Violence against health personnel before and during the health contingency COVID-19

Workplace violence against healthcare workers during the COVID-19 pandemic: a systematic review and meta-analysis

Workplace violence (WPV) is a prevalent phenomenon, especially in the healthcare setting. WPV against healthcare workers (HCWs) has increased during the COVID-19 epidemic. This meta-analysis determined the prevalence and risk factors of WPV. A database search was conducted across six databases in May 2022, which was updated in October 2022. WPV prevalence among HCWs was the main outcome. Data were stratified by WPV/HCW type, pandemic period (early, mid, late), and medical specialty. WPV risk factors were the secondary outcome. All analyses were conducted through STATA. Newcastle Ottawa Scale evaluated the quality. Sensitivity analysis identified effect estimate changes. A total of 38 studies (63,672 HCWs) were analyzed. The prevalence of WPV of any kind (43%), physical (9%), verbal (48%), and emotional (26%) was high. From mid-pandemic to late-pandemic, WPV (40-47%), physical violence (12-23%), and verbal violence (45-58%) increased. Nurses had more than double the rate of physical violence (13% vs. 5%) than physicians, while WPV and verbal violence were equal. Gender, profession, and COVID-19 timing did not affect WPV, physical, or verbal violence risk. COVID-19 HCWs were more likely to be physically assaulted (logOR = 0.54; 95% CI: 0.10: 0.97). Most healthcare employees suffer verbal violence, followed by emotional, bullying, sexual harassment, and physical assault. Pandemic-related workplace violence increased. Nurses were twice as violent as doctors. COVID-19 healthcare employees had a higher risk of physical and workplace violence.

Sources of Conflict and Prevention Proposals in User Violence Toward Primary Care Staff: A Qualitative Study of the Perception of Professionals

Background

Some studies indicate that at least one in four cases of workplace violence occurs in the health sector, with a higher incidence in Emergency Departments, Mental Health Services or Primary Care. Unlike other professional groups, healthcare workers perceive this type of behavior mainly from users or patients. This is the reason why both the detection of conflict between users and professionals and the ways to face and reduce these conflicts has been and is one of the main fields of study in this population. The aim of this study was to delve into the sources of conflict between users and professionals in Primary Care from the perspective of the professionals themselves. In addition, the aim was to explore the proposals for intervention/prevention of this conflict that the professionals perceived as necessary to improve the work environment.

Methods

This study uses qualitative methodology conducting 8 focus groups with professionals related to Primary Health Care. The final sample was composed of 44 workers who were part of the regional management, labor unions, area coordinators, center coordinators and representatives of the professional groups of these centers (medicine, nursing and administration). Thematic analysis was used to extract topics and subtopics.

Results

The results are divided into areas of conflict and intervention proposals. The professionals detect a lack of training or education in themselves, absence of functional multidisciplinary teams or competencies to improve the patient-professional relationship, among others. To address these shortcomings, they propose the creation of protocols for action in the face of aggression, the formation of spaces and channels of communication both among the center's own workers and between them and other organizations (e.g., hospitals), fostering a positive relationship with the user community and ongoing training in various topics such as self-safety, management of emotions, empathy or interpersonal communication.

Conclusions

This study allows to highlight specific areas of user-professional conflict in Primary Care. Furthermore, the inclusion of intervention proposals by the professionals allows to propose starting points for the development of complete plans.