Psychosocial correlates of harassment, threats and fear of violence in the workplace

School violence in Saudi Arabia: A scoping review

School violence comprises a broad spectrum of physical, psychological, and sexual acts that impact children and adolescents physically, psychologically, and academically. The aim of this article is to provide a scoping review of school violence in Saudi Arabia. The adversities of school violence and related forensic, legal, and social aspects from a Saudi Arabian perspective are discussed. The articles were extracted through the Medline, Embase, and Web of Science databases in a comprehensive criteria-based search strategy using relevant MeSH terms to identify papers related to school violence in Saudi Arabia from inception to October 6, 2022, and a total of 14 studies have been extracted and discussed. There were indicates that male students tend to engage in physical violence while females tend to engage in verbal violence. The consequences included having a significant impact on students' mental wellbeing, followed by a decrease in academic performance. Therefore, this study will identify the risk factors and present the preventive methods that can guide local institutions to establish new policies to increase awareness and implement culturally acceptable, community-based programs against school violence in Saudi Arabia.

Relational practice in health, education, criminal justice, and social care: a scoping review

BACKGROUND

Establishing and maintaining relationships and ways of connecting and being with others is an important component of health and wellbeing. Harnessing the relational within caring, supportive, educational, or carceral settings as a systems response has been referred to as relational practice. Practitioners, people with lived experience, academics and policy makers, do not yet share a well-defined common understanding of relational practice. Consequently, there is potential for interdisciplinary and interagency miscommunication, as well as the risk of policy and practice being increasingly disconnected. Comprehensive reviews are needed to support the development of a coherent shared understanding of relational practice.

METHOD

This study uses a scoping review design providing a scope and synthesis of extant literature relating to relational practice focussing on organisational and systemic practice. The review aimed to map how relational practice is used, defined and understood across health, criminal justice, education and social work, noting any impacts and benefits reported. Searches were conducted on 8 bibliographic databases on 27 October 2021. English language articles were included that involve/discuss practice and/or intervention/s that prioritise interpersonal relationships in service provision, in both external (organisational contexts) and internal (how this is received by workers and service users) aspects.

RESULTS

A total of 8010 relevant articles were identified, of which 158 met the eligibility criteria and were included in the synthesis. Most were opinion-based or theoretical argument papers (n = 61, 38.60%), with 6 (3.80%) critical or narrative reviews. A further 27 (17.09%) were categorised as case studies, focussing on explaining relational practice being used in an organisation or a specific intervention and its components, rather than conducting an evaluation or examination of the effectiveness of the service, with only 11 including any empirical data. Of the included empirical studies, 45 were qualitative, 6 were quantitative, and 9 mixed methods studies. There were differences in the use of terminology and definitions of relational practice within and across sectors.

CONCLUSION

Although there may be implicit knowledge of what relational practice is the research field lacks coherent and comprehensive models. Despite definitional ambiguities, a number of benefits are attributed to relational practices.

SYSTEMATIC REVIEW REGISTRATION

PROSPERO CRD42021295958.

Incidence and prevalence of violence toward health care workers in emergency departments: a multicenter cross-sectional survey

Background

Workplace violence and abuse in the emergency department (ED) has increasingly become a serious and alarming phenomenon worldwide where health care professionals are more prone to violence compared with other specialties.

Aims

We aimed to estimate prevalence, and types of work place violence made against health care workers (HCW) in emergency departments of Arabian Gulf area.

Methods

We performed a descriptive cross-sectional study at several emergency departments in Saudi Arabia and United Arab Emirates wherein a previously validated questionnaire was distributed among health care workers. The survey consisted of 22 questions that assessed respondent’s workplace violence and/or abuse encounters, protective measures, available work place policies, and actions implemented to detect and deal with violence and abuse against healthcare providers. Descriptive statistics was used and P value < 0.05 was considered significant for all statistical tests performed.

Results

Seven hundred HCW in eleven emergency departments agreed to participate in the survey. Four hundred ninety-two completed the questionnaire with a response rate of 70%. More than 90% of the respondents were in the 20–39 years old bracket with an approximately equal gender distribution. Then, 20.9% of the respondents stated that they were physically attacked and 32.3% were attacked with a weapon. Most of the respondents (75.6%) reported that they were verbally abused or bullied by patients or relatives of patients. Staff responses to emotional abuse varied among respondents with the most frequent response of “told the person to stop” (22%), followed by “took no action” (19%). Further, 83.3% of respondents stated that there was an existing policy and procedure guidelines for reporting work place violence while 30.1% reported that they had not used any of these measures.

Conclusion

Workplace violence among HCW in the emergency departments are common in the Gulf area and can be serious in as far as use of weapons. Staff awareness focus on this under reported issue, and staff training to recognize and report potential aggression can predict a significant reduction of incidents.

Prevalence of Workplace Bullying and Risk Groups in Chinese Employees in Hong Kong

Most studies on workplace bullying have been conducted in high-income countries and on Caucasian samples. Little is known about workplace bullying in Asian countries despite its recognition as a serious public health issue in the workplace. We examined the annual and lifetime prevalence of workplace bullying and its risk factors among Chinese employees in Hong Kong. The study was part of a larger project consisting of two waves. Respondents were recruited from a convenience sampling technique and completed a self-reported survey. Respondents reported whether they had been bullied at work for the past 12 months and during their lifetime. A multivariate logistic regression was conducted to explore the sociodemographic risk factors for workplace bullying. There were a total of 2657 respondents (54.6% male), with a mean age of 41.53 years. The annual and lifetime prevalence of workplace bullying were 39.1% and 58.9%, respectively. Multivariate analyses showed that workplace bullying in the past 12 months was associated with a high monthly income, and the combination of a high monthly income and higher educational attainment was associated with bullying at some point in the participants’ career. Suitable policies and interventions to reduce the extent of workplace bullying in Hong Kong are warranted.

Risk Factors for Workplace Bullying: A Systematic Review

Objective: The goal of this study was to systematically review risk factors for workplace bullying. Methods: The search was carried out in two databases. Studies with estimates of risk factors for workplace bullying were included in the review. We assessed the quality of the selected studies using an adapted version of the Downs and Black checklist. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and Meta-analyses of Observational Studies in Epidemiology (MOOSE) guidelines were used for reporting papers. Results: Fifty-one papers were included, and 70.6% were from European countries. Women were reported to be at higher risk of being bullied in most studies (odds ratio (OR) from 1.17 to 2.77). Authoritarian and laissez-faire leadership styles were positively associated with bullying. Several psychosocial factors, such as stress (OR from 1.37 to 4.96), and occupational risks related to work organization, such as flexible work methods, role conflict, role ambiguity, monotonous or rotating tasks, high demands, pressure of work, and unclarity of duties were strongly associated with bullying. Discussion: The findings highlight the central role of organizational factors in bullying. Policies to prevent bullying must address the culture of organizations, facing the challenge of developing a new management and leadership framework.

Encountering staff-directed aggression within mental health and substance abuse services: exploring conceptions of practice following education

Background

Staff-directed aggression represents a considerable concern in mental health and substance abuse services, and presents a substantial challenge to the quality and continuity of service provision for people with mental health and substance abuse problems. The practitioners themselves frequently request increased competence as a way to mediate the negative effects of staff-directed violence and aggression. The aim of this study is to explore how practitioners in municipal mental health and substance abuse services conceptualize practice in prevention and management of staff-directed violence. Furthermore, we seek to explore how these conceptions change following participation in two complementary and specially developed courses advancing respectively, qualified risk assessment and situational awareness and disempowerment-sensitive and de-escalation principles for practice.

Method

The study was conducted by using a qualitative phenomenographic research approach. The data-material comprised two-step semi-structured interviews with ten participants from various parts of community mental health and substance abuse services in the Municipality of Oslo, Norway.

Results

The analysis resulted in the development of five qualitatively different, hierarchically ordered, yet logically interrelated conceptual categories of practice concerning prevention and management of staff-directed aggression in community mental health and substance abuse services. These are: (1) Observation, reporting and expectation of organizational intervention, (2) Application of personalized de-escalating skills and behaviour, (3) Delivery of team-based and standardized services, (4) Provision of perceptive and responsive services, and (5) Facilitation of sensitive, involving and reflexive care. The categories vary according to the participants' attentional focus on either the responsibility of the organization, staff members' personally developed skills and techniques, team-based solutions, knowledgeable information processing in making professional judgements and reflexive, interpersonal service provision, as well as according to what meaning participants assign to practice. The authors have identified varying degrees of conceptual change following education in half of the participants.

Conclusion

The results of this study both show that practitioners conceptualize practice in aggressive encounters quite differently. The study also indicate that it is important to consider participant awareness of the phenomenon of interest when devising educational activities for personnel in mental health and substance abuse services.

Working Time Society consensus statements: Psychosocial stressors relevant to the health and wellbeing of night and shift workers

This consensus report summarizes the negative impact of work-related psychosocial factors and job stressors on the health and wellbeing of shift workers. Psychosocial factors may (a) directly affect work schedules or (b) mediate or moderate relationships between work schedules, circadian factors, and health. In this paper, prominent psychosocial models (e.g. Job Strain and Effort-Reward Imbalance) are used to help assess detrimental effects, including pathophysiologic outcomes. Several studies indicate the psychosocial environment can be more problematic for shift workers compared to regular day workers. This is likely due to shift worker's experiencing greater risks of low job control, high physical work demands, lower support from supervisors, and greater levels of over-commitment. Workplace violence is another frequently encountered psychosocial stressor for shift workers more likely to be in regular contact with the general public, such as police officers, security personnel, professional drivers, and other service employees being at elevated risk. A large body of literature confirms night and irregular shift schedules increase risk for injury. Non-diurnal schedules can trigger and worsen such incidents, especially under unsafe conditions. The problem of workplace violence for shift workers, in terms of severity and consequences, is probably underestimated, especially when present among other occupational stressors. Practical considerations and recommendations for action to mitigate the detrimental effects of psychosocial stressors on night and shift workers are presented.

Precarious schedules linked with workplace aggression in a high-risk occupation

INTRODUCTION

Night work and prolonged work hours increase the risk for workplace aggression, however, the risk related to precarious schedules remains unknown.

METHODS

Cross-sectional study among Parole Probation Officers (PPOs) (n = 35). A precarious schedules index was created including the following indicators (a) experiencing one or more unexpected shifts during the last 4 weeks; (b) having minimal control over work hours; and (c) shifts notifications of less than a week. Generalized Poisson Regressions estimated the association between precarious schedules and self-reported client-based aggressive incidents (verbal, threating, property, or physical) during the last 12 months.

RESULTS

Workplace aggression was highly prevalent (94.3%). PPOs who experienced precarious schedules (74.3% prevalence) had an adjusted rate of workplace aggression 1.55 times greater than PPOs without precarious schedules (IRR = 1.55, 95% CI 1.25, 1.97, P < 0.001).

CONCLUSIONS

Precarious schedules were associated with workplace aggression. Further research ought to examine whether improving schedule predictability may reduce client-based aggression.

Workplace Harassment and Morbidity Among US Adults: Results from the National Health Interview Survey

Most research on workplace harassment originates from European countries.Prevalence of workplace harassment and associated morbidity has not been well studied in the United States. The purpose of this study was to assess in a sample of US workers the prevalence of workplace harassment and the psychological and physical health consequences of workplace harassment. The 2010 National Health Interview Survey data were analyzed in 2014 for this study. We computed the prevalence of workplace harassment, assessed the demographic and background characteristics of victims of harassment, and tested the association between harassment and selected health risk factors by using logistic regression analysis. Statistical significance was established as p < 0.01. A total of 17,524 adults were included in our study (51.5% females and 74.9% Whites). A little <1 in 10 (8.1%) reported being harassed in the workplace in the past 12 months. The odds of harassment were significantly higher for females (OR 1.47, p < 0.001),multiracial individuals (OR 2.30, p < 0.001), and divorced or separated individuals (OR 1.88, p < 0.001). Victims of harassment were significantly more likely to: be obese, sleep less, and smoke more. In addition, harassment was associated with psychosocial distress, pain disorders, work loss, bed days, and worsening health of employees in the past 12 months. Analysis was stratified by gender and distinct health risk patterns for men and women victims were observed. Workplace harassment in the US is associated with significant health risk factors and morbidity. Workplace policies and protocols can play a significant role in reducing harassment and the associated negative health outcomes.

Clinically assessed consequences of workplace physical violence

Objectives

To assess consequences of physical violence at work and identify their predictors.

Methods

Among the patients in a medicolegal consultation from 2007 to 2010, the subsample of workplace violence victims (n = 185) was identified and contacted again in average 30 months after the assault. Eighty-six victims (47 %) participated. Ordinal logistic regression analyses assessed the effect of 9 potential risk factors on physical, psychological and work consequences summarized in a severity score (0–9).

Results

Severity score distribution was as follows: 4+: 14 %; 1–3: 42 %; and 0: 44 %. Initial psychological distress resulting from the violence was a strong predictor (p < 0.001) of the severity score both on work and long-term psychological consequences. Gender and age did not reach significant levels in multivariable analyses even though female victims had overall more severe consequences. Unexpectedly, only among workers whose jobs implied high awareness of the risk of violence, first-time violence was associated with long-term psychological and physical consequences (p = 0.004). Among the factors assessed at follow-up, perceived lack of employers’ support or absence of employer was associated with higher values on the severity score. The seven other assessed factors (initial physical injuries; previous experience of violence; preexisting health problems; working alone; internal violence; lack of support from colleagues; and lack of support from family or friends) were not significantly associated with the severity score.

Conclusions

Being a victim of workplace violence can result in long-term consequences on health and employment, their severity increases with the seriousness of initial psychological distress. Support from the employer can help prevent negative outcomes.

A Computer-based Training Intervention for Work Supervisors to Respond to Intimate Partner Violence

Objectives

Intimate partner violence (IPV), commonly known as domestic violence is a problem throughout the world. An estimated 36% to 75% of employed abused woman are monitored, harassed and physically assaulted by their partners or ex-partners while trying to get to work and while at work. The objective of this research is to evaluate the effectiveness of interactive training to increase knowledge, change perceptions and develop an intention to address domestic violence that spills over into the workplace.

Methods

Community-based participatory research approaches were employed to develop and evaluate an interactive computer-based training (CBT) intervention, aimed to teach supervisors how to create supportive and safe workplaces for victims of IPV.

Results

The CBT intervention was administered to 53 supervisors. All participants reacted positively to the training, and there was a significant improvement in knowledge between pre- and post-training test performance (72% versus 96% correct), effect size (d) = 3.56. Feedback from focus groups was more productive than written feedback solicited from the same participants at the end of the training.

Conclusion

Effective training on the impacts of IPV can improve knowledge, achieving a large effect size, and produce changes in perspective about domestic violence and motivation to address domestic violence in the workplace, based on questionnaire responses.

Violence against primary health care workers in Al-Hassa, Saudi Arabia

This self-report questionnaire study was carried out in Al-Hassa, Saudi Arabia to highlight the magnitude, predictors, and circumstances of workplace violence against primary health care (PHC) workers. A total of 1,091 workers completed a self-administered questionnaire. About 28% were exposed to at least one violent event during the past year. Logistic regression analysis revealed that the most important predictors of violence are high education of workers (OR = 9.3), working in emergency clinics (OR = 6.8), and in Hegar (OR = 3.2). Emotional and physical violence accounted for 92.1% and 7.9% of violent events, respectively. Unmet needs of patients, overcrowding, and reaction to injury or illness were the leading contributing factors for violence. There is a need for violence prevention and control program in health care facilities.

Association of psychosocial factors and bullying at individual and department levels among naval military personnel

OBJECTIVE

We studied the associations between bullying at work and psychosocial factors both at the individual and at the department levels.

METHODS

The data were collected in a cross-sectional study from a questionnaire sent by mail in 2002 to all military personnel in the Royal Norwegian Navy as part of a general work and health study. Self-experienced and observed bullying as well as scores for psychosocial scales using the General Nordic Questionnaire for Psychological and Social Factors at Work were calculated both for the individuals (n=1604) and as a mean for each Navy department (n=97).

RESULTS

Low scores on the fair leadership, innovative climate, and inequality scales were associated with high occurrence of bullying at the individual level in a backward stepwise multivariate logistic regression, which means that lack of fair leadership and innovative climate and unequal treatment were associated with high occurrence of bullying. At the department level, the three scales were similarly significantly associated with percentage observed bullying when analyzed separately. A low score on the fair leadership scale and lower departmental mean age were associated with high percentage observed bullying in a stepwise multiple linear regression analysis. Repeating the analyses excluding those being bullied did not change the estimates markedly.

CONCLUSION

Our findings indicate that the work environment as perceived by the individual and at the department level is related to the occurrence of bullying.

Work-related factors and violence among nursing staff in the European NEXT study: A longitudinal cohort study

BACKGROUND

The occurrence of workplace violence is rather frequent within the nursing profession, with well-known consequences on the psychological health of victims.

OBJECTIVES

This study is aimed at assessing the relationships between relevant individual, organizational, and psychosocial factors, and the frequency of several types of workplace violence; the direct as well as the interactive impact of violence and psychosocial factors on organizational commitment and perceived health.

DESIGN

Questionnaire-based cross-sectional and longitudinal survey designs were employed for the two study objectives, respectively.

SETTING

Five hundred and sixty-five healthcare institutions from eight European countries participated in the Nurses' Early Exit Study.

PARTICIPANTS

The 34,107 participants were nursing staff holding different qualifications. The response rate was 55.1% in the cross-sectional part and 40.5% in the follow-up phase. At baseline, the respondents were mostly female (89.3%), in the age group 30-44 years (52.9%), registered or specialized nurses (67.0%), working mainly in medico-surgical wards (36.3%), and employed full-time (72.8%).

METHODS

In the cross-sectional analysis, the relationship between the predictor variables and frequency of violence was assessed by means of a hierarchical multiple linear regression. In the longitudinal analysis, main direct and interactive effects of violence and psychosocial factors on perceived health and organizational commitment were assessed by means of hierarchical multiple linear regression analyses with interaction terms.

RESULTS

Higher levels of adverse work-related factors were significantly associated with higher frequency of the distinguished types of violence. Significant interactions were found between psychosocial factors and violence only in predicting organizational commitment, even if effect sizes were very low. No interactions were observed for perceived health. The prevalence of the distinguished types of violence varied across the participating countries according to the presence of adverse work- and non-work-related factors.

CONCLUSIONS

These findings suggest the necessity of interventions both over working conditions conducive to violence and violent behaviours themselves.

Economic activities and occupations at high risk for workplace bullying: results from a large-scale cross-sectional survey in the general working population in France

OBJECTIVES

To evaluate the prevalence of workplace bullying in the general working population in France, and explore this prevalence across economic activities and occupations.

METHODS

The studied population consisted of a sample of 3,132 men and 4,562 women of the general working population in the southeast of France. A self-administered anonymous questionnaire included the 45-item inventory of workplace bullying elaborated by Leymann, frequency and duration of bullying, and self-report of being exposed to bullying. Cases of bullying were defined using both Leymann's definition (exposure to at least one form of bullying within the previous 12 months, weekly or more, and for at least 6 months) and self-report of bullying.

RESULTS

The 12 month prevalence of workplace bullying was 9% for men and 11% for women. The point prevalence was 7.5% on the day of the survey for men and women, and varied from 3 to 18% according to economic activities and occupations among men. High-risk groups for bullying included activities of services for men, and various categories of associate professionals, and of low levels of white and blue collar workers for men, and government associate professionals for women.

CONCLUSIONS

This first study on workplace bullying in France showed that around 10% of the population studied, and more women than men, had been exposed to bullying within the last 12 months. This study also found that some economic activities and occupations would be at elevated risk for bullying, pointing out the need to better understand and prevent bullying in these high-risk groups.

Identification of violence in Turkish health care settings

This study sought to investigate the contributing factors to and frequency of violence against health care workers (HCWs) working in western Turkey. The population is composed of a random sample of 1,209 HCWs from 34 health care workplaces. Written questionnaires were given to HCWs at all sites, where staff were instructed to register all types of violence they had experienced. In all, 49.5% of HCWs reported having experienced verbal, physical, or verbal and physical violence, with this total being made up of 39.6% men and 60.4% women. A larger percentage (69.6%) of general practitioners reported experiencing verbal abuse and physical violence by patients and patients' family members or friends. Younger workers, inexperienced staff, and those in emergency services were more likely to report violence. Violence directed toward HCWs is a common occupational hazard. Public health authorities should plan preventive interventions based on the findings of this study.

Bullying at work, health outcomes, and physiological stress response

The relationships among bullying or witnessing bullying at work, self-reported health symptoms, and physiological stress reactivity were analysed in a sample of 437 employees (294 women and 143 men). Physiological stress reactivity was measured as cortisol in the saliva. Of the respondents, 5% of the women (n=15) and 5% of the men (n=7) reported bullying, whereas 9% of the women (n=25) and 11% of the men (n=15) had witnessed bullying at work. The results indicated that the bullied respondents had lower social support from coworkers and supervisors, and they reported more symptoms of somatisation, depression, anxiety, and negative affectivity (NA) than did the nonbullied respondents. Witnesses reported more symptoms of anxiety and lower support from supervisor than did the nonbullied employees. Concentrations of cortisol in the saliva were lower at awakening in bullied respondents compared with nonbullied respondents. Previous studies have reported lower diurnal concentration of cortisol for people with posttraumatic stress disorder (PTSD) and chronic fatigue. To our knowledge, this is the first full study on the associations among being subjected to bullying, health outcomes, and physiological stress response.

Violence toward health care workers in emergency departments in west Turkey

The aims of this study were to describe the epidemiology of violence in Turkish emergency departments (EDs), and to provide a more specific focus on violence. This study was conducted in 18 EDs in west Turkey for 3 months. Emergency staff in the EDs were asked to recall experiences of violence directed at them at work over the previous year. We then put these experiences into five categories: verbal abuse, specific threats, physical action with or without injury, sexual violence, and the last category, acts not falling in the other four categories. The data were analyzed using chi-square test and percent ratios. Of the 195 respondents answering the questions regarding violence against them, 72.3% (141/195) had experienced some form of violence. Most of the respondents stated that they had experienced verbal/emotional abuse (69.5%), followed by specific threats (53.2%), and physical action (8.5%). Groups experiencing the highest percentage of any type of violence during the previous year were as follows: 30-39-year-olds (82.1%), nurses and physicians (80.8% and 78.0%, respectively), public hospital health care staff (81.0%), staff working for 61-120 months (82.8%), those working between 8:00 a.m. and 5:00 p.m. (81.8%), and those working in low deprivation practices (79.6%). Most of the aggressors were patients' relatives (89%) as compared with patients' themselves (52%). Half of those experiencing physical action (50% [6/12]) during the course of the last year received support and inability reports due to minor injuries. There were no major injuries such as lacerations or fractures. We recommend that training to deal with violence in the workplace be specifically targeted at members of staff who are most likely to be at risk of threats of violence and actual physical aggression.

Impact of training on work-related assault

Although training is often recommended as a part of a comprehensive approach to address occupational violence, little empirical literature exists to support this recommendation. Over 40% of nurses responding to the Minnesota Nurses Study reported being trained about occupational violence, involving seven different training topics. Although at the univariate level, an increased risk was identified for nurses trained in managing assaultive/violent patients, no statistically significant results remained at the multivariate level. This lack of protection from training is consistent with previous research, although the explanations for this lack of effect remain unclear. Additional research is necessary to obtain more specific details on occupational violence training, including training content and methods, to understand more thoroughly the impact of training on occupational violence.

Workplace Violence in Oregon: An Analysis Using Workers???Compensation Claims from 1990???1997

One of the most serious occupational problems in the workplace is the occurrence of violent assaults. This study examined 2028 workers' compensation claims of workplace violence from Oregon between 1990 and 1997, and used Current Population Survey data for risk analysis. The rate of workplace violence was 1.86 per 10,000 employees annually (95% confidence interval, 1.78-1.94), with females and workers under 35 years of age experiencing the most violence. The average claim resulted in approximately 40 days of indemnity and $6200 in costs. Workers on evening and night shifts had significantly higher rates of being victims of violence, as did those working on weekends. Preventative interventions should be targeted at younger workers and those with less tenure. Special measures should be focused on ensuring the safety of evening/night-shift workers and weekend employees.

Multiple Risk Factors for Violence to Seven Occupational Groups in the Swedish Caring Sector

Violence towards health-care personnel represent an increasing problem, but little is known in terms of how different occupational groups are affected. A questionnaire was sent to a stratified sample of 2,800 of 173,000 employees in the Swedish municipal health and welfare sector. Seven major groups working with the elderly or persons with developmental disabilities were considered: administrators, nursing specialists, supervisors, direct carers, nursing auxiliaries, assistant nurses, and personal assistants. The response rate was 85 percent. Fifty-one percent of respondents reported exposure to violence or threats of violence over one year. The most vulnerable groups were assistant nurses and direct carers (usually of the developmentally disabled). Individual characteristics, such as age and organizational tenure, were related to exposure. Work-related characteristics, such as type of workplace, working full-time with clients, organizational downsizing, and high workload, were also associated with risk. Greater knowledge of impacts on different professional groups and relevant prevention are required.

Climate perceptions matter: a meta-analytic path analysis relating molar climate, cognitive and affective states, and individual level work outcomes

Although workplace climate has been extensively studied, the research has not led to firm conclusions as to its relationship with individual level work outcomes. The authors used C. Ostroff's (1993) taxonomy to organize dimensions labeled as workplace climate and then used meta-analytic techniques to test a path analytic model. The model posited that climate affects individual level outcomes through its impact on underlying cognitive and affective states. An extensive literature search yielded 51 empirical studies with 70 samples. The results suggest that the 3 higher order facets of climate (affective, cognitive, and instrumental) affected individual level outcomes of job performance, psychological well-being, and withdrawal through their impact on organizational commitment and job satisfaction.

Risk factors for physical assault. State-managed workers' compensation experience

BACKGROUND

The estimation of incidence and evaluation of risk factors associated with nonfatal occupational assault injuries have rarely been documented in a statewide population context. A state-managed workers' compensation system can provide estimates of incidence of such injuries and allow evaluation of risk factors.

METHODS

Using claims data from the state-managed West Virginia Workers' Compensation, the incidence rates of workplace injuries resulting from physical assault were estimated for the period 1997-1999. Data on potential risk factors were obtained from the claim-related electronic data files, and the risk associated with each factor was assessed using proportional injury ratios (PIRs).

RESULTS

During the study period, 2122 compensated injuries were associated with workplace violence. The incidence of assault injuries was 108.2 cases per 100,000 employee years. Women sustained a higher incidence than men. Healthcare workers, public safety workers, and teachers accounted for almost 75% of all assault injuries. Workers in these occupations also differed from each other with regard to seasonality and timing of assault, perpetrator-victim relationship, and types of injury. Evidence of gender-occupation interaction indicated higher risk of assault injury in men compared to women across the three leading occupations. Nighttime work shifts were associated with greater risk of assault for female healthcare workers (PIR=1.8; 95% confidence interval, 1.09-2.87).

CONCLUSIONS

The healthcare sector sustained the bulk of assault injuries in West Virginia. Although the majority of healthcare-sector employees were women, the risk of assault injuries was higher in male employees. Risk factors and injury characteristics identified in this study, particularly for three high-risk occupations, should help develop strategies for preventing workplace violence. Protecting female healthcare workers on night-shift duty, especially in nursing home settings, appears to be an important target for intervention.