: 10.2147/jmdh.s460343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2024] [Accepted: 04/16/2024] [Indexed: 05/01/2024] Open
Abstract
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.
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Affiliation(s)
- Iyus Yosep
- Department of Mental Health, Faculty of Nursing, Universitas Padjadjaran, Sumedang, West Java, Indonesia
| | - Suryani Suryani
- Department of Mental Health, Faculty of Nursing, Universitas Padjadjaran, Sumedang, West Java, Indonesia
| | - Henny Suzana Mediani
- Department of Pediatric Nursing, Faculty of Nursing, Universitas Padjadjaran, Sumedang, West Java, Indonesia
| | - Ai Mardhiyah
- Department of Pediatric Nursing, Faculty of Nursing, Universitas Padjadjaran, Sumedang, West Java, Indonesia
| | - Indra Maulana
- Department of Mental Health, Faculty of Nursing, Universitas Padjadjaran, Sumedang, West Java, Indonesia
| | - Taty Hernawaty
- Department of Mental Health, Faculty of Nursing, Universitas Padjadjaran, Sumedang, West Java, Indonesia
| | - Helmy Hazmi
- Department of Nursing, Faculty of Medicine, University of Malaysia Sarawak, Kota Samarahan, 94300, Malaysia
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Ekpor E, Kobiah E, Akyirem S. Prevalence and predictors of workplace violence against nurses in Africa: A systematic review and meta-analysis. Health Sci Rep 2024; 7:e2068. [PMID: 38650728 PMCID: PMC11033334 DOI: 10.1002/hsr2.2068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2023] [Revised: 03/22/2024] [Accepted: 04/10/2024] [Indexed: 04/25/2024] Open
Abstract
Background and Aims Workplace violence (WPV) against nurses is a pervasive global issue, yet the extent of this phenomenon in the African context remains insufficiently explored. This review aimed to synthesize the available literature to identify the prevalence and predictors of WPV against nurses in Africa. Methods A systematic search was conducted across MEDLINE, CINAHL, PsycINFO, and Scopus, to identify studies published from 2000 to October 2023. The pooled prevalence of WPV and it subtypes were estimated using random-effect meta-analysis. Heterogeneity between studies was quantified with I 2 statistics. Subgroup analysis and meta-regression were performed to identify sources of heterogeneity. Results This review included 27 studies, involving 9831 nurses. The pooled prevalence of WPV was 62.3% (95% confidence interval [CI]: 51.6-72.0). Verbal abuse emerged as the most common form of WPV, with a prevalence rate of 51.2% (95% CI: 41.3-61.1), followed by threat 23.3% (95% CI: 6.5-57.2), bullying 22.9% (95% CI: 14.0-35.2), physical abuse 15.1% (95% CI: 11.0-20.4), and sexual harassment 10.3% (95% CI: 5.9-17. 5). The proportion of WPV varied across geographical areas in Africa; however, the differences were not significant. The predictors of WPV encompassed demographic factors, personal habits, workplace characteristics, and nurses' past experience. Conclusion WPV against nurses is prevalent in Africa and transcends geographical boundaries in this region. This underscores the urgent need for targeted interventions and policy changes to address this issue in Africa.
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Affiliation(s)
- Emmanuel Ekpor
- School of Nursing and MidwiferyUniversity of GhanaAccraGhana
- Christian Health Association of GhanaAccraGhana
| | | | - Samuel Akyirem
- Yale School of NursingYale UniversityNew HavenConnecticutUSA
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Xiao Y, Chen TT, Zhu SY, Li CY, Zong L. Factors associated with workplace violence against Chinese healthcare workers: an online cross-sectional survey. Front Public Health 2024; 12:1295975. [PMID: 38550327 PMCID: PMC10977601 DOI: 10.3389/fpubh.2024.1295975] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2023] [Accepted: 03/06/2024] [Indexed: 04/02/2024] Open
Abstract
Objectives Workplace violence (WPV) against healthcare workers (HCWs) has reached significant levels globally, impeding the quality and accessibility of healthcare systems. However, there is limited available knowledge regarding the determinants linked with WPV among HCWs and the discrepancies observed across various levels of hospitals in China. The objective of the present research was to investigate the factors linked to WPV and job satisfaction among HCWs in China. Methods A self-developed questionnaire based on WeChat was employed to collect data. The questionnaire consisted of demographic information as well as occupational factors. To measure WPV, the Chinese version of the Workplace Violence Scale was utilized. Career satisfaction was assessed through two questions regarding career choices. The collected data was analyzed using descriptive analyses, chi-square tests, and multivariate logistic regressions. Results A total of 3,781 valid questionnaires (1,029 doctors and 2,752 nurses) were collected. Among all participants, 2,201 (58.2%) reported experiencing at least one form of WPV in the past year, with emotional abuse being the most frequent occurrence (49.7%), followed by threats (27.9%). The multivariate logistic regression analysis revealed several risk factors associated with WPV, including male gender, shift work, senior professional title, bachelor's degree education, employment in secondary-level hospitals, and working over 50 h per week (p < 0.05). Career satisfaction among HCWs who experienced high levels of WPV was low, with only 11.2% remaining confident in their profession, and a mere 2.0% supporting their children pursuing careers in healthcare. Conclusion WPV poses a significant challenge within the Chinese healthcare system. Efforts should be made to address the identified risk factors and promote a safe and satisfying working environment for HCWs.
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Affiliation(s)
- Yu Xiao
- Psychosomatic Medical Center, The Fourth People’s Hospital of Chengdu, Chengdu, China
- Psychosomatic Medical Center, The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuroinformation, University of Electronic Science and Technology of China, Chengdu, China
| | - Ting-ting Chen
- Nursing Department, West China Hospital of Sichuan University, Chengdu, China
| | - Shao-yi Zhu
- Department of Psychiatry, Shantou University Mental Health Center, Shantou, China
| | - Chun-ya Li
- Psychosomatic Medical Center, The Fourth People’s Hospital of Chengdu, Chengdu, China
| | - Ling Zong
- Department of Judicial Expertise, Zhongshan Third People’s Hospital, Zhongshan, China
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Chen W, Shi J, Xu J, Wang Y, Wu Y. Workplace violence against Chinese licensed doctors: a cross-sectional study. Front Public Health 2024; 12:1235576. [PMID: 38356951 PMCID: PMC10864590 DOI: 10.3389/fpubh.2024.1235576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Accepted: 01/08/2024] [Indexed: 02/16/2024] Open
Abstract
Introduction China has issued and implemented a series of policies aimed at preventing and controlling workplace violence (WPV) against licensed doctors. However, the prevalence of WPV has not been fundamentally curbed. The aim of this study was to present the prevalence of WPV, identify its influencing factors and propose responsive measures. Method The online Chinese Physician Practice Survey was conducted with purposive sampling method among licensed doctors in China from January 2022 to June 2022. Data covered licensed doctors' sociodemographic characteristics, occupational characteristics, prevalence of WPV, and perception of effective countermeasures. Results A total of 74,305 licensed doctors participated in this study. A total of 44.88% of respondents had experienced WPV, among them, either physical violence only (1.06%) or non-physical violence only (89.91%) or encountered both of them (9.03%). Age, gender, marital status, education level, professional title and registration type were all associated with WPV, being younger, non-married, more educated, and higher professional title are all risk factors for WPV. Male (OR = 1.396, 95CI%: 1.355 to 1.439), clinicians (OR = 1.342,95%CI: 1.177 to 1.529), who were single (OR = 1.174, 95%CI: 1.111 to 1.241), with master's degree (OR = 2.021, 95%CI: 1.739 to 2.349) and professional title were subsenior (OR = 1.194, 95%CI: 1.125 to 1.267) were most likely to occur WPV. WPV occurred mostly in provincial capitals, public hospitals, primary and community hospitals, and departments of internal medicine, surgery, pediatrics, emergency medicine and mental health. Overall, 44.24% of doctors perceived that strengthening crackdowns on criminal behaviors was the most effective measure to prevent WPV against healthcare staff. Conclusion The frequency of WPV decreased after the implementation of relevant laws and policies. Future efforts should be made to strengthen crackdowns on illegal and criminal activities and to issue specific legal provisions on the prevention and control of WPV against doctors.
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Affiliation(s)
- Wenhao Chen
- School of Health Humanities, Peking University, Beijing, China
| | - Jingyu Shi
- School of Public Health, Peking University, Beijing, China
| | - Jingyi Xu
- School of Health Humanities, Peking University, Beijing, China
| | - Yue Wang
- School of Health Humanities, Peking University, Beijing, China
| | - Yanbin Wu
- School of Health Humanities, Peking University, Beijing, China
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Ipek M, Özlük B. Patients' opinion on violence against healthcare workers and their level of satisfaction in emergency department in Turkey: A cross-sectional study. Int Emerg Nurs 2023; 71:101350. [PMID: 37708667 DOI: 10.1016/j.ienj.2023.101350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2023] [Revised: 07/07/2023] [Accepted: 08/29/2023] [Indexed: 09/16/2023]
Abstract
BACKGROUND Violence, with an increasing rate of cases in the health care system which adversely affects the quality of provision of services, has become a social health issue that also has negative impacts both on healthcare workers and patients. This study was conducted to determine the opinion of patients, who had been admitted to the emergency department, towards violence against healthcare workers, and their level of satisfaction with health services. METHODS The study employed a cross-sectional design and was conducted with 348 patients who had received healthcare services in the adult emergency department in Turkey. The Emergency Department Patient Satisfaction Survey and An eight-item questionnaire prepared by the researchers consisting of the patient's characteristics and their statements on violence were used to collect the data. RESULTS Among the patients, 26.7% stated that they had been violent toward healthcare workers. It was determined that 91.4% of the cases were verbal and 8.6% were physical. Among the patients, 82.2% had not known about the legal sanctions for violence against healthcare workers. The low level of propensity for violence in patients who were satisfied with the emergency department service was statistically significant (p < 0.05). CONCLUSIONS As a result of the study, it was found that one in four patients had been violent to healthcare workers, and the vast majority had a lack of information about legal sanctions. Policymakers should take deterrent measures to prevent the occurrence of violence and develop more critical sanctions.
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Affiliation(s)
- Muhammet Ipek
- Emergency Unit Nurse, Konya Numune Hospital, Konya, Turkey
| | - Bilgen Özlük
- Necmettin Erbakan University, Faculty of Nursing, Department of Nursing Management, Konya, Turkey.
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Cai J, Wu S, Wang H, Zhao X, Ying Y, Zhang Y, Tang Z. The effectiveness of a workplace violence prevention strategy based on situational prevention theory for nurses in managing violent situations: a quasi-experimental study. BMC Health Serv Res 2023; 23:1164. [PMID: 37885009 PMCID: PMC10605776 DOI: 10.1186/s12913-023-10188-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Accepted: 10/20/2023] [Indexed: 10/28/2023] Open
Abstract
BACKGROUND Workplace violence (WPV) poses a significant occupational hazard for nurses. The efficacy of current education and training programs in mitigating WPV incidence among nurses remains uncertain, possibly due to insufficient consideration of clinical contexts and nurses' specific needs. Therefore, this study developed a WPV prevention strategy based on the actual requirements of clinical nurses and situational prevention theory and aimed to explore its application effects. METHODS Under the guidance of situational prevention theory, a WPV prevention strategy for nurses was constructed through literature review, semi-structured interviews and focus group discussion. This study adopted a self-controlled research design, and trained 130 nurses selected from a comprehensive tertiary grade A hospital in Suzhou in this WPV prevention strategy. Data were collected through structured questionnaires, including the revised WPV questionnaire, WPV severity grading scale, and hospital WPV coping resources scale. The WPV incidence, severity, and WPV coping resource scores of nurses were collected before the intervention, as well as at 3 months, 6 months, and 9 months after training. RESULTS The WPV prevention strategy comprised 11 prevention plans based on 11 high-risk situational elements of WPV. Each prevention plan included the WPV prevention flowchart, treatment principle, and communication strategy. The strategy demonstrated excellent feasibility and practicality. Following the intervention, the overall incidence of WPV among nurses significantly decreased from 63.85% (baseline) to 46.15% (9 months after training) (P < 0.05). After the training, the severity of psychological violence (Wald χ² = 20.066, P < 0.001) and physical violence (Wald χ² = 9.100, P = 0.028) reported by nurses decreased compared to the baseline (P < 0.05). Moreover, the overall WPV coping resource score significantly increased from [66.50 (57.00, 77.25) points] (baseline) to [80.00 (68.00, 97.25) points] (9 months after training) (P < 0.05). CONCLUSIONS The described WPV prevention strategy, grounded in situational prevention theory and tailored to the needs of clinical nurses, effectively reduced WPV incidence, mitigated its severity, and enhanced nurses' WPV coping resources. This approach offered new avenues for nurses in the prevention of WPV.
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Affiliation(s)
- Jianzheng Cai
- Department of Nursing, the First Affiliated Hospital of Soochow University, Suzhou, 215006, China
| | - Sisi Wu
- Medical Branch, Shanghai Jiao Tong University Press, Shanghai, 200030, China
| | - Haifang Wang
- Department of Nursing, the First Affiliated Hospital of Soochow University, Suzhou, 215006, China.
| | - Xiaoqing Zhao
- Department of Nursing, the First Affiliated Hospital of USTC, Hefei, 230036, China.
| | - Yajie Ying
- Department of Nursing, the First Affiliated Hospital of Soochow University, Suzhou, 215006, China
| | - Yingying Zhang
- Department of Nursing, the First Affiliated Hospital of Soochow University, Suzhou, 215006, China
| | - Zhaofang Tang
- Department of Emergency, the First Affiliated Hospital of Soochow University, Suzhou, 215006, China
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Yap CYL, Daniel C, Knott JC, Myers E, Gerdtz M. Causes and management of aggression and violence: A survey of emergency department nurses and attendees. Int Emerg Nurs 2023; 69:101292. [PMID: 37150146 DOI: 10.1016/j.ienj.2023.101292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2022] [Revised: 03/12/2023] [Accepted: 03/26/2023] [Indexed: 05/09/2023]
Affiliation(s)
- Celene Y L Yap
- Department of Nursing. Melbourne School of Health Sciences, Faculty of Medicine, Dentistry and Health Sciences, 161 Barry Street, The University of Melbourne, Victoria 3010, Australia; Melbourne Health, The Royal Melbourne Hospital, Grattan Street, Parkville, Victoria 3052, Australia; Department of Critical Care, The University of Melbourne, Victoria 3010, Australia.
| | - Catherine Daniel
- Department of Nursing. Melbourne School of Health Sciences, Faculty of Medicine, Dentistry and Health Sciences, 161 Barry Street, The University of Melbourne, Victoria 3010, Australia; Melbourne Health, The Royal Melbourne Hospital, Grattan Street, Parkville, Victoria 3052, Australia; Department of Critical Care, The University of Melbourne, Victoria 3010, Australia.
| | - Jonathan C Knott
- Melbourne Health, The Royal Melbourne Hospital, Grattan Street, Parkville, Victoria 3052, Australia; Department of Critical Care, The University of Melbourne, Victoria 3010, Australia; Department of Medical Education, The University of Melbourne, Victoria 3010, Australia.
| | - Erin Myers
- Department of Nursing. Melbourne School of Health Sciences, Faculty of Medicine, Dentistry and Health Sciences, 161 Barry Street, The University of Melbourne, Victoria 3010, Australia.
| | - Marie Gerdtz
- Department of Nursing. Melbourne School of Health Sciences, Faculty of Medicine, Dentistry and Health Sciences, 161 Barry Street, The University of Melbourne, Victoria 3010, Australia; Melbourne Health, The Royal Melbourne Hospital, Grattan Street, Parkville, Victoria 3052, Australia; Department of Critical Care, The University of Melbourne, Victoria 3010, Australia.
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