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Venkatesan S, Kozhumam A, Strand E, Staton CA, Natesan SM, Vissoci JRN, Purakal JD. Preliminary Assessment of Post-traumatic Stress Disorder Symptoms Among Emergency Medicine Physicians During the COVID-19 Outbreak. J Am Coll Emerg Physicians Open 2025; 6:100098. [PMID: 40236627 PMCID: PMC11999589 DOI: 10.1016/j.acepjo.2025.100098] [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: 03/01/2024] [Revised: 02/01/2025] [Accepted: 02/03/2025] [Indexed: 04/17/2025] Open
Abstract
Objectives The COVID-19 pandemic has caused significant increases in work-related emotional stress and emergency department (ED) volumes. Our study aimed to provide a preliminary assessment of posttraumatic stress disorder (PTSD) symptoms among emergency medicine (EM) physicians in the United States following the COVID-19 pandemic and explore related factors and predictors of PTSD symptoms. Methods Participants were recruited using a convenience sampling approach via professional listservs from national and state EM societies. Eligible participants included board-certified or board-eligible EM physicians, EM residents, and non-EM physicians working in an EM setting during the pandemic. The survey was distributed online using Qualtrics, ensuring anonymity and data security, from September 2020 to April 2021, with active recruitment during 2 periods: September to October 2020 and March to April 2021. To optimize clarity, the survey was prepiloted and measures were included to prevent duplicate responses. Descriptive analyses were reported with percentages, means, and medians using RStudio, PBC. Results A total of 362 surveys were distributed, of which 315 (87%) were completed and included in the analysis. Participants were predominantly aged 35 to 50 years (46%), White (86%), and board-certified in EM (70%), with most practicing in urban level 1 trauma centers (45%). Geographic representation included 40 states, with the largest proportions from the South (33%) and Midwest (29%). Overall, 92% of participants reported experiencing PTSD symptoms, with 41% classified as minimal, 22% mild, 18% moderate, 12% severe, and 7% very severe. The median PTSD Symptom Scale (PSS-I-5) score was 13 (IQR, 23). Factors associated with more severe PTSD symptoms included prior mental health diagnoses, female sex, and working in rural settings. Conclusions The study highlights the widespread occurrence of PTSD symptoms, with 92% of EM physicians reporting symptoms during the COVID-19 pandemic. Demographic and workplace factors, such as prior mental health diagnoses, female sex, and rural practice settings, contributed to greater symptom severity. These findings underscore the need for targeted mental health interventions and resources tailored to the specific needs of this at-risk group.
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Affiliation(s)
- Sriram Venkatesan
- Sri Ramachandra Medical College & Research Institute, Chennai, India
| | - Arthi Kozhumam
- Medical Scientist Training Program, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Eleanor Strand
- Rural Health Research Center, University of Minnesota – Twin Cities, Minneapolis, Minnesota, USA
| | - Catherine A. Staton
- Global Emergency Medicine Innovation and Implementation Research Center (GEMINI), Duke University, Durham, North Carolina, USA
- Department of Emergency Medicine, Duke University School of Medicine, Durham, North Carolina, USA
- Duke Global Health Institute, Durham, North Carolina, USA
| | - Sreeja M. Natesan
- Department of Emergency Medicine, Duke University School of Medicine, Durham, North Carolina, USA
| | - João Ricardo Nickenig Vissoci
- Global Emergency Medicine Innovation and Implementation Research Center (GEMINI), Duke University, Durham, North Carolina, USA
- Division of Translational Health Sciences, Department of Emergency Medicine, Duke University School of Medicine, Durham, North Carolina, USA
- Research Design and Analysis Core (RDAC), Duke Global Health Institute, Duke University, Durham, North Carolina, USA
| | - John David Purakal
- Department of Emergency Medicine, Duke University School of Medicine, Durham, North Carolina, USA
- Duke-Margolis Institute for Health Policy, Duke University, Durham, North Carolina, USA
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Mehtap Ö, Kökalan Ö. The effects of workplace violence and work-to- family conflict on job engagement of nurses: A multilevel longitudinal research. Work 2025; 80:1653-1659. [PMID: 39973632 DOI: 10.1177/10519815241298115] [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] [Indexed: 02/21/2025] Open
Abstract
BackgroundWorkplace violence in hospitals has been a longstanding concern, and in recent years, it has been on the rise. This research specifically examines this issue as it pertains to nurses. The violence they encounter and the work-family conflict (WFC) resulting from the difficulties in their work environment both play roles in diminishing their work engagement.ObjectiveThe aim of this study is to reveal the impact of workplace violence (WV) and WFC on the work engagement (WE) of nurses by conducting a longitudinal research design.MethodsConvenience sampling was used. The study includes 52 nurses working in a private hospital in the province of Kocaeli. Participants were required to fill out daily-level surveys at the conclusion of each workday for continuous period of 5 days. A daily short form of Utrecht Employment Engagement Scale (UWES), daily Work to Family Conflict Scale developed by Netemeyer, Boles & McMurrian in 1996, and Workplace Violence Scale was developed by Chen et al. in 2004 were used to form questionnarie. Cronbach's alpha score for scales across 5 consecutive days ranged from .70 to 0.76. All scales were accepted as reliable.ResultCorrelation results showed that WV and WFC had a significant relation with WE. It is also seen that there is a positive association between WV and WFC. WV and WFC are supported to negatively affect WE of nursesConclusionHealth care institutions should develop practices that will reduce workplace violence and eliminate the causes of workplace violence.
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Affiliation(s)
- Özge Mehtap
- Department of Business Administration, Kocaeli University, Kocaeli, Türkiye
| | - Özgür Kökalan
- Department of Business Administration, İstanbul Sabahattin Zaim University, İstanbul, Türkiye
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Zheng Y, Li X, Sun Y, Mao C, Huang J, Li J, Zhang G, Wei N, Wang X, Teng Y. Association between workplace violence from patients and the mental health status of healthcare workers in Zhuhai China: a cross-sectional study. Front Public Health 2025; 12:1441389. [PMID: 39839398 PMCID: PMC11747547 DOI: 10.3389/fpubh.2024.1441389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2024] [Accepted: 12/16/2024] [Indexed: 01/23/2025] Open
Abstract
Objective Workplace violence (WPV) poses a serious occupational risk. This study aims to explore the association between WPV from patients and the occurrence of insomnia, depression, and anxiety among healthcare workers. Methods Information about the WPV from patients was collected by a self-designed questionnaire. Generalized Anxiety Disorder-7 (GAD-7), Patient Health Questionnaire-9 (PHQ-9), and Insomnia Severity Index (ISI) were used for the assessment of mental health. Logistic regression was used to explore the association between WPV from patients and insomnia, depression, and anxiety. Mediation analysis was used to evaluate the mediation effect of depression and anxiety on the relationships between WPV from patients and insomnia. Results Of 10,413 included healthcare workers, 40.05% experienced verbal violence, 6.44% experienced physical violence from patients in the past year. There is a significant association between verbal violence and insomnia (OR = 1.780, 95% CI: 1.591-1.990), depression (OR = 1.823, 95% CI: 1.640-2.026), and anxiety (OR = 1.831, 95% CI: 1.606-2.087), as well as physical violence (insomnia: OR = 1.220, 95% CI: 1.002-1.481; depression: OR = 1.274, 95% CI: 1.052-1.540; anxiety: OR = 1.316, 95% CI: 1.058-1.630). Moreover, depression and anxiety mediated the relationship between WPV and insomnia, the mediated proportion was 62.21% in the association between verbal violence and insomnia, and 60.22% in the association between physical violence and insomnia. Conclusions The association between WPV from patients and heightened risks of mental health issues emphasizes the necessity of supportive work environments. Recognizing the mediating role of depression and anxiety stresses the significance of tailored mental health training for healthcare staff.
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Affiliation(s)
- Ying Zheng
- Xiangya School of Public Health, Central South University, Changsha, Hunan, China
| | - Xuping Li
- Xiangya School of Public Health, Central South University, Changsha, Hunan, China
| | - Yajun Sun
- The Third People's Hospital of Zhuhai, Zhuhai, Guangdong, China
- Zhuhai Mental Health Association, Zhuhai, Guangdong, China
| | - Chun Mao
- The Third People's Hospital of Zhuhai, Zhuhai, Guangdong, China
- Zhuhai Mental Health Association, Zhuhai, Guangdong, China
| | - Jiaju Huang
- The Third People's Hospital of Zhuhai, Zhuhai, Guangdong, China
- Zhuhai Mental Health Association, Zhuhai, Guangdong, China
| | - Jingya Li
- Xiangya School of Public Health, Central South University, Changsha, Hunan, China
| | - Guangchuan Zhang
- The Third People's Hospital of Zhuhai, Zhuhai, Guangdong, China
- Zhuhai Mental Health Association, Zhuhai, Guangdong, China
| | - Ning Wei
- The Third People's Hospital of Zhuhai, Zhuhai, Guangdong, China
- Zhuhai Mental Health Association, Zhuhai, Guangdong, China
| | - Xiaohui Wang
- The Third People's Hospital of Zhuhai, Zhuhai, Guangdong, China
- Zhuhai Mental Health Association, Zhuhai, Guangdong, China
| | - Yongyong Teng
- The Third People's Hospital of Zhuhai, Zhuhai, Guangdong, China
- Zhuhai Mental Health Association, Zhuhai, Guangdong, China
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Huang L, Zhang Q, Wu H, Lan Y, Jiang F, Zhang Y. Work-related violence, occupational stress and psychological distress among medical staff in China: A structural equation modeling analysis. Work 2025; 80:314-322. [PMID: 39121150 DOI: 10.3233/wor-240323] [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] [Indexed: 08/11/2024] Open
Abstract
BACKGROUND Psychological issues and work-related violence are the main challenges faced by medical staff. The situation has become even more prevalent during the COVID-19 pandemic. OBJECTIVE This research aimed to analyze the relationships among work-related violence, occupational stress and psychological distress and to further identify the direct or indirect effects of violence on psychological distress. METHODS A total of 1,765 medical staff members were surveyed using the Kessler Psychological Distress Scale and Revised Occupational Stress Inventory. Work-related violence was assessed using a self-made 5-question questionnaire. STATA 14.0 and Amos 21.0 software were used for correlation analysis, variance analysis, and structural equation modeling analysis. RESULTS A total of 66.1% of the medical staff suffered workplace violence, and 61.2% witnessed workplace violence. The psychological distress score (Kessler 10 Scale) of the medical staff was 22.7±7.67. The psychological strain score and physical strain score were 26.8±7.14 and 24.2±6.51, respectively. Work-related violence (suffered: β= 0.467; witnessed: β= 0.258) and occupational stress (psychological strain: β= 0.269; physical strain: β= 0.317) were predictors of psychological distress, and social support (β= -0.265) was a protective factor. Work-related violence and social support had both direct and indirect effects on psychological distress, and the intermediate factor was occupational stress. The total effects of suffered workplace violence and witnessed workplace violence were 0.181 and 0.092, respectively, and the total effect of social support was -0.262. CONCLUSIONS Work-related violence may exacerbate symptoms of occupational stress and psychological distress. Reducing workplace violence and protecting medical staff from work-related violence are extremely important aspects of mental health prevention.
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Affiliation(s)
- Lei Huang
- Department of Postgraduate Students, West China Hospital and West China School of Medicine, Sichuan University, Chengdu, China
| | - Qin Zhang
- Department of Postgraduate Students, West China Hospital and West China School of Medicine, Sichuan University, Chengdu, China
| | - Huiyi Wu
- Department of Epidemiology and Biostatistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Yajia Lan
- Department of Environmental Health and Occupational Medicine, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Fugui Jiang
- Sichuan Provincial Center for Mental Health, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, Chengdu, China
| | - Yang Zhang
- Department of Periodical Press and National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, China
- Chinese Evidence-Based Medicine Center, West China Hospital, Sichuan University, Chengdu, China
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Hadmon R, Pierre DM, Banga A, Clerville JW, Mautong H, Akinsanya P, Gupta RD, Soliman S, Hunjah TM, Hunjah BA, Hamza H, Qasba RK, Nawaz FA, Surani S, Kashyap R. Violence study of healthcare workers and systems in the Caribbean: ViSHWaS-Caribbean study. World J Methodol 2024; 14:92932. [PMID: 39310234 PMCID: PMC11230073 DOI: 10.5662/wjm.v14.i3.92932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2024] [Revised: 04/24/2024] [Accepted: 05/07/2024] [Indexed: 06/25/2024] Open
Abstract
BACKGROUND Violence against healthcare workers (HCWs) in the Caribbean continues to prevail yet remains underreported. Our aim is to determine the cause, traits, and consequences of violence on HCWs in the Caribbean. AIM To determine the cause, traits, and consequences of violence on HCWs in the Caribbean. METHODS This research adopted an online cross-sectional survey approach, spanning over eight weeks (between June 6th and August 9th, 2022). The survey was generated using Research Electronic Data Capture forms and followed a snowballing strategy to contact individuals using emails, social media, text messages, etc. Logistic regression analysis was performed to evaluate the variables that influence violence, including gender, age, years of experience, institution type, and night shift frequency. RESULTS The survey was completed by 225 HCWs. Females comprised 61%. Over 51% of respondents belonged to the 21 to 35 age group. Dominica (n = 61), Haiti (n = 50), and Grenada (n = 31) had the most responses. Most HCWs (49%) worked for government academic institutions, followed by community hospitals (23%). Medical students (32%), followed by attending physicians (22%), and others (16%) comprised the most common cadre of respondents. About 39% of the participants reported experiencing violence themselves, and 18% reported violence against colleague(s). Verbal violence (48%), emotional abuse (24%), and physical misconduct (14%) were the most common types of violence. Nearly 63% of respondents identified patients or their relatives as the most frequent aggressors. Univariate logistic regression analyses demonstrated that female gender (OR = 2.08; 95%CI: 1.16-3.76, P = 0.014) and higher frequency of night shifts (OR = 2.22; 95%CI: 1.08-4.58, P = 0.030) were associated with significantly higher odds of experiencing violence. More than 50% of HCWs felt less motivated and had decreased job satisfaction post-violent conduct. CONCLUSION A large proportion of HCWS in the Caribbean are exposed to violence, yet the phenomenon remains underreported. As a result, HCWs' job satisfaction has diminished.
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Affiliation(s)
- Reshon Hadmon
- Department of Medicine, St. George University School of Medicine, Grenada FZ818, West Indies
| | - Daniella Myriam Pierre
- Department of Research, Global Remote Research Scholar Program, St Paul, MN 55101, United States
- Department of Public Health, Cuny Graduate School of Public Health and Health Policy, New York, NY 10027, United States
| | - Akshat Banga
- Department of Internal Medicine, Sawai Man Singh Medical College, Jaipur 302004, India
| | - Jacques W Clerville
- School of Public Health, Georgia State University, Atlanta, GA 30302, United States
| | - Hans Mautong
- Department of Sociology and Demography, School of Health, Universidad de Especialidades Espiritu Santo, Samborondon 092301, Ecuador
| | - Precious Akinsanya
- Department of Medicine, Holy Name Medical Center, Teaneck, NJ 07666, United States
| | - Rajat Das Gupta
- Department of Epidemiology and Biostatistics, University of South Carolina, Columbia, SC 29208, United States
| | - Sama Soliman
- Department of Medicine, Pavlov First State Medical University of St Petersburg, Sankt-Peterburg 197022, Russia
| | - Tolupe M Hunjah
- Department of Medicine, University of Suffolk, Ipswich IP4 1QJ, United Kingdom
| | - Bamidele A Hunjah
- Department of Medicine, Unicaf University of Zambia, Lusaka 20842, Zambia
| | - Hafeez Hamza
- Department of Pharmacy, School of Pharmacy, Girne 99428, Cyprus
| | - Ruman Khurshid Qasba
- Department of Medicine, Sher-i-Kashmir, Institute of Medical Science, Srinagar 190011, India
| | - Faisal A Nawaz
- Department of Research, Global Remote Research Scholar Program, St Paul, MN 55101, United States
- Department of Psychiatry, Al Amal Psychiatric Hospital, Emirates Health Services, Dubai, United Arab Emirates
| | - Salim Surani
- Department of Research, Global Remote Research Scholar Program, St Paul, MN 55101, United States
- Department of Medicine and Pharmacology, Texas A and M University, College Station, TX 77843, United States
- Anesthesiology and Critical Care, Mayo Clinic, Rochester, MN 55905, United States
| | - Rahul Kashyap
- Department of Research, Global Remote Research Scholar Program, St Paul, MN 55101, United States
- Anesthesiology and Critical Care, Mayo Clinic, Rochester, MN 55905, United States
- Department of Research, Wellspan Health, York, PA 17403, United States
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Wang Y, Xu M, Wei Z, Sun L. Associations between workplace violence and suicidal ideation among Chinese medical staff: a propensity score matching analysis. PSYCHOL HEALTH MED 2024; 29:1020-1034. [PMID: 37656046 DOI: 10.1080/13548506.2023.2254037] [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: 10/02/2022] [Accepted: 08/25/2023] [Indexed: 09/02/2023]
Abstract
Physical and mental health problems had been identified as the negative outcomes of workplace violence (WPV) against medical staff. Considering the proven associations between physical and mental health and suicidal ideation, it is reasonable to assume that WPV may associate with suicidal ideation. However, few studies were conducted to explore the relationship between WPV and their suicidal ideation against medical staff. Based on a cross-sectional design, 3, 426 medical staff working in general hospitals were interviewed in Shandong Province, China. Socio-demographic characteristics, work-related factors, psychological variables, WPV, and suicidal ideation were evaluated. Propensity score matching (PSM) was performed to explore the association between WPV and suicidal ideation. The prevalence of suicidal ideation among medical staff was 9.1% (312/3426), and 52.2% (1788/3426) of medical staff reported the WPV experience. Before PSM, we found that the association between WPV and suicidal ideation was statistically significant (aOR = 1.606, p < 0.01). After PSM, there was a statistically significant correlation between WPV and suicidal ideation (aOR = 1.525, p < 0.01). This study supported the correlations between WPV against medical staff and their suicidal ideation. The results of PSM further implied that WPV might cause suicidal ideation among medical staff. Psychological health, especially for suicidal ideation, should be paid attention for medical staff with WPV experiences.
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Affiliation(s)
- Yifan Wang
- Center for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine Shandong University, Jinan, Shandong, China
- NHC Key Laboratory of Health Economics and Policy Research (Shandong University), Jinan, Shandong, China
- Jinan Center for Disease Control and Prevention, Jinan, China
| | - Meixia Xu
- Department of Current Situation and Policy, Shandong Women's University Jinan Shandong, Jinan, China
| | - Zhen Wei
- Center for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine Shandong University, Jinan, Shandong, China
- NHC Key Laboratory of Health Economics and Policy Research (Shandong University), Jinan, Shandong, China
| | - Long Sun
- Center for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine Shandong University, Jinan, Shandong, China
- NHC Key Laboratory of Health Economics and Policy Research (Shandong University), Jinan, Shandong, China
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Wu Y, Buljac-Samardzic M, Zhao D, Ahaus CTB. The importance and feasibility of hospital interventions to prevent and manage patient aggression and violence against physicians in China: a Delphi study. HUMAN RESOURCES FOR HEALTH 2024; 22:34. [PMID: 38802830 PMCID: PMC11131301 DOI: 10.1186/s12960-024-00914-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Accepted: 05/16/2024] [Indexed: 05/29/2024]
Abstract
BACKGROUND Aggression and violence by patient (and their relatives/friends) is widely acknowledged as a serious occupational hazard, with physicians being particularly susceptible to witnessing and experiencing such incidents within hospitals. Research has shown that the negative consequences of such aggression and violence are not only felt at the individual level, but also at the team and organizational levels. Understanding how to prevent and manage this behavior towards physicians in hospitals is urgent and not fully researched. While there are many potentially effective interventions, it is unclear which ones would be valuable and feasible for Chinese hospitals. Because patient aggression and violence may occur more frequently in Chinese hospitals than in other countries, this suggests that cultural differences play a role and that tailored interventions may be needed. METHOD We conducted a Delphi study to reach a consensus on the importance and feasibility of hospital interventions to prevent and manage patient (and their relatives/friends) aggression and violence against physicians in Chinese hospitals. Seventeen experts in China were invited to complete online questionnaires over three rounds. RESULTS After three rounds, consensus was achieved concerning 44 interventions, five other interventions were rejected, and no consensus was reached on another two. These interventions were clustered into eight categories: environment design, access and entrance, staffing and working practices, leadership and culture, training and education, support, during/after-the-event actions, and hospital policy. Each category is considered important in preventing and managing patient (and their relatives/friends) aggression and violence towards physicians in Chinese hospitals. This study also investigated the feasibility of the suggested interventions and found that 36 of the 44 interventions were considered not only relevant, but also feasible for implementation in Chinese hospitals. CONCLUSIONS This study provides an overview of interventions that can be implemented in Chinese hospitals to prevent and manage patient (and their relatives/friends) aggression and violence before, during, and after a violent incident occurs.
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Affiliation(s)
- Yuhan Wu
- Erasmus School of Health Policy and Management, Erasmus University Rotterdam, Rotterdam, The Netherlands.
| | - Martina Buljac-Samardzic
- Erasmus School of Health Policy and Management, Erasmus University Rotterdam, Rotterdam, The Netherlands
| | - Dahai Zhao
- School of International and Public Affairs, Shanghai Jiao Tong University, Shanghai, China
| | - C T B Ahaus
- Erasmus School of Health Policy and Management, Erasmus University Rotterdam, Rotterdam, The Netherlands
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Kim HJ, Bruni E, Gorodetska G, Van den Bergh R, Bezer L, Artykutsa S, Andriamiseza N, Habicht J. Typology and implications of verified attacks on health care in Ukraine in the first 18 months of war. PLOS GLOBAL PUBLIC HEALTH 2024; 4:e0003064. [PMID: 38781240 PMCID: PMC11115218 DOI: 10.1371/journal.pgph.0003064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Accepted: 04/13/2024] [Indexed: 05/25/2024]
Abstract
Attacks on health care are part of the spectrum of threats that health care endures during conflict. Protecting health care services against attacks depends on understanding the nature and types of attacks that occur during conflict. The World Health Organisation has implemented the Surveillance System for Attacks on Health Care (SSA) in Ukraine since 2020, and the system has continued to monitor and report on attacks on health care during the war in Ukraine. This study aims to analyse the data reported through the SSA for the first 18 months of the war. This paper involves a retrospective, descriptive study based on the analysis of publicly available SSA data of all incidents of attacks on health care in Ukraine reported through the SSA between February 24th 2022 and August 24th 2023. Out of the 1503 verified attacks, 37% occurred in the initial six weeks of the war. Attacks involving violence with heavy weapons were among the most common incidents reported (83%). The reported attacks were associated with a total of 113 deaths and 211 injuries among health care workers and patients: 32 (2%) attacks were associated with a death of a health care worker or patient, and 63 (4%) were associated with an injury. Health transports facing attacks had a higher probability of experiencing casualties than other health resources (p<0.0001, RR 3.1, 95%CI 1.9-4.9). In conclusion, the burden of attacks on health care in Ukraine was high and sustained over the course of the first 18 months of the war. Reported casualties were not homogenously distributed among attack incidents, but occurred in a set of high-casualty incidents. Health transports were found to be particularly vulnerable. In addition to continued calls for a cessation of hostilities, prevention, protection, mitigation, and reconstruction strategies are urgently required.
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Affiliation(s)
- Hyo-Jeong Kim
- Attacks on Health Care Initiative, WHO, Geneva, Switzerland
| | | | | | | | - Lamia Bezer
- WHO Country Office for Ukraine, Kyiv, Ukraine
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Al-Kalbani M, Al-Mahrouqi T, Al-Shamli S, Murthi S, Al-Balushi N, Al-Sinawi H. Workplace Violence Against Nurses in Psychiatric Hospitals in Oman: A cross-sectional multi-centre study. Sultan Qaboos Univ Med J 2024; 24:194-202. [PMID: 38828255 PMCID: PMC11139374 DOI: 10.18295/squmj.1.2024.002] [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: 08/13/2023] [Revised: 12/01/2023] [Accepted: 12/26/2023] [Indexed: 06/05/2024] Open
Abstract
Objectives This study aimed to assess the prevalence of workplace violence (WPV) against nurses in Oman's psychiatric hospitals and explore associated factors. Methods This cross-sectional study was conducted between October and December 2021 and included all tertiary mental healthcare hospitals in Oman (Al Masarra Hospital and Sultan Qaboos University Hospital, Muscat, Oman). The participants completed a sociodemographic survey and a questionnaire on WPV in the health sector. Results A total of 106 participants (response rate = 80.3%) were included in this study. Most were female (52.8%) and Omani (72.6%) and aged 30-39 years. WPV prevalence was high (90.6%), with verbal (86.8%) and physical violence (57.5%) being the most common types. WPV incidents were more frequent on weekdays (26.4%) and during morning shifts (34%), while 81.1% of the nurses worked in shifts and had direct physical contact with patients (83.0%). The majority (92.5%) were aware of standardised WPV reporting procedures and 89.7% confirmed the presence of such procedures in hospitals. WPV was more prevalent among nurses in inpatient wards (P = 0.047). Conclusion WPV against nurses in Omani psychiatric hospitals is alarmingly high. Future studies should investigate contributing factors among healthcare providers and emphasise violence prevention by providing staff nurses with effective training to handle violent incidents involving psychiatric patients.
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Affiliation(s)
- Maryam Al-Kalbani
- Psychiatry Residency Training Program, Oman Medical Specialty Board, Muscat, Oman
| | - Tamadhir Al-Mahrouqi
- Psychiatry Residency Training Program, Oman Medical Specialty Board, Muscat, Oman
| | - Siham Al-Shamli
- Department of Behavioral Medicine, Sultan Qaboos University Hospital, Sultan Qaboos University, Muscat, Oman
| | - Sathiya Murthi
- Research Department, Oman Medical Specialty Board, Muscat, Oman
| | - Naser Al-Balushi
- Department of Behavioral Medicine, Sultan Qaboos University Hospital, Sultan Qaboos University, Muscat, Oman
| | - Hamed Al-Sinawi
- Department of Behavioral Medicine, Sultan Qaboos University Hospital, Sultan Qaboos University, Muscat, Oman
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Ibrahim ME, El-Zoghby SM, Zaghloul NM, Shehata SA, Farghaly RM. Musculoskeletal pain among medical residents: role of workplace safety climate and sexual harassment. BMC Musculoskelet Disord 2024; 25:167. [PMID: 38388888 PMCID: PMC10882788 DOI: 10.1186/s12891-024-07272-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Accepted: 02/08/2024] [Indexed: 02/24/2024] Open
Abstract
BACKGROUND Workplace factors are important predictors of occurrence of musculoskeletal pain among different occupational populations. In healthcare, a psychologically unsafe work environment can negatively affect the emotional, physical and psychological well-being of physicians. This study aimed to examine the relationship between workplace violence, sexual harassment and musculoskeletal pain among Egyptian physicians in their years of residency. METHODS We distributed an online self-administered questionnaire to 101 residents working in various healthcare sectors in Egypt. It included sections on demographic data, working conditions, widespread pain index (WPI), pain interference short-form, workplace violence and harassment questionnaire, psychosocial safety climate questionnaire (PSC) and sexual harassment climate questionnaire. RESULTS All residents had at least one painful site on the WPI (range 1-11). The mean WPI was 3.5 ± 2.4, and 39.6% satisfied the criteria of having widespread pain by having at least 4 pain sites. Widespread pain index showed a weak statistically significant negative correlation with workplace PSC score (rho = - 0.272, p = 0.006), and a statistically significant weak positive correlation with the calculated total abuse index (rho = 0.305, p = 0.002). Workplace violence and abuse, as measured by a calculated abuse index was the only significant predictors of widespread pain among residents. CONCLUSION WPV was found to be a predictor of musculoskeletal pain among medical residents. Healthcare organizations need to address WPV by employing preventive strategies to minimize its hazardous effects and ensure a safe working environment for physicians.
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Affiliation(s)
- Maha E Ibrahim
- Department of Physical Medicine, Rheumatology and Rehabilitation, Faculty of Medicine, Suez Canal University, Ismailia, 41522, Egypt.
| | - Safaa M El-Zoghby
- Department of Family Medicine, Faculty of Medicine, Suez Canal University, Ismailia, 41522, Egypt
| | - Nancy M Zaghloul
- Department of Forensic Medicine and Clinical Toxicology, Misr University for Science and Technology, Cairo, Egypt
| | - Shaimaa A Shehata
- Department of Forensic Medicine and Clinical Toxicology, Faculty of Medicine, Suez Canal University, Ismailia, 41522, Egypt
| | - Rasha M Farghaly
- Department of Community, Occupational and Environmental Medicine, Faculty of Medicine, Suez Canal University, Ismailia, 41522, Egypt
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11
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Somville F, Van Bogaert P, Wellens B, De Cauwer H, Franck E. Work stress and burnout among emergency physicians: a systematic review of last 10 years of research. Acta Clin Belg 2024; 79:52-61. [PMID: 37889050 DOI: 10.1080/17843286.2023.2273611] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2023] [Accepted: 10/17/2023] [Indexed: 10/28/2023]
Abstract
AIM OF THE STUDY First, to provide a synthesis and analysis of available scientific literature regarding the level of work stress and burnout among emergency physicians. Second, to identify the effect of the specific work situation-related factors. METHODS A systematic search was performed in NCBI PubMed and Embase. Comparative primary studies, both systematic review and cross-sectional, quantifying burnout in emergency physicians were included. Only studies published between 2011 and 2022 were retained. Synonym sets were compiled for the search key for 'burnout & stress', 'emergency', 'physician' and 'burnout & posttraumatic stress disorder'. RESULTS Thirty-five papers were retained for further research. Emergency physicians scored significantly higher for all dimensions of burnout compared to other healthcare professions. Significant correlations for burnout were found with work characteristic and organizational factors. Critical incidents and aggression were identified as the most important acute work characteristics and organizational factors impacting emergency physician's mental wellbeing including the development of posttraumatic stress disorder. Moreover, personal factors such as age, personality, and coping strategies also play an important role in the development of burnout as well as work-related trauma. CONCLUSION Available studies show that emergency physicians report higher scores of emotional exhaustion and depersonalization when compared to other healthcare professionals. Work characteristics contribute to this, but work-related traumatic incidents and aggression are important determinants. Personal characteristics such as age, personality type D, previous experiences and coping strategies seem to be determining factors likewise. Emergency physicians showed a high risk for developing burnout and work stress-related problems.
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Affiliation(s)
- F Somville
- Department of Emergency Medicine, University of Antwerp, Edegem, Belgium
- Department of Emergency and Traumatology, AZ St Dimpna, Geel, Belgium
- Department of Nursing and Midwifery Sciences, Centre for Research and Innovation in Care (CRIC), Wilrijk, Belgium
- Faculty of Medicine and Health Sciences, University of Antwerp, Wilrijk, Belgium
| | - P Van Bogaert
- Department of Nursing and Midwifery Sciences, Centre for Research and Innovation in Care (CRIC), Wilrijk, Belgium
| | - B Wellens
- Department of Emergency and Traumatology, AZ St Dimpna, Geel, Belgium
| | - H De Cauwer
- Faculty of Medicine and Health Sciences, University of Antwerp, Wilrijk, Belgium
- Department of Neurology, AZ St Dimpna, Geel, Belgium
| | - E Franck
- Department of Nursing and Midwifery Sciences, Centre for Research and Innovation in Care (CRIC), Wilrijk, Belgium
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12
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Irshad HA, Mahar MU, Jahangir A, Aamir SR, Jamil MA, Ahsan K, Taufiq M, Ahmed A, Golani S, Amir S, Kakar WG, Ali A, Nafees AA. An assessment of public experiences and expectations with physicians: a cross sectional study from Karachi, Pakistan. BMC Health Serv Res 2024; 24:108. [PMID: 38238699 PMCID: PMC10797951 DOI: 10.1186/s12913-023-10519-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2023] [Accepted: 12/22/2023] [Indexed: 01/22/2024] Open
Abstract
BACKGROUND Although physicians are highly regarded members of society, patients are not always satisfied with their care, suggesting a mismatch between the public's expectations and reality. Thus, the aim of this study was to determine the public's expectations regarding roles and responsibilities of a physician, to assess patient experiences, and to evaluate factors associated with the two outcomes. METHODS A cross-sectional study was conducted via face-to-face structured interviews from July 14th to August 2nd, 2023, in Karachi, Pakistan. The study sample comprised 424 consenting adults enrolled by visiting public spaces (malls, parks, hospitals, and residential areas). A modified version of 'Exceptionally Good Doctor Likert scale', and 'Patient Picker-15' (PPE-15) questionnaires was used. The Likert and PPE-15 sections were scored through pre-decided criteria for expectations and experience, respectively, and categorized using a median cut-off into high and low expectations and negative and positive experiences, respectively for simple and multivariable logistic regression. RESULTS A median score of 30.5/ 34 (IQR = 3.3) was found for expectations and 4/ 14 (IQR = 4) for experiences. Significant factors associated with expectations were older age groups (OR = 4.54 [1.18-17.50]) and higher monthly household incomes (0.40 [0.20-0.79]), while the odds of negative experiences were lower after visits to emergency departments (0.38 [0.18-0.84]) and private health care centers (0.31 [0.13-0.70]). CONCLUSION These results suggest that the public has high expectations from physicians, however their experiences are not always positive. Initiatives to develop a patient-centric ethos are needed for which we outline recommendations to both the public and physicians, respectively.
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Affiliation(s)
| | | | | | | | | | - Khizer Ahsan
- Medical College, Aga Khan University, Karachi, Pakistan
| | - Maliha Taufiq
- Medical College, Aga Khan University, Karachi, Pakistan
| | | | - Shilpa Golani
- Medical College, Aga Khan University, Karachi, Pakistan
| | - Sehba Amir
- Medical College, Aga Khan University, Karachi, Pakistan
| | | | - Abida Ali
- Medical College, Aga Khan University, Karachi, Pakistan
| | - Asaad Ahmed Nafees
- Department of Community Health Sciences, Aga Khan University, Karachi, Pakistan.
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13
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Liu J, Zheng H, Lu L, Liu H, Xu X, He W. The impact of patients' hostile attribution bias on aggression in doctor-patient interactions. Heliyon 2024; 10:e23971. [PMID: 38268606 PMCID: PMC10805917 DOI: 10.1016/j.heliyon.2024.e23971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Revised: 12/06/2023] [Accepted: 01/01/2024] [Indexed: 01/26/2024] Open
Abstract
Background Doctor-patient conflict is trending in social attention research. However, the existing literature rarely explores whether a patient's hostile attribution bias (HAB) in the doctor-patient interaction affects the aggression level against doctors. Objective This study aimed to explore the relationship and mechanism between different types of HAB and aggression in patients. Method In Study 1, 80 patients completed the word sentence association paradigm for hostility (WSAP-Hostility), and their explicit and implicit aggression levels were measured using the hot sauce paradigm and the single-category implicit association test (SC-IAT), respectively. In Study 2, 63 patients were randomly divided into an experimental (rejection) and a control group. Their state hostile attribution bias (SHAB) was activated through social rejection materials. They completed the SHAB questionnaire and anger expression inventory, and their explicit and implicit aggression levels were measured as in Study 1. Results In both studies, results indicated that patients' trait and state HAB were significantly related to explicit aggression but not implicit aggression. Hostile interpretation positively predicted explicit aggression, whereas benign interpretation had a negative predictive effect on explicit aggression. Patients' anger played a mediating role between SHAB and explicit aggression. Conclusions These findings suggest that patients' HAB affects explicit aggression toward doctors and anger plays a mediating role.
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Affiliation(s)
- Jie Liu
- School of Psychology, Shanghai Normal University, Shanghai, 200234, China
| | - Hong Zheng
- Changning Mental Health Center Affiliated with East China Normal University, Shanghai, China
| | - Lu Lu
- School of Psychology, Shanghai Normal University, Shanghai, 200234, China
| | - Hongying Liu
- Hangzhou Kang Sheng Health Consulting Co., Ltd. Hangzhou 310023, China
| | - Xiongwei Xu
- School of Education, Shanghai Normal University, Shanghai, 200234, China
| | - Wen He
- School of Psychology, Shanghai Normal University, Shanghai, 200234, China
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14
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Ullah H, Arbab S, Liu CQ, Khan SA, Shahzad S, Li K. Professional Quality of Life and Psychological Impact on Frontline Healthcare Worker during the Fourth Wave of COVID-19. J Nurs Manag 2024; 2024:2865063. [PMID: 40224890 PMCID: PMC11919194 DOI: 10.1155/2024/2865063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Revised: 11/12/2023] [Accepted: 12/19/2023] [Indexed: 04/15/2025]
Abstract
Aim This research study aims to examine the professional quality of life (ProQOL) among healthcare workers (HCWs) in Pakistan during the fourth wave of COVID-19. Background Under intense pressure to fight the coronavirus disease 2019 (COVID-19) pandemic, HCWs are more likely to experience psychological problems. Numerous investigations carried out in the past at various points during the pandemic have shown that COVID-19 has had important detrimental effects on HCWs. However, there are many unknowns with regard to ProQOL for HCWs. Methods This is a cross-sectional study conducted with Pakistani HCWs who performed their duties during the fourth wave of COVID-19. Data were collected between January 1 and March 31, 2022. A total of 258 HCWs took part in the study evaluating ProQOL. The significance level was <0.05. Results Most respondents were males (79.1%), and 20.9% were females. The scores of secondary traumatic stress (STS), burnout (BO), and compassion satisfaction (CS) were 24.03 ± 3.79, 19.18 ± 2.92, and 35.29 ± 4.37, respectively. Compared with higher-income groups, HCWs with lower incomes were significantly (P < 0.001) more likely to experience psychological issues. Males had lower BO and STS than female HCWs (P < 0.001). Similarly, doctors had a lower STS than nurses (P < 0.05). HCWs who worked hours per day longer had a heavier STS (P < 0.001). Conclusion This study shows low BO levels, moderate CS levels, and STS levels among HCWs. HCWs with lower salary were at a higher risk of mental distress due to the pandemic. HCWs who worked for long hours and had less income had more STS and BO. HCWs who were dissatisfied with their works had poor CS. Implications for Nursing Management. It is supposed that these results may help HCW managers to improve job satisfaction and rewards while reducing working hours and workload to improve the ProQOL of HCWs fighting COVID-19. The government should focus on the mental health of HCWs, enhancing their satisfaction and allocating sufficient resources.
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Affiliation(s)
- Hanif Ullah
- West China Hospital, West China School of Nursing, Sichuan University, Chengdu, China
| | - Safia Arbab
- Lanzhou Institute of Husbandry and Pharmaceutical Sciences, Chinese Academy of Agricultural Sciences, Lanzhou, China
| | - Chang-Qing Liu
- West China Hospital, West China School of Nursing, Sichuan University, Chengdu, China
| | - Sher Alam Khan
- Department of Pediatrics, Ayub Medical College, Abbottabad, Pakistan
| | - Sohail Shahzad
- Department of Children Ward, Combined Military Hospital, Abbottabad, Pakistan
| | - Ka Li
- West China Hospital, West China School of Nursing, Sichuan University, Chengdu, China
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15
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Rehan ST, Shan M, Shuja SH, Khan Z, Hussain HU, Ochani RK, Shaikh A, Ratnani I, Nashwan AJ, Surani S. Workplace violence against healthcare workers in Pakistan; call for action, if not now, then when? A systematic review. Glob Health Action 2023; 16:2273623. [PMID: 37938187 PMCID: PMC10653705 DOI: 10.1080/16549716.2023.2273623] [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: 05/03/2023] [Accepted: 10/17/2023] [Indexed: 11/09/2023] Open
Abstract
BACKGROUND Workplace violence (WPV) is a global problem that affects healthcare workers' physical and mental health and impairs work performance. Pakistan's healthcare system is not immune to WPV, which the World Health Organization recognises as an occupational hazard. OBJECTIVES The primary objective of this systematic review is to determine the prevalence of physical, verbal, or other forms of WPV in healthcare workers in Pakistan. Secondary objectives include identifying the associated risk factors and perpetrators of WPV. METHODS A systematic review of six electronic databases was conducted through August 2022. Studies were included if they met the following criteria: 1) healthcare workers (HCWs), including physicians, nurses, and paramedic staff working in the private or public sector of Pakistan; 2) exposure to physical, verbal, or any type of violence. Data were extracted and analysed for the prevalence of WPV, types of violence, associated risk factors, and perpetrators of violence. RESULTS Twenty-four studies including 16,070 HCWs were included in this review. Verbal violence was the most common form of violence levied, with its highest prevalence (100%) reported in Islamabad and lowest verbal violence prevalence (25%) in Karachi. Verbal abuse was preponderant against female HCWs, while physical abuse was directed more towards males. The most common perpetrators were patient attendants, followed by the patients. CONCLUSION Our review determines a 25-100% prevalence of WPV against HCWs in Pakistani medical setups. This occupational hazard needs the attention of relevant authorities in the country to put protective enforcement policies in place. Large-scale surveys should be conducted to better gauge the current plight of HCWs in the nation.
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Affiliation(s)
- Syeda Tayyaba Rehan
- Department of Medicine, Dow University of Health Sciences, Karachi, Pakistan
| | - Mishal Shan
- Department of Pediatrics, Dr. Ruth KM Pfau Civil Hospital, Karachi, Pakistan
| | - Syed Hasan Shuja
- Department of Medicine, Dow University of Health Sciences, Karachi, Pakistan
| | - Zayeema Khan
- Department of Medicine, Dow University of Health Sciences, Karachi, Pakistan
| | - Hassan Ul Hussain
- Department of Medicine, Dow University of Health Sciences, Karachi, Pakistan
| | - Rohan Kumar Ochani
- Department of Medicine, Dow University of Health Sciences, Karachi, Pakistan
| | - Asim Shaikh
- Department of Medicine, The Aga Khan University, Karachi, Pakistan
| | - Iqbal Ratnani
- Department of Anesthesiology and Critical Care, Methodist DeBakey Heart & Vascular Center, Houston Methodist Hospital, Houston, TX, USA
| | | | - Salim Surani
- Adjunct Clinical Professor, Texas A&M University, Corpus Christi, TX, USA
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16
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Abedi G, Haghgoshayie E, Hasanpoor E, Etemadi J, Nazari M, Vejdani R. Improvement of violence management among nurses in Iran: The best practice implementation project in a health promoting hospital. PLoS One 2023; 18:e0284758. [PMID: 38011071 PMCID: PMC10681186 DOI: 10.1371/journal.pone.0284758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Accepted: 04/08/2023] [Indexed: 11/29/2023] Open
Abstract
BACKGROUND This project aimed to assess compliance with evidence-based criteria' for the prevention and management of workplace violence against nursing staff in Shahid-Beheshti hospital, Maragheh, Iran. Workplace violence is a managerial and workplace occupational health and safety issue that can affect the performance of an institution. Further, it might turn the work environment into an insecure and hostile one which can influence the performance of employees and their professional relationships negatively. Nevertheless, staff have their own legal rights, and their organizations are legally and ethically in charge of providing them with safe work environments. METHODS Following the JBI Practical Application of Clinical Evidence System and Getting Research into Practice audit and feedback tool with three phases of activities, this project utilized an implementation framework incorporating quality improvement. Furthermore, the audit tool was used to establish the project and set up the measurement and evaluation of three evidence-based criteria. RESULTS The post-implementation audit results indicated a significant improvement in violence management and prevention. The compliance rate on the first criterion, i.e. aggression management training, increased from 49% at baseline to 81% at the end. The second criterion, i.e. timely support and assistance following an incident, exhibited greater increase from eight to 73%. Finally, an increased compliance was noted on the third criterion, i.e. policy for risk management and safe environment, from 22 to 77%. CONCLUSIONS The current project successfully implements evidence-based violence management in Shahid-Beheshti hospital. It reveals significant results on compliance and the increasing knowledge of nurses on evidence-based stress management, communication skills and self-companion.
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Affiliation(s)
- Ghasem Abedi
- Health Sciences Research Center, Mazandaran University of Medical Sciences, Sari, Iran
| | - Elaheh Haghgoshayie
- Research Center for Evidence-Based Health Management, Maragheh University of Medical Sciences, Maragheh, Iran
| | - Edris Hasanpoor
- Research Center for Evidence-Based Health Management, Maragheh University of Medical Sciences, Maragheh, Iran
| | - Jalil Etemadi
- Department of Clinical Sciences, Maragheh University of Medical Sciences, Maragheh, Iran
| | - Morteza Nazari
- Department of Healthcare Services Management, School of Health, Alborz University of Medical Sciences, Karaj, Iran
| | - Razieh Vejdani
- Assistant Professor of Obstetrics and Gynecology, Shahid Beheshti Hospital, Maragheh University of Medical Sciences, Maragheh, Iran
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Chandini MA, Van den Bergh R, Agbor Junior AA, Willliam F, Obi AMM, Ngeha NC, Karimu I, Douba ECE, Kim HJ, Tendongfor N. "It is because of the love for the job that we are still here": Mental health and psychosocial support among health care workers affected by attacks in the Northwest and Southwest regions of Cameroon. PLOS GLOBAL PUBLIC HEALTH 2023; 3:e0002422. [PMID: 37917598 PMCID: PMC10621865 DOI: 10.1371/journal.pgph.0002422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Accepted: 10/06/2023] [Indexed: 11/04/2023]
Abstract
Attacks on health care have important consequences for the mental health (MH) and work availability of health care workers (HCW). In the conflict-affected Northwest and Southwest (NWSW) regions of Cameroon, health care attacks are common; however, little is known on the MH burden and/or (mental) health-seeking behavior among affected HCW. We therefore conducted a survey on mental conditions (relying on SRQ-20 and WASSS assessments) and access to MH services among 470 HCW from 12 districts in NWSW Cameroon in January-February 2022. In-depth interviews on personal experiences with attacks and on accessing MH services were conducted with a subset of 96 HCW. Among surveyed HCW, 153 (33%) had experienced an attack in the past 6 months, and a further 121 (26%) had experienced attacks more than 6 months ago. HCW facing attacks <6 months ago had significantly higher odds of exhibiting mental disorders (aOR 5.8, 95%CI 3.0-11.3, p<0.001) and of being unable to function (aOR 3.3, 95%CI 1.9-5.7, p<0.001). HCW who experienced an attack >6 months also had higher odds of being unable to function (aOR 2.9, 95%CI 1.7-5.2, p<0.001), and of missing time off work in the week preceding the survey (aOR 3.1, 95%CI 1.8-5.5, p<0.001). Previous access to MH services was also higher among HCW facing attacks. HCW showed a good understanding of the added values of accessing MH services, but faced multiple access barriers (including poor availability of services and their own prioritization of the care of others) and indicated a preference for self-care, peer-support and/or religious support. In conclusion, health care attacks in NWSW Cameroon contributed significantly to severe mental conditions and absenteeism rates among HCW. Strengthening access to MH support among attack-affected HCW is indicated; this should include strengthening of formal MH services and building the capacity of HCW and religious leaders to provide peer-support.
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Affiliation(s)
| | | | | | - Farnyu Willliam
- Department of Public Health and Hygiene, University of Buea, Buea, Cameroon
| | | | - Ngu Claudia Ngeha
- Department of Public Health and Hygiene, University of Buea, Buea, Cameroon
| | - Ismaila Karimu
- Department of Public Health and Hygiene, University of Buea, Buea, Cameroon
| | | | - Hyo-Jeong Kim
- Attacks on Health Care Initiative, WHO, Geneva, Switzerland
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18
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Lim ZY, Idris DR, Abdullah HMAL, Omar HR. Violence toward staff in the inpatient psychiatric setting: Nurses' perspectives: A qualitative study. Arch Psychiatr Nurs 2023; 46:83-90. [PMID: 37813510 DOI: 10.1016/j.apnu.2023.08.008] [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: 07/29/2022] [Revised: 01/30/2023] [Accepted: 08/19/2023] [Indexed: 10/17/2023]
Abstract
BACKGROUND Workplace violence is a universal phenomenon faced by employees in all industries but more so by employees working in sectors that require interpersonal contact, especially with individuals who may be violent, distressed, or vulnerable. Globally, healthcare professionals working in the emergency and psychiatric sectors are at the highest risk of workplace violence. In fact, healthcare professionals in the psychiatric setting have a higher risk rate of facing workplace violence opposed to other healthcare settings. Workplace violence can lead to adverse physical and psychological outcomes and impact the quality of care provided to patients. OBJECTIVE This study aims to explore nurses' experiences with workplace violence and the impact of violence on nurses. Whereas the objectives of this study are to explore and analyze mental health nurses' experiences with workplace violence in Brunei Darussalam, identify and explore the impact of violence on mental health nurses, and discuss nurses' coping mechanisms following a workplace violence experience. DESIGN Qualitative explorative study. SETTING(S) Mental Health Unit Kiarong of Raja Isteri Pengiran Anak Saleha Hospital, Brunei Darussalam. PARTICIPANTS Nurses (n = 12). METHODS Data was collected by conducting individual via online platforms. The interviews were carried out in English and/or Malay, the verbatim transcripts produced were transcribed in their source languages and only relevant excerpts were translated into English for the write-up. The data were analyzed utilizing thematic analysis by the researcher independently. RESULTS This study identified three themes: Violence as a norm in the psychiatric setting, perceived impact of workplace violence, and "Talk, Report and Accept" as Coping mechanisms. CONCLUSIONS In conclusion, it is apparent that globally workplace violence is normalized in the nursing industry, especially in the psychiatric setting. Workplace violence yields a plethora of negative long-term and short-term impacts on nurses. Despite this, workplace violence often goes unreported for numerous reasons but mainly due to the lack of changes after reporting. Nurses should be encouraged to report all instances of workplace violence by demonstrating effective changes and providing hazard pay. The management should actively attempt to reduce the risk of workplace violence by preemptively equipping nurses with the necessary training including identification of potential risks of workplace violence, effective de-escalation methods, and proper control and restraint methods.
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Affiliation(s)
- Zhi Ying Lim
- PAPRSB Institute of Health Sciences, Universiti Brunei Darussalam, Brunei Darussalam.
| | - Deeni Rudita Idris
- PAPRSB Institute of Health Sciences, Universiti Brunei Darussalam, Brunei Darussalam
| | | | - Hjh Radiah Omar
- Head of Nursing Administration, Psychiatric Services, Ministry of Heath, Brunei Darussalam
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Banga A, Mautong H, Alamoudi R, Faisal UH, Bhatt G, Amal T, Mendiratta A, Bollu B, Kutikuppala LVS, Lee J, Simadibrata DM, Huespe I, Khalid A, Rais MA, Adhikari R, Lakhani A, Garg P, Pattnaik H, Gandhi R, Pandit R, Ahmad F, Camacho-Leon G, Ciza N P, Barrios N, Meza K, Okonkwo S, Dhabuliwo A, Hamza H, Nemat A, Essar MY, Kampa A, Qasba RK, Sharma P, Dutt T, Vekaria P, Bansal V, Nawaz FA, Surani S, Kashyap R. ViSHWaS: Violence Study of Healthcare Workers and Systems-a global survey. BMJ Glob Health 2023; 8:e013101. [PMID: 37696546 PMCID: PMC10496720 DOI: 10.1136/bmjgh-2023-013101] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2023] [Accepted: 08/08/2023] [Indexed: 09/13/2023] Open
Abstract
OBJECTIVE To provide insights into the nature, risk factors, impact and existing measures for reporting and preventing violence in the healthcare system. The under-reporting of violence against healthcare workers (HCWs) globally highlights the need for increased public awareness and education. METHODS The Violence Study of Healthcare Workers and Systems study used a survey questionnaire created using Research Electronic Data Capture (REDCap) forms and distributed from 6 June to 9 August 2022. Logistic regression analysis evaluated violence predictors, including gender, age, years of experience, institution type, respondent profession and night shift frequency. A χ2 test was performed to determine the association between gender and different violence forms. RESULTS A total of 5405 responses from 79 countries were analysed. India, the USA and Venezuela were the top three contributors. Female respondents comprised 53%. The majority (45%) fell within the 26-35 age group. Medical students (21%), consultants (20%), residents/fellows (15%) and nurses (10%) constituted highest responders. Nearly 55% HCWs reported firsthand violence experience, and 16% reported violence against their colleagues. Perpetrators were identified as patients or family members in over 50% of cases, while supervisor-incited violence accounted for 16%. Around 80% stated that violence incidence either remained constant or increased during the COVID-19 pandemic. Among HCWs who experienced violence, 55% felt less motivated or more dissatisfied with their jobs afterward, and 25% expressed willingness to quit. Univariate analysis revealed that HCWs aged 26-65 years, nurses, physicians, ancillary staff, those working in public settings, with >1 year of experience, and frequent night shift workers were at significantly higher risk of experiencing violence. These results remained significant in multivariate analysis, except for the 55-65 age group, which lost statistical significance. CONCLUSION This global cross-sectional study highlights that a majority of HCWs have experienced violence, and the incidence either increased or remained the same during the COVID-19 pandemic. This has resulted in decreased job satisfaction.
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Affiliation(s)
- Akshat Banga
- Department of Medicine, Sawai Man Singh Medical College and Hospital, Jaipur, India
| | - Hans Mautong
- Department of Medicine, Universidad de Especialidades Espíritu Santo, Samborondon, Ecuador
| | - Razan Alamoudi
- Department of Pharmaceutical Services, King Fahd Armed Forces Hospital, Jeddah, Makkah, Saudi Arabia
| | - Umme Habiba Faisal
- Department of Urology, All India Institute of Medical Sciences, Kalyani, India
| | - Gaurang Bhatt
- Department of Plastic Reconstructive and Burns Surgery, All India Institute of Medical Sciences, Rishikesh, India
| | - Tanya Amal
- Department of Medicine, Maulana Azad Medical College, New Delhi, India
| | - Ayushi Mendiratta
- Department of Internal medicine, Parkview Medical Center, Pueblo, Colorado, USA
| | - Bhaswanth Bollu
- Department of General medicine, Narayana Medical College and Hospital, Nellore, Andhra Pradesh, India
| | - L V Simhachalam Kutikuppala
- Department of General Surgery, Konaseema Institute of Medical Sciences and Research Foundation Hospital, Amalapuram, Andhra Pradesh, India
| | - Joanna Lee
- Department of Medicine, David Tvildiani Medical University, Tbilisi, Georgia
| | - Daniel Martin Simadibrata
- Department of Medicine, Universitas Indonesia, Depok, Indonesia
- Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Ivan Huespe
- Department of Intensive Care Medicine, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - Aisha Khalid
- Department of Gastroenterology, Postgraduate Medical Education, Harvard Medical School, Boston, Massachusetts, USA
| | | | - Ramesh Adhikari
- Department of Internal medicine, Franciscan Health Lafayette East, Lafayette, Indiana, USA
| | - Alisha Lakhani
- Department of Internal medicine, Shantabaa Medical College and General Hospital, Amreli, Gujarat, India
| | - Piyush Garg
- Department of Cardiology, Medanta The Medicity, Gurgaon, Haryana, India
| | - Harsha Pattnaik
- Department of Undergraduate Medicine, Lady Hardinge Medical College, New Delhi, Delhi, India
| | - Raghu Gandhi
- Department of Psychiatry, University of Minnesota, Minneapolis, Minnesota, USA
| | - Ramesh Pandit
- Department of Internal medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Faizan Ahmad
- Public Health Reference Laboratory Department, Khyber Medical University, Peshawar, Pakistan
| | - Genesis Camacho-Leon
- Division de estúdios para graduados, Universidad del Zulia, Maracaibo, Venezuela
| | - Pierre Ciza N
- Department of Psychiatry, Kampala International University, Kampala, Uganda
| | - Nimsi Barrios
- Department of Medicine, Universidad de San Carlos de Guatemala, Guatemala, Guatemala
| | - Kelly Meza
- Department of Internal medicine, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
| | - Susan Okonkwo
- Department of Family Health, Society for Family Health Nigeria, Abuja, Nigeria
| | - Amuza Dhabuliwo
- Department of Pediatrics, Kawempe National Refferal hospital, Kampala, Uganda
| | - Hafeez Hamza
- Department of Pharmacy, Girne American University, Girne, Cyprus
| | - Arash Nemat
- Microbiology Department, Kabul University of Medical Sciences Abu Ali Ibn Sina, Kabul, Afghanistan
| | | | - Anne Kampa
- Department of Development, Mayo Clinic, Rochester, Minnesota, USA
| | - Rakhtan K Qasba
- Department of Medicine, Green Life Medical College and Hospital, Dhanmondi, Bangladesh
| | - Pranjal Sharma
- Department of Nephrology, MercyOne Clinton, Clinton, Iowa, USA
| | - Taru Dutt
- Department of Psychiatry, Hennepin County Medical Center, Minneapolis, Minnesota, USA
| | - Pratikkumar Vekaria
- Department of Internal medicine, University of South Carolina School of Medicine, Columbia, South Carolina, USA
- Internal Medicine, Prisma Health Upstate, Greenville, South Carolina, USA
| | - Vikas Bansal
- Department of Anesthesiology and Critical Care Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Faisal A Nawaz
- Department of Psychiatry, Al Amal Psychiatric Hospital, Al Aweer, Dubai, UAE
| | - Salim Surani
- Department of Anesthesiology and Critical Care Medicine, Mayo Clinic, Rochester, Minnesota, USA
- Department of Pulmonary, and Critical Care & Sleep Medicine, Texas A&M University, College Station, Texas, USA
| | - Rahul Kashyap
- Department of Gastroenterology, Postgraduate Medical Education, Harvard Medical School, Boston, Massachusetts, USA
- Department of Research, WellSpan Health, York, Pennsylvania, USA
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Ernur D, Hanci V, Gökmen N. Workplace violence against physicians in intensive care units in Turkey: A cross-sectional study. THE NATIONAL MEDICAL JOURNAL OF INDIA 2023; 36:327-333. [PMID: 38759988 DOI: 10.25259/nmji_691_2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/19/2024]
Abstract
Background Although there are many studies on violence against physicians in the literature, there are few studies on violence against physicians working in intensive care units (ICUs). We aimed to investigate the frequency, type and underlying factors of violence against physicians working in ICUs in Turkey in the past 1 year. Methods We collected data by sending a questionnaire about violence against physicians working in ICUs via e-mail and WhatsApp between 1 and 15 May 2022. IBM SPSS Statistics V.24.0 was used for data analysis. The chi-square test and Fisher precision test were used to compare categorical data. Results Over one-third (38.6%) of the 354 physicians participating in our study reported that they had been exposed to violence in the past year, while 20.7% reported that they had been exposed to violence more than once in the past year. There was a significant relationship between the frequency of exposure to violence, female gender, age group, title, subspecialization status, working style and duration of working in the ICU (p<0.05). There was no relationship between the working area, type of hospital and ICU and exposure to violence (p>0.05). The presence of restriction and control points at the entrance to ICUs prevented violence (p<0.05). Conclusion Physicians working in ICUs encounter violence against them. The frequency of violence increased after the Covid-19 pandemic. A significant relationship was found between the frequency of violence and female gender, age group, title, subspecialization status, working style and duration of working in ICUs.
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Affiliation(s)
- Damla Ernur
- Department of Internal Diseases, Subdivision of Critical Care Medicine, Dokuz Eylul University Faculty of Medicine, Balçova, Ýzmir 35150, Turkey
| | - Volkan Hanci
- Department of Anesthesia and Reanimation, Subdivision of Critical Care Medicine, Dokuz Eylul University Faculty of Medicine, Balçova, Ýzmir 35150, Turkey
| | - Necatý Gökmen
- Department of Anesthesia and Reanimation, Subdivision of Critical Care Medicine, Dokuz Eylul University Faculty of Medicine, Balçova, Ýzmir 35150, Turkey
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21
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Alshehri FF, Alghamdi SA, Alrashoudi AM, Albednah FA, Alotaibi AB, Alojayri AM, Aloushan AF, Ahmed G. Post-traumatic Stress Disorder and Its Associated Risk Factors Among Emergency Healthcare Workers: A Saudi Cross-Sectional Analytical Study. Cureus 2023; 15:e44327. [PMID: 37779819 PMCID: PMC10538461 DOI: 10.7759/cureus.44327] [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] [Accepted: 08/28/2023] [Indexed: 10/03/2023] Open
Abstract
BACKGROUND Post-traumatic stress disorder (PTSD) is a psychiatric disease characterized by exposure to threatened death or serious injury and directly experiencing or witnessing the event. Many healthcare professionals have had PTSD, but emergency physicians may be particularly susceptible. To our knowledge, no study has been performed in Saudi Arabia to identify the prevalence and associated risk factors of PTSD among emergency staff. OBJECTIVE This study aims to determine the prevalence and risk factors of post-traumatic stress disorder (PTSD) among emergency healthcare workers (HCWs) in Saudi Arabia. METHODS A cross-sectional analytical study will be conducted in emergency departments around Saudi Arabia in all regions. The study population will include healthcare workers in emergency departments who work and presently live in Saudi Arabia. The survey was divided into two sections. The first section focuses on the emergency personnel's demographic data; the second concentrates on screening for post-traumatic stress disorder using the PTSD checklist for DSM-5 (PCL-5). RESULTS Our population included 519 emergency healthcare staff, including males (51.4%) and females (48.6%). Most emergency HCWs worked in the Ministry of Health Hospitals (58%). The highest diagnosed psychological disorders among emergency staff were anxiety (19.3%) and mood disorders (10.2%). The prevalence of PTSD among emergency workers in Saudi Arabia was 14.1%. The prevalence of PTSD was significantly higher among emergency HCWs who had chronic diseases, emergency workers with anxiety or mood disorders, emergency staff who were using psychiatric medication (p<0.001), and those with psychotic disorders (p=0.002). CONCLUSION The prevalence of PTSD among emergency healthcare workers in Saudi Arabia is estimated to be 14.1%, and pre-existing mental illnesses are associated with a higher risk of PTSD.
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Affiliation(s)
- Faisal F Alshehri
- College of Medicine, Imam Mohammad Ibn Saud Islamic University (IMSIU), Riyadh, SAU
| | - Saleh A Alghamdi
- Department of Psychiatry, College of Medicine, Imam Mohammad Ibn Saud Islamic University (IMSIU), Riyadh, SAU
| | | | - Fahed A Albednah
- College of Medicine, Imam Mohammad Ibn Saud Islamic University (IMSIU), Riyadh, SAU
| | | | - Abdullah M Alojayri
- College of Medicine, Imam Mohammad Ibn Saud Islamic University (IMSIU), Riyadh, SAU
| | - Amairah F Aloushan
- Department of Emergency Medicine, King Abdulaziz Medical City (KAMC) and Ministry of National Guard Health Affairs (MNGHA), Riyadh, SAU
| | - Ghali Ahmed
- Department of Emergency Medicine, King Abdulaziz Medical City (KAMC) and Ministry of National Guard Health Affairs (MNGHA), Riyadh, SAU
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22
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Yosep I, Mardhiyah A, Hendrawati H, Hendrawati S. Interventions for Reducing Negative Impacts of Workplace Violence Among Health Workers: A Scoping Review. J Multidiscip Healthc 2023; 16:1409-1421. [PMID: 37251104 PMCID: PMC10216865 DOI: 10.2147/jmdh.s412754] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Accepted: 05/18/2023] [Indexed: 05/31/2023] Open
Abstract
Workplace violence on health workers in the workplace causes physical and psychological problems. Negative impacts on victims of workplace violence such as physical problems, anxiety, depression, stress, and risk of death or risk of suicide. This problem needs to be addressed immediately so as not to impact post-traumatic stress disorder and reduce the work performance of health workers. The purpose of this study is to explore interventions to reduce the negative impact of workplace violence on health workers. This study used scoping review design with a descriptive approach to data analysis. The CINAHL, PubMed, and Scopus databases were used in this investigation. This study used PCC's framework (Population, Content, Context). The keywords are workplace violence, healthcare personnel, interventions, and programs were used by the authors. Search strategy used PRISMA Extension for Scoping Reviews. The sample are health workers, original research used a randomized control trial or quasi-experiment design, and the publication time had to be within the previous ten years (2014-2023). The JBI assessment was used to assess the quality of the article. We found 11 articles who discuss about interventions to reduce negative effects of workplace violence among health workers. This study shows that there is a decrease in psychological problems in victims of workplace violence such as anxiety, depression, and incidents of workplace violence. The range of sample in this study are 30-440 respondents. The authors discovered three different types of interventions: training programs, cognitive behavior therapy, and workplace violence programs. Interventions must focus on both the physical and psychological needs of the victims of workplace violence, psychiatric nurses and psychologists carried out interventions in a thorough manner. Interventions carried out by psychiatric nurses and psychologists can reduce the negative impact of workplace violence on health workers such as anxiety, depression and other psychological problems.
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Affiliation(s)
- Iyus Yosep
- Department of Mental Health, Faculty of Nursing, Universitas Padjadjaran, Sumedang, Jawa Barat, Indonesia
| | - Ai Mardhiyah
- Department of Pediatric Nursing, Faculty of Nursing, Universitas Padjadjaran, Sumedang, Jawa Barat, Indonesia
| | - Hendrawati Hendrawati
- Department of Mental Health, Faculty of Nursing, Universitas Padjadjaran, Sumedang, Jawa Barat, Indonesia
| | - Sri Hendrawati
- Department of Pediatric Nursing, Faculty of Nursing, Universitas Padjadjaran, Sumedang, Jawa Barat, Indonesia
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Yan S, Feng J, Gan Y, Wang R, Song X, Luo Z, Han X, Lv C. Prevalence and predictors of workplace violence against emergency physicians in China: a cross-sectional study. HUMAN RESOURCES FOR HEALTH 2023; 21:8. [PMID: 36755287 PMCID: PMC9907873 DOI: 10.1186/s12960-022-00784-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Accepted: 11/27/2022] [Indexed: 06/18/2023]
Abstract
BACKGROUND Workplace violence (WPV) is considered a global problem, particularly in the health sector; however, no studies have assessed the national prevalence of WPV against emergency physicians and the associated factors in China. METHODS A national cross-sectional survey was conducted in 31 provinces/autonomous regions/municipalities across China between July 2019 and September 2019. A total of 15 455 emergency physicians were selected using a multistage stratified random sampling method. A structured self-administered questionnaire was used to collect information on WPV and potential associated factors among emergency physicians. Descriptive and multivariable logistic regression analyses were used to identify the predictors of WPV. RESULTS A total of 14 848 emergency physicians responded effectively (effective response rate: 96.07%). Of the respondents, 90.40%, 51.45%, and 90.00% reported exposure to any type of WPV, physical or nonphysical violence in the preceding year, respectively. Verbal aggression (87.25%) was the most common form of violence, followed by threat (71.09%), physical assault (48.24%), verbal sexual harassment (38.13%), and sexual assault (19.37%). Patients' families were the main perpetrators of these incidents. Unmet patient needs, taking drugs or drinking, and long waiting times were the main contributors to WPV. Physicians who were from low-developed regions, female, and without shift work were less likely to have experienced any type of WPV. Chinese emergency physicians who were from medium-developed regions, had a bachelor's degree, worked in a higher level hospital, had a higher professional title, with lower incomes, had a history of hypertension or coronary heart disease, were smokers or drinkers, and worked in hospitals without preventive measures or training for WPV and not encouraging to report WPV were more likely to have experienced any type of WPV. The predictors of WPV varied in different types of WPV. CONCLUSIONS This study shows that the prevalence of WPV against emergency physicians is high in China. Measures should be taken at the physicians, patients, hospital, and national levels to protect GPs from WPV; for example, improving physicians' level of service and hospital' reporting procedures. Creating a prevention strategy and providing a safer workplace environment for emergency physicians should be prioritized.
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Affiliation(s)
- Shijiao Yan
- Department of Emergency Medicine, Hunan Provincial People's Hospital/The First Affiliated Hospital, Hunan Normal University, Changsha, Hunan, China
- School of Public Health, Hainan Medical University, Haikou, Hainan, China
| | - Jing Feng
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Yong Gan
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Rixing Wang
- Department of Emergency, Hainan Clinical Research Center for Acute and Critical Diseases, The Second Affiliated Hospital of Hainan Medical University, Haikou, Hainan, China
| | - Xingyue Song
- Department of Emergency, Hainan Clinical Research Center for Acute and Critical Diseases, The Second Affiliated Hospital of Hainan Medical University, Haikou, Hainan, China
- Research Unit of Island Emergency Medicine, Chinese Academy of Medical Sciences (No. 2019RU013), Hainan Medical University, Haikou, Hainan, China
| | - Zhiqian Luo
- Department of Emergency Medicine, Hunan Provincial People's Hospital/The First Affiliated Hospital, Hunan Normal University, Changsha, Hunan, China
- Research Unit of Island Emergency Medicine, Chinese Academy of Medical Sciences (No. 2019RU013), Hainan Medical University, Haikou, Hainan, China
- Emergency and Trauma College, Hainan Medical University, Haikou, Hainan, China
| | - Xiaotong Han
- Department of Emergency Medicine, Hunan Provincial People's Hospital/The First Affiliated Hospital, Hunan Normal University, Changsha, Hunan, China.
- Clinical Research Center for Emergency and Critical Care in Hunan Province, Changsha, Hunan, China.
| | - Chuanzhu Lv
- Research Unit of Island Emergency Medicine, Chinese Academy of Medical Sciences (No. 2019RU013), Hainan Medical University, Haikou, Hainan, China.
- Emergency Medicine Center, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, No. 32 Yi Huan Lu Xi Er Duan, Chengdu, 610072, Sichuan, China.
- Key Laboratory of Emergency and Trauma of Ministry of Education, Hainan Medical University, Haikou, Hainan, China.
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24
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Meng Y, Wang J, Jiang N, Gong Y, Ye F, Li J, Zhou P, Yin X. Occurrence and correlated factors of physical and verbal violence among emergency physicians in China. J Glob Health 2023; 13:04013. [PMID: 36655917 PMCID: PMC9850876 DOI: 10.7189/jogh.13.04013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
Background Workplace violence against emergency physicians is a global concern. However, there was relatively little research on the incidence and correlated factors of workplace violence among emergency physicians in China. We aimed to investigate the occurrence and correlated factors of physical and verbal violence among emergency physicians in China. Methods We conducted a nationwide cross-sectional study from July 2018 to August 2018. We included a total of 10 457 emergency physicians from 31 provinces across China in the analysis. The questionnaire covered socio-demographic characteristics, work-related factors, psychological characteristics, and workplace violence. We applied binary logistic regression to examine the correlated factors of physical and verbal violence among emergency physicians. Results The prevalence of physical and verbal violence among emergency physicians in China was 27.63% and 81.81%, respectively. Regarding socio-demographic factors, male emergency physicians with bachelor's degrees or higher, poor sleep quality, and unfavorable health conditions were more likely to experience workplace violence. Concerning work-related factors, emergency physicians who had longer years of service, worked a higher frequency of night shifts per month and served more patients per day had a greater prevalence of workplace violence. As for individual psychological characteristics, negative affect was positively correlated with workplace violence, while self-efficacy and positive affect were negatively correlated with workplace violence. Conclusions The situation of physical and verbal violence against emergency physicians in China is severe, especially verbal violence. Hospital administrators should pay more attention to the workplace violence of emergency physicians and take measures to decrease the occurrence of workplace violence efficiently, such as reducing their workload and cultivating their positive affect and self-efficacy.
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25
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Lu J, Yu Y, Wang B, Zhang Y, Ji H, Chen X, Sun M, Daun Y, Pan Y, Chen Y, Yi Y, Dou X, Zhou L. The mediating role of self-efficacy between workplace violence and PTSD among nurses in Liaoning Province, China: A cross-sectional study. Front Psychol 2023; 14:1090451. [PMID: 36910753 PMCID: PMC9995771 DOI: 10.3389/fpsyg.2023.1090451] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2022] [Accepted: 02/06/2023] [Indexed: 02/25/2023] Open
Abstract
Purpose Nurses are at high risk for workplace violence, which can lead to psychological problems. The purpose of this study was to determine the relationship between workplace violence, self-efficacy, and PTSD, and to further explore whether self-efficacy mediates the relationship between workplace violence and PTSD among Chinese nurses. Materials and methods This cross-sectional study was conducted in Liaoning Province, China in 2020. A total of 1,017 valid questionnaires were returned. Each questionnaire included the Workplace Violence Scale, the General Self-Efficacy Scale, the Post-traumatic Stress Disorder Scale (PTSS-10), and demographics information. A hierarchical multiple regression approach was used to explore the mediating role of self-efficacy in the relationship between workplace violence and PTSD. The mediation model was then tested by the PROCESS macro in SPSS. Results A total of 1,017 nurses were included in this study, and the average score of PTSD among Chinese nurses was 26.85 ± 13.13 (mean ± SD). After further adjustment for control variables, workplace violence was positively associated with PTSD, explaining 13% of the variance. High self-efficacy was associated with low PTSD, explaining 18% of the variance. Self-efficacy partially mediated the role of workplace violence and PTSD. Conclusion The high scores of PTSD among Chinese nurses demand widespread attention. Workplace violence is an important predictor of PTSD in nurses. Self-efficacy is a significant factor in improving PTSD in nurses and mediates the relationship between workplace violence and PTSD. Measures and strategies to improve self-efficacy may mitigate the effects of workplace violence on PTSD in nurses.
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Affiliation(s)
- Jiachen Lu
- School of Public Health, Dalian Medical University, Dalian, China
| | - Yingying Yu
- School of Public Health, Dalian Medical University, Dalian, China
| | - Bin Wang
- Department of Nursing, The First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Yanni Zhang
- Laboratory Animal Center, Affiliated Zhongshan Hospital Dalian University, Dalian, China
| | - Haoqiang Ji
- School of Public Health, Shandong University, Jinan, China
| | - Xu Chen
- School of Public Health, Dalian Medical University, Dalian, China
| | - Meng Sun
- School of Public Health, Dalian Medical University, Dalian, China
| | - Yuxin Daun
- School of Public Health, Dalian Medical University, Dalian, China
| | - Yuanping Pan
- School of Public Health, Dalian Medical University, Dalian, China
| | - Yunting Chen
- School of Public Health, Dalian Medical University, Dalian, China
| | - Yaohui Yi
- School of Public Health, Dalian Medical University, Dalian, China
| | - Xiaofeng Dou
- School of Public Health, Dalian Medical University, Dalian, China
| | - Ling Zhou
- School of Public Health, Dalian Medical University, Dalian, China
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26
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Elhadi YAM, Mohamed HMH, Ahmed A, Haroun IH, Hag MH, Farouk E, Almadani M, Mohamed AE, Adam MF, Abdelhamed OS, Salih EB, Mohamed SK, Sanosi MOO. Workplace violence against healthcare workers during the COVID-19 pandemic in Sudan: A cross-sectional study. PUBLIC HEALTH CHALLENGES 2022; 1:e31. [PMID: 37519311 PMCID: PMC9877812 DOI: 10.1002/puh2.31] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Accepted: 09/26/2022] [Indexed: 05/28/2023]
Abstract
Background Workplace violence (WPV) against healthcare workers (HCWs) is a growing global issue. During the coronavirus diseases-2019 (COVID-19) pandemic, violent attacks on HCWs have been documented worldwide. This study aimed to investigate the magnitude and pattern of WPV among HCWs in Sudan during the COVID-19 pandemic. Methods A web-based cross-sectional study of WPV was conducted among registered medical and health workers (pharmacists, physicians, dentists, nurses, laboratory technicians, and administrative and paramedical staff) during the COVID-19 pandemic in Sudan. Data were collected from August to December 2021 using a self-administered questionnaire distributed through social media platforms. Results A total of 792 HCWs returned the online questionnaire. The mean age was 33.5 ± 8.6 years, where more than half were females (54.9%) and working during the day shift (58.8%). During the COVID-19 pandemic, three out of every four participants (78.3%) reported experiencing violence, with 65.8 % experiencing it more than three times. The common types of violence experienced were verbal (91.6%), physical (50.0%), and sexual abuse (11.0%). The emergency department reported the highest number of violent incidents (46.9%). Half of these violent events were not reported (50.3%), primarily due to a lack of a reporting system. The demographic factors that were significantly associated with exposure to violence were participants' occupation (p < 0.001), age (p = 0.001), marital status (p = 0.002), and years of working experience (p = 0.020). Conclusion WPV was rampant among the HCWs in Sudan during the COVID-19 pandemic. The current findings are presented to draw the attention of policy leaders and stakeholders in Sudan to this alarming problem prompting the pressing need for policy and system interventions.
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Affiliation(s)
| | | | - Abdelmuniem Ahmed
- Physiology DepartmentFaculty of MedicineUniversity of GeziraWad MedaniSudan
| | - Islam Hamza Haroun
- Department of AnatomyFaculty of Medicine and Medical SciencesOmdurman Islamic UniversityOmdurmanSudan
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Ahmed SH, Waseem S, Shaikh TG, Mehedi Hasan M. Baffling dilemma of workplace violence in healthcare: will there be an end? Med Confl Surviv 2022; 38:289-294. [PMID: 35538883 DOI: 10.1080/13623699.2022.2073648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Affiliation(s)
- Syed Hassan Ahmed
- Department of Internal Medicine, Dow University of Health Sciences, Karachi, Pakistan
| | - Summaiyya Waseem
- Department of Internal Medicine, Dow University of Health Sciences, Karachi, Pakistan
| | - Taha Gul Shaikh
- Department of Internal Medicine, Dow University of Health Sciences, Karachi, Pakistan
| | - Mohammad Mehedi Hasan
- Department of Biochemistry and Molecular Biology, Faculty of Life Science, Mawlana Bhashani Science and Technology University, Tangail, Bangladesh
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28
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Özdamar Ünal G, İşcan G, Ünal O. The occurrence and consequences of violence against healthcare workers in Turkey: before and during the COVID-19 pandemic. Fam Pract 2022; 39:1001-1008. [PMID: 35395085 PMCID: PMC9383775 DOI: 10.1093/fampra/cmac024] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Before and throughout the COVID-19 pandemic, healthcare workers (HCWs) were victims of workplace violence (WPV). There are no reliable statistics on the occurrence and consequences of WPV against HCWs in Turkey throughout the pandemic period. OBJECTIVE We investigated the rates of WPV against HCWs in Turkey in the pre-pandemic and pandemic periods, variables associated with WPV, and the relationship between these variables and job satisfaction and burnout. METHODS A structured online questionnaire was disseminated through social media channels to HCWs in various healthcare settings. All the respondents also completed the Maslach Burnout Inventory (MBI) and Job Satisfaction Scale. Based on the data obtained, we determined the frequency, causes, and consequences of WPV against HCWs before and during the pandemic. RESULTS There were 701 completed questionnaires. 68.2% of participants were female, and 65.6% of them were doctors. The rate of WPV was 54.1% and 24.3% before and during the pandemic, respectively. Verbal abuse was the most common kind of WPV. Female HCWs were more likely to be physically assaulted than their male counterparts, especially those working in COVID-19 units. The majority of HCWs who were exposed to the violence at least once did not report WPV. HCWs exposed to WPV during the pandemic reported more emotional exhaustion and depersonalization and a lower perceived level of personal achievement. CONCLUSION HCWs were exposed to significant levels of violence both before and during the pandemic. Preventing WPV against HCWs and removing barriers to reporting abuse is crucial.
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Affiliation(s)
- Gülin Özdamar Ünal
- Department of Psychiatry, Faculty of Medicine, University of Süleyman Demirel, Çünür East Campus, Isparta 32200, Turkey
| | - Gökçe İşcan
- Department of Family Medicine, Faculty of Medicine, University of Süleyman Demirel, Çünür East Campus, Isparta 32200, Turkey
| | - Onur Ünal
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, University of Süleyman Demirel, Çünür East Campus, Isparta 32200, Turkey
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Otachi JK, Robertson H, Okoli CTC. Factors associated with workplace violence among healthcare workers in an academic medical center. Perspect Psychiatr Care 2022; 58:2383-2393. [PMID: 35388480 DOI: 10.1111/ppc.13072] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Revised: 03/10/2022] [Accepted: 03/13/2022] [Indexed: 12/22/2022] Open
Abstract
PURPOSE We examined demographic, work-related, and behavioral factors associated with witnessing and/or experiencing workplace violence among healthcare workers. DESIGN AND METHODS Utilizing a correlational design, we analyzed the data to determine the associative factors related to workplace violence among the participants. FINDINGS More than half of the participants (54.5%) reported witnessing (23.8%) or experiencing (30.7%) workplace violence. There were significant differences between health provider groups in witnessing or experiencing workplace violence (Χ2 = 41.9[df12], p < 0.0001). Moreover, the experience of workplace violence differed by practice setting (Χ2 = 65.9[df14], p < 0.0001), with highest rates occurring in psychiatric (45.1%) and emergency (44.1%) services. PRACTICE IMPLICATIONS Findings may inform research, policies, and practice interventions to assess risks for workplace violence and implement preventative policies within high-risk professional groups and settings.
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Affiliation(s)
- Janet K Otachi
- NIH HEAL Initiative, Healing Communities Study, Substance Use Priority Research Area, University of Kentucky, Lexington, Kentucky, USA
| | - Heather Robertson
- Mental and Behavioral Health Nursing, Behavioral Health Wellness Environments for Living and Learning (BH WELL), University of Kentucky College of Nursing, Lexington, Kentucky, USA
| | - Chizimuzo T C Okoli
- Behavioral Health Wellness Environments for Living and Learning (BH WELL), University of Kentucky College of Nursing, Lexington, Kentucky, USA
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Chowdhury SR, Kabir H, Mazumder S, Akter N, Chowdhury MR, Hossain A. Workplace violence, bullying, burnout, job satisfaction and their correlation with depression among Bangladeshi nurses: A cross-sectional survey during the COVID-19 pandemic. PLoS One 2022; 17:e0274965. [PMID: 36137141 PMCID: PMC9499253 DOI: 10.1371/journal.pone.0274965] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Accepted: 09/07/2022] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Depression is one of the most serious yet understudied issues among Bangladeshi nurses, bringing health dangers to this workforce. This study aimed to investigate how workplace violence (WPV), bullying, burnout, and job satisfaction are correlated with depression and identify the factors associated with depression among Bangladeshi nurses. METHODS For this cross-sectional study, data were collected between February 26, 2021, and July 10, 2021 from the Bangladeshi registered nurses. The Workplace Violence Scale (WPVS), the Short Negative Acts Questionnaire [S-NAQ], the Burnout Measure-Short version (BMS), the Short Index of Job Satisfaction (SIJS-5), and the Patient Health Questionnaire (PHQ-9) were used to measure WPV, bullying, burnout, job satisfaction, and depression, respectively. Inferential statistics include Pearson's correlation test, t-test, one-way ANOVA test, multiple linear regression, and multiple hierarchal regression analyses were performed. RESULTS The study investigated 1,264 nurses (70.02% female) with an average age of 28.41 years (SD = 5.54). Depression was positively correlated with WPV, bullying, and burnout and negatively correlated with job satisfaction (p <0.001). According to the multiple linear regression model, depression was significantly lower among nurses with diploma degrees (β = -1.323, 95% CI = -2.149 to -0.497) and bachelor's degrees (β = -1.327, 95% CI = -2.131 to- 0.523) compared to the nurses with master's degree. The nurses who worked extended hours (>48 hours) had a significantly higher depression score (β = 1.490, 95% CI = 0.511 to 2.470) than those who worked ≤ 36 hours. Depression was found to be significantly higher among those who did not receive a timely salary (β = 2.136, 95% CI = 1.138 to 3.134), rewards for good works (β = 1.862, 95% CI = 1.117 to 2.607), and who had no training on WPV (β = 0.895, 95% CI = 0.092 to 1.698). CONCLUSIONS Controlling burnout, bullying, and workplace violence, as well as improving the work environment for nurses and increasing job satisfaction, are the essential indicators of reducing depression. This can be accomplished with integrative support from hospital executives, policymakers, and government officials.
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Affiliation(s)
- Saifur Rahman Chowdhury
- Department of Public Health, North South University, Dhaka, Bangladesh
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Humayun Kabir
- Department of Public Health, North South University, Dhaka, Bangladesh
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Sinthia Mazumder
- Department of Public Health, North South University, Dhaka, Bangladesh
| | - Nahida Akter
- Penn State Ross and Carol Nese College of Nursing, Penn State University, University Park, PA, United States of America
| | - Mahmudur Rahman Chowdhury
- Begum Rabeya Khatun Chowdhury Nursing College, Sylhet, Bangladesh
- School of Medical Sciences, Shahjalal University of Science and Technology, Sylhet, Bangladesh
| | - Ahmed Hossain
- Department of Public Health, North South University, Dhaka, Bangladesh
- Health Services Administration, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
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Zhong D, Liu C, Luan C, Li W, Cui J, Shi H, Zhang Q. Mental health problems among healthcare professionals following the workplace violence issue-mediating effect of risk perception. Front Psychol 2022; 13:971102. [PMID: 36160531 PMCID: PMC9491225 DOI: 10.3389/fpsyg.2022.971102] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Accepted: 07/11/2022] [Indexed: 11/24/2022] Open
Abstract
Although there have been numerous studies on mental wellbeing impairment or other negative consequences of Workplace Violence (WPV) against healthcare professionals, however, the effects of WPV are not limited to those who experience WPV in person, but those who exposed to WPV information indirectly. In the aftermath of "death of Dr. Yang Wen," a cross-sectional study was conducted to explore the psychological status of healthcare professionals. A total of 965 healthcare professionals from 32 provinces in China participated in our research. The prevalence rates of Post-Traumatic Stress Disorder (PTSD) symptoms, depression, anxiety among healthcare professional in the current study were 25.60, 46.01, and 27.88%, respectively. Moreover, our research suggested that the awareness of WPV-incident had a significant association with PTSD symptoms. In addition, risk perception was shown to mediate the effect of WPV awareness on PTSD symptoms. Furthermore, the present research also found a U-shaped relationship between issue salience and PTSD symptoms, and the relationship between issue salience and anxiety, indicating that higher awareness of WPV issue was negatively related to mental health status (including PTSD and anxiety) but only to the points at which there were no additional effects of more issue salience. This study highlighted that more protective measures for healthcare professionals need to be implemented in response to potential WPV events. More importantly, risk perception was found to mediate the effect of WPV issue salience on PTSD symptoms, it is critical to reduce the mental health burden through intervening in risk perception.
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Affiliation(s)
- Deping Zhong
- School of Social Development and Public Policy, Beijing Normal University, Beijing, China
| | - Chengcheng Liu
- School of Social Development and Public Policy, Beijing Normal University, Beijing, China
| | - Chunna Luan
- Beijing Nutrinst Medical Research Institute, Beijing, China
| | - Wei Li
- Department of Oncology, The First Hospital, Jilin University, Changchun, China
| | - Jiuwei Cui
- Department of Oncology, The First Hospital, Jilin University, Changchun, China
| | - Hanping Shi
- Department of Gastrointestinal Surgery/Clinical Nutrition, Capital Medical University Affiliated Beijing Shijitan Hospital, Beijing, China
| | - Qiang Zhang
- School of Social Development and Public Policy, Beijing Normal University, Beijing, China
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Ahmad S, Yaqoob S, Safdar S, Cheema HA, Islam Z, Iqbal N, Tharwani ZH, Swed S, Ijaz MS, Rehman MU, Shahid A, Tahir U, Ahmad S, Bilal W, Essar MY, Iqbal S, Choudry ZA. Burnout in health care workers during the fourth wave of COVID-19: A cross sectional study from Pakistan. Ann Med Surg (Lond) 2022; 80:104326. [PMID: 35958288 PMCID: PMC9357282 DOI: 10.1016/j.amsu.2022.104326] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Revised: 07/30/2022] [Accepted: 07/31/2022] [Indexed: 11/29/2022] Open
Abstract
Objective To assess the burnout among the healthcare workers during the fourth wave of COVID-19. Methods In this cross-sectional study, burn out was measured in health care professionals using the MBI scale inventory during the fourth wave of COVID-19. Age, gender, marital status, having children, hospital, job type, experience, and workload, as well as the severity of burnout in each subscale, were all measured. We used the chi-square test to detect the difference between the level of burnout and other demographic variables, and a multiple logistic regression test was used to define the predicted correlation between the high level of burnout and the risk factors. Odds ratios and corresponding 95% confidence intervals (CI) were reported. A p-value of less than 0.05 indicated a statistically significant outcome. Results Out of 776 healthcare workers who participated in our study, 468 (63.2%), 161 (21.7%) and 112 (15.1%) participants experienced low, moderate and high levels of emotional exhaustion, respectively. For the depersonalization subscale, 358 (48.3%), 188 (25.4%) and 195 (26.3%) people suffered from low, moderate, and high levels of depersonalization, respectively while 649 (87.6%), 40 (5.4%) and 52 (7.0%) respondents had low, moderate and high levels in the personal accomplishment subscale, respectively. Conclusion During the fourth wave of COVID-19, the healthcare workers reported increased level of burnout overall possibly due to the long term physical and mental impacts that the pandemic has had over the time. Moreover, healthcare workers in Pakistan were more prone to burnout as compared to other countries.
Higher levels of burnout were observed in the fourth wave of COVID-19, possibly due to the long term physical and mental impacts that the pandemic has had over time. Healthcare workers in Pakistan were more prone to burnout as compared to other countries. This study yielded key findings that have important implications for preventing and reducing burnout in hospital settings.
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Affiliation(s)
- Shoaib Ahmad
- Punjab Medical College, Faisalabad, Pakistan.,DHQ Teaching Hospital, Faisalabad, Pakistan
| | | | | | | | - Zarmina Islam
- Faculty of Medicine, Dow Medical College, Dow University of Health Sciences, Pakistan
| | - Nida Iqbal
- Mohtarma Benazir Bhutto Shaheed Medical College, Mirpur AJK, Pakistan
| | - Zoaib Habib Tharwani
- Faculty of Medicine, Dow Medical College, Dow University of Health Sciences, Pakistan
| | - Sarya Swed
- Faculty of Medicine, Aleppo University, Aleppo, Syria
| | | | | | - Abia Shahid
- Department of Medicine, King Edward Medical University, Lahore, Pakistan
| | | | - Shkaib Ahmad
- Dera Ghazi Khan Medical College, DG Khan, Pakistan
| | - Wajeeha Bilal
- Faculty of Medicine, Dow Medical College, Dow University of Health Sciences, Pakistan
| | | | - Saleem Iqbal
- Department of Surgery, Allied Hospital Faisalabad, Pakistan
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Wang L, Ni X, Li Z, Ma Y, Zhang Y, Zhang Z, Gao L, Liu X, Yan W, Fan L, Shi L. Mental Health Status of Medical Staff Exposed to Hospital Workplace Violence: A Prospective Cohort Study. Front Public Health 2022; 10:930118. [PMID: 35903384 PMCID: PMC9315312 DOI: 10.3389/fpubh.2022.930118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Accepted: 06/03/2022] [Indexed: 11/17/2022] Open
Abstract
Objective Hospital workplace violence is one of the most frequently reported types of workplace violence in the world, and it harms the mental and physical health of medical staff. Existing research on workplace violence focused more on cross-sectional studies, than longitudinal studies. Therefore, this study examined the dynamic impact of hospital workplace violence on the mental health of medical staff, with the aim of providing appropriate countermeasures and suggestions for hospitals to develop targeted psychological intervention measures in time for medical staff who experience workplace violence. Design A prospective cohort study. Participants A total of 112 medical staff who had experienced workplace violence in the hospital for the first time were chosen. Setting An unconditional latent variable growth curve model was established based on the average value of the general health scale scores of medical staff, and gender and violence types (intimidation threats, physical violence) as control variables. Each medical staff was assessed for depression and anxiety at 4 different time points and the changes in the trajectories was observed. Results There were significant differences in the incidence of mental health and anxiety among medical staff at different observation times. There were significant individual differences in the initial mental health status, growth rate of anxiety and depression of medical staff. Conclusions Hospitals should undertake various psychological intervention strategies based on the staff's mental health to safeguard those who have experienced workplace violence.
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Affiliation(s)
- Licheng Wang
- School of Health Management, Harbin Medical University, Harbin, China
| | - Xin Ni
- National Center for Children's Health, Children's Hospital Affiliated Capital Medical University, Beijing, China
| | - Zhe Li
- National Center for Children's Health, Children's Hospital Affiliated Capital Medical University, Beijing, China
| | - Yuanshuo Ma
- School of Health Management, Harbin Medical University, Harbin, China
| | - Yafeng Zhang
- School of Health Management, Harbin Medical University, Harbin, China
| | - Zhong Zhang
- School of Health Management, Harbin Medical University, Harbin, China
| | - Lei Gao
- School of Health Management, Harbin Medical University, Harbin, China
| | - Xinyan Liu
- School of Health Management, Harbin Medical University, Harbin, China
| | - Wenxin Yan
- The Fourth Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Lihua Fan
- School of Health Management, Harbin Medical University, Harbin, China
- *Correspondence: Lihua Fan
| | - Lei Shi
- School of Health Management, Southern Medical University, Guangzhou, China
- Lei Shi
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Wong AH, Ray JM, Eixenberger C, Crispino LJ, Parker JB, Rosenberg A, Robinson L, McVaney C, Iennaco JD, Bernstein SL, Yonkers KA, Pavlo AJ. Qualitative study of patient experiences and care observations during agitation events in the emergency department: implications for systems-based practice. BMJ Open 2022; 12:e059876. [PMID: 35545394 PMCID: PMC9096567 DOI: 10.1136/bmjopen-2021-059876] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVES Agitation, defined as excessive psychomotor activity leading to aggressive or violent behaviour, is prevalent in the emergency department (ED) due to rising behavioural-related visits. Experts recommend use of verbal de-escalation and avoidance of physical restraint to manage agitation. However, bedside applications of these recommendations may be limited by system challenges in emergency care. This qualitative study aims to use a systems-based approach, which considers the larger context and system of healthcare delivery, to identify sociotechnical, structural, and process-related factors leading to agitation events and physical restraint use in the ED. DESIGN Qualitative study using a grounded theory approach to triangulate interviews of patients who have been physically restrained with direct observations of agitation events. SETTING Two EDs in the Northeast USA, one at a tertiary care academic centre and the other at a community-based teaching hospital. PARTICIPANTS We recruited 25 individuals who experienced physical restraint during an ED visit. In addition, we performed 95 observations of clinical encounters of agitation events on unique patients. Patients represented both behavioural (psychiatric, alcohol/drug use) and non-behavioural (medical, trauma) chief complaints. RESULTS Three primary themes with implications for systems-based practice of agitation events in the ED emerged: (1) pathways within health and social systems; (2) interpersonal contexts as reflections of systemic stressors on behavioural emergency care and (3) systems-based and patient-oriented strategies and solutions. CONCLUSIONS Agitation events represented manifestations of patients' structural barriers to care from socioeconomic inequities and high burden of emotional and physical trauma as well as staff members' simultaneous exposure to external stressors from social and healthcare systems. Potential long-term solutions may include care approaches that recognise agitated patients' exposure to psychological trauma, improved coordination within the mental health emergency care network, and optimisation of physical environment conditions and organisational culture.
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Affiliation(s)
- Ambrose H Wong
- Department of Emergency Medicine, Yale School of Medicine, New Haven, Connecticut, USA
| | - Jessica M Ray
- Department of Emergency Medicine, Yale School of Medicine, New Haven, Connecticut, USA
- Department of Health Outcomes & Biomedical Informatics, University of Florida College of Medicine, Gainesville, Florida, USA
| | | | - Lauren J Crispino
- Department of Emergency Medicine, Virginia Tech Carilion Clinic, Roanoke, Virginia, USA
| | - John B Parker
- Department of Emergency Medicine, Coliseum Health System, Macon, Georgia, USA
| | | | - Leah Robinson
- Yale School of Public Health, New Haven, Connecticut, USA
| | - Caitlin McVaney
- Department of Emergency Medicine, Yale School of Medicine, New Haven, Connecticut, USA
| | - Joanne DeSanto Iennaco
- Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut, USA
- Yale School of Nursing, Orange, Connecticut, USA
| | - Steven L Bernstein
- Department of Emergency Medicine, Dartmouth-Hitchcock Health System, Lebanon, New Hampshire, USA
| | - Kimberly A Yonkers
- Department of Psychiatry, University of Massachusetts Medical School, Worchester, Massachusetts, USA
| | - Anthony J Pavlo
- Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut, USA
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Matthews LR, Alden LE, Wagner S, Carey MG, Corneil W, Fyfe T, Randall C, Regehr C, White M, Buys N, White N, Fraess-Phillips A, Krutop E. PREVALENCE AND PREDICTORS OF POSTTRAUMATIC STRESS DISORDER, DEPRESSION, AND ANXIETY IN PERSONNEL WORKING IN EMERGENCY DEPARTMENT SETTINGS: A SYSTEMATIC REVIEW. J Emerg Med 2022; 62:617-635. [PMID: 35379514 DOI: 10.1016/j.jemermed.2021.09.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Revised: 08/15/2021] [Accepted: 09/11/2021] [Indexed: 11/25/2022]
Abstract
BACKGROUND Professionals working in the emergency department (ED) are regularly exposed to traumatic events. Rates of posttraumatic mental health conditions vary widely in the literature and there is no agreement that rates in ED staff are elevated relative to other populations. OBJECTIVE We conducted a systematic review of international literature reporting prevalence of posttraumatic stress disorder (PTSD), depression, and anxiety in ED personnel to determine whether prevalence is elevated compared to the general community, and to evaluate convergent evidence across the literature for predictive factors. To our knowledge, there is no comprehensive review on this topic in the literature at this time. METHODS Seven databases were searched for studies reporting rates of PTSD, depression, and anxiety in ED personnel. Two independent researchers screened studies and assessed quality using Munn's Prevalence Critical Appraisal Instrument. Best-evidence synthesis determined whether conditions demonstrated elevated prevalence compared to the general population of Canada, a conservative benchmark. RESULTS Twenty-four studies from 12 countries and a combined sample size of 4768 were included. PTSD rates ranged from 0% to 23.6% (mean 10.47%), depression ranged from 0.7% to 77.1% (mean 24.8%), and anxiety rates ranged from 2.4% to 14.6% (mean 9.29%). Each condition was elevated compared to the general population. Sociodemographic variables were not consistent predictors. Elevated PTSD seemed most strongly related to workplace exposure and maladaptive coping. CONCLUSIONS ED professionals have an elevated risk of experiencing PTSD, depression, and anxiety. Identification of organizational and workplace predictors are needed to inform interventions that will reduce risk and provide optimal treatment and management of PTSD, depression, and anxiety in ED settings.
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Affiliation(s)
- Lynda R Matthews
- School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, New South Wales, Australia
| | - Lynn E Alden
- Department of Psychology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Shannon Wagner
- College of Arts, Social and Health Sciences, University of Northern British Columbia, Prince George, British Columbia, Canada
| | - Mary G Carey
- School of Nursing, University of Rochester, Rochester, New York
| | - Wayne Corneil
- Interdisciplinary School of Health Sciences and Telfer School of Management, University of Ottawa, Ottawa, Ontario, Canada
| | - Trina Fyfe
- Northern Medical Program, University of Northern British Columbia, Prince George, British Columbia, Canada
| | - Christine Randall
- School of Allied Health Sciences, Health Group, Menzies Health Institute of Queensland, Griffith University, Gold Coast Campus, Southport, Queensland, Australia
| | | | - Marc White
- Department of Family Practice, University of British Columbia, Vancouver, British Columbia, Canada
| | - Nicholas Buys
- Menzies Health Institute of Queensland, Griffith University, Gold Coast Campus, Southport, Queensland, Australia
| | - Nicole White
- University of Northern British Columbia, Prince George, British Columbia, Canada
| | - Alex Fraess-Phillips
- School of Health Sciences, University of Northern British Columbia, Prince George, British Columbia, Canada
| | - Elyssa Krutop
- Aligned Kamloops, Kamloops, British Columbia, Canada
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Naseem M, Shahil Feroz A, Arshad H, Ashraf S, Asim M, Jamali S, Mian A. Perceptions, challenges and experiences of frontline healthcare providers in Emergency Departments regarding Workplace Violence during the COVID-19 pandemic: A protocol for an exploratory qualitative study from an LMIC. BMJ Open 2022; 12:e055788. [PMID: 35135775 PMCID: PMC8830240 DOI: 10.1136/bmjopen-2021-055788] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
INTRODUCTION Workplace violence (WPV) against Healthcare Workers (HCWs) has emerged as a global issue. Emergency Department (ED) HCWs as front liners are more vulnerable to it due to the nature of their work and exposure to unique medical and social situations. COVID-19 pandemic has led to a surge in the number of cases of WPV against HCWs, especially against ED HCWs. In most cases, the perpetrators of these acts of violence are the patients and their attendants as families. The causes of this rise are multifactorial; these include the inaccurate spread of information and rumours through social media, certain religious perspectives, propaganda and increasing anger and frustration among the general public,ED overcrowding, staff shortages etc. We aim to conduct a qualitative exploratory study among the ED frontline care providers at the two major EDs of Karachi city. The purpose of this study is to determine the perceptions, challenges and experiences regarding WPV faced by ED healthcare providers during the COVID-19 pandemic. METHODS AND ANALYSIS For this research study, a qualitative exploratory research design will be employed using in-depth interviews and a purposive sampling approach. Data will be collected using in-depth interviews from study participants working at the EDs of Jinnah Postgraduate Medical Centre (JPMC) and the Aga Khan University Hospital(AKUH) Karachi, Pakistan. Thestudy data will be analysed thematically using NVivo V.12 Plus software. ETHICS AND DISSEMINATION The ethical approval for this study was obtained from the Aga Khan University Ethical Review Committee and from Jinnah postgraduate Medical Center (JPMC). The results of the study will be disseminated to the scientific community and to the research subjects participating in the study.The findings of this study will help to explore the perceptions of ED healthcare providers regarding WPV during the COVID-19 pandemic and provide a better understanding of study participant's' challenges concerning WPV during the COVID-19 pandemic.
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Affiliation(s)
- Maleeha Naseem
- Community Health Sciences, The Aga Khan University, Karachi, Pakistan
| | - Anam Shahil Feroz
- Community Health Sciences, The Aga Khan University, Karachi, Pakistan
- Dalla Lana School of Public Health, Institute of Health Policy Management and Evaluation, Toronto, Ontario, Canada
| | - Hajra Arshad
- Medical College, The Aga Khan University Hospital, Karachi, Sindh, Pakistan
| | - Sarah Ashraf
- Medical College, The Aga Khan University Hospital, Karachi, Sindh, Pakistan
| | - Muhammad Asim
- Community Health Sciences, The Aga Khan University, Karachi, Pakistan
| | - Seemin Jamali
- Emergency Department, Jinnah Post Graduate Medical Centre, Karachi, Pakistan
| | - Asad Mian
- Emergency Medicine, The Aga Khan University Hospital, Karachi, Sindh, Pakistan
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Bock C, Zimmermann T, Kahl KG. The impact of post-traumatic stress on the mental state of university hospital physicians - a cross sectional study. BMC Psychiatry 2022; 22:85. [PMID: 35114970 PMCID: PMC8815118 DOI: 10.1186/s12888-022-03719-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Accepted: 01/20/2022] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Hospital physicians have an increased risk for post-traumatic stress caused by work-related trauma. This study examines the frequency of reported traumatic events (TE), post-traumatic stress (PTS) and its possible consequences for the mental state and work ability of physicians at a university hospital. METHODS As part of the mandatory psychological risk assessment, n = 145 physicians (n = 56 female; 38.6%) were examined at a university hospital in Germany in a cross sectional study. TE, PTS and symptoms of depression and anxiety were assessed using the self-report questionnaires "Freiburger Screening Fragebogen to identify patients at risk for the development of a post-traumatic stress disorder in the group of severely injured patients" (PTBS-13), the "Patient Health Questionnaire" (PHQ-2) and the "Generalized Anxiety Disorder scale" (GAD-2). Work ability was assessed using a modified version of the questionnaire for workplace analysis (KFZA). The response rate was 52%. RESULTS Traumatic events were experienced by n = 125 physicians (86.2%) throughout their whole career. Of these, 19 physicians (15.2%) reported PTS. PTS is reported by 12 of 56 female physicians (63.2%), compared to 7 of 89 reports of PTS by male physicians (36.8%). Physicians with PTS symptoms had higher depression scores (p = 0.007) compared to physicians without TE or with TE, but without PTS. Physicians with PTS reported significantly reduced work ability caused by constantly interrupted work (p = 0.03). Female gender was the greatest risk factor for the development of PTS. (p = 0.001). CONCLUSIONS Physicians - especially females - with PTS may have an increased risk of developing depressive symptoms. Therefore, interventions aimed at reducing trauma-related stress symptoms may be helpful in improving mental health of hospital physicians. Further studies with more physicians from different hospitals are necessary to support the results.
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Affiliation(s)
- Christian Bock
- Department of Occupational Safety, Hannover Medical School, Hannover, Germany.
| | - Tanja Zimmermann
- grid.10423.340000 0000 9529 9877Department of Psychosomatic Medicine and Psychotherapy, Hannover Medical School, Hannover, Germany
| | - Kai G. Kahl
- grid.10423.340000 0000 9529 9877Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Hannover, Germany
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Wong AH, Sabounchi NS, Roncallo HR, Ray JM, Heckmann R. A qualitative system dynamics model for effects of workplace violence and clinician burnout on agitation management in the emergency department. BMC Health Serv Res 2022; 22:75. [PMID: 35033071 PMCID: PMC8760708 DOI: 10.1186/s12913-022-07472-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Accepted: 12/30/2021] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Over 1.7 million episodes of agitation occur annually across the United States in emergency departments (EDs), some of which lead to workplace assaults on clinicians and require invasive methods like physical restraints to maintain staff and patient safety. Recent studies demonstrated that experiences of workplace violence contribute to symptoms of burnout, which may impact future decisions regarding use of physical restraints on agitated patients. To capture the dynamic interactions between clinicians and agitated patients under their care, we applied qualitative system dynamics methods to develop a model that describes feedback mechanisms of clinician burnout and the use of physical restraints to manage agitation. METHODS We convened an interprofessional panel of clinician stakeholders and agitation experts for a series of model building sessions to develop the current model. The panel derived the final version of our model over ten sessions of iterative refinement and modification, each lasting approximately three to four hours. We incorporated findings from prior studies on agitation and burnout related to workplace violence, identifying interpersonal and psychological factors likely to influence our outcomes of interest to form the basis of our model. RESULTS The final model resulted in five main sets of feedback loops that describe key narratives regarding the relationship between clinician burnout and agitated patients becoming physically restrained: (1) use of restraints decreases agitation and risk of assault, leading to increased perceptions of safety and decreasing use of restraints in a balancing feedback loop which stabilizes the system; (2) clinician stress leads to a perception of decreased safety and lower threshold to restrain, causing more stress in a negatively reinforcing loop; (3) clinician burnout leads to a decreased perception of colleague support which leads to more burnout in a negatively reinforcing loop; (4) clinician burnout leads to negative perceptions of patient intent during agitation, thus lowering threshold to restrain and leading to higher task load, more likelihood of workplace assaults, and higher burnout in a negatively reinforcing loop; and (5) mutual trust between clinicians causes increased perceptions of safety and improved team control, leading to decreased clinician stress and further increased mutual trust in a positively reinforcing loop. CONCLUSIONS Our system dynamics approach led to the development of a robust qualitative model that illustrates a number of important feedback cycles that underly the relationships between clinician experiences of workplace violence, stress and burnout, and impact on decisions to physically restrain agitated patients. This work identifies potential opportunities at multiple targets to break negatively reinforcing cycles and support positive influences on safety for both clinicians and patients in the face of physical danger.
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Affiliation(s)
- Ambrose H Wong
- Department of Emergency Medicine, Yale School of Medicine, 464 Congress Ave Suite 260, New Haven, CT, 06519, USA.
| | - Nasim S Sabounchi
- Department of Health Policy and Management, Center for Systems and Community Design, CUNY Graduate School of Public Health & Health Policy, 55 W. 125th Street, 7th Floor, New York, NY, 10027, USA
| | - Hannah R Roncallo
- Department of Emergency Services, Yale New-Haven Hospital, 20 York Street, New Haven, CT, 06510, USA
| | - Jessica M Ray
- Department of Emergency Medicine, Yale School of Medicine, 464 Congress Ave Suite 260, New Haven, CT, 06519, USA
| | - Rebekah Heckmann
- Department of Emergency Medicine, Yale School of Medicine, 464 Congress Ave Suite 260, New Haven, CT, 06519, USA
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Workplace harassment in university libraries: A qualitative study of female Library and Information Science (LIS) professionals in Pakistan. JOURNAL OF ACADEMIC LIBRARIANSHIP 2021. [DOI: 10.1016/j.acalib.2021.102464] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Ielapi N, Andreucci M, Bracale UM, Costa D, Bevacqua E, Giannotta N, Mellace S, Buffone G, Cerabona V, Arturi F, Provenzano M, Serra R. Workplace Violence towards Healthcare Workers: An Italian Cross-Sectional Survey. NURSING REPORTS 2021; 11:758-764. [PMID: 34968266 PMCID: PMC8715454 DOI: 10.3390/nursrep11040072] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 09/15/2021] [Accepted: 09/28/2021] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Workplace violence (WPV) is a major healthcare problem with important consequences in healthcare areas and may impact negatively not only healthcare workers but also the quality and safety of patient care. OBJECTIVES This an observational online web-based survey using Google® Modules, specifically aiming to investigate the phenomenon of WPV in Italian healthcare services. METHODS Data collection for this study lasted one month, with the questionnaire available from 1 May 2021 to 31 May 2021. Continuous variables were considered as either mean ± standard deviation (SD) or median and interquartile range (IQR) based on their distribution. Comparison between groups was assessed by unpaired t-test or Mann-Whitney U test according to variable distribution. Categorical variables were analyzed using the chi-squared test. RESULTS The study population consisted of 203 healthcare workers, represented by nurses (61.6%), medical doctors (16.8%), patient care assistants (4.9%), and others (16.7%). Female gender was associated with a 2.6 times higher risk for the presence of aggression (p = 0.034), and nurse as a job with about 4 times increased risk for the presence of aggression (p = 0.006). The risk for aggression increased by 5% for each year of work experience. CONCLUSIONS WPV is still matter of concern in Italian healthcare services. A strong organizational effort is demanded from healthcare institutions in order prevent internal and external violence in healthcare settings.
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Affiliation(s)
- Nicola Ielapi
- Department of Public Health and Infectious Disease, “Sapienza” University of Rome, 00185 Rome, Italy;
- Interuniversity Center of Phlebolymphology (CIFL), International Research and Educational Program in Clinical and Experimental Biotechnology, University Magna Graecia of Catanzaro, Viale Europa, 88100 Catanzaro, Italy; (D.C.); (E.B.)
| | - Michele Andreucci
- Department of Health Sciences, University of Catanzaro, 88100 Catanzaro, Italy;
| | | | - Davide Costa
- Interuniversity Center of Phlebolymphology (CIFL), International Research and Educational Program in Clinical and Experimental Biotechnology, University Magna Graecia of Catanzaro, Viale Europa, 88100 Catanzaro, Italy; (D.C.); (E.B.)
- Department of Law, Economics and Sociology, University Magna Graecia of Catanzaro, 88100 Catanzaro, Italy
| | - Egidio Bevacqua
- Interuniversity Center of Phlebolymphology (CIFL), International Research and Educational Program in Clinical and Experimental Biotechnology, University Magna Graecia of Catanzaro, Viale Europa, 88100 Catanzaro, Italy; (D.C.); (E.B.)
- Department of Medical and Surgical Sciences, University of Catanzaro, 88100 Catanzaro, Italy; (N.G.); (F.A.); (M.P.)
| | - Nicola Giannotta
- Department of Medical and Surgical Sciences, University of Catanzaro, 88100 Catanzaro, Italy; (N.G.); (F.A.); (M.P.)
| | - Sabrina Mellace
- Department of Surgery, Health Agency of Trento, 38100 Trento, Italy;
| | - Gianluca Buffone
- Department of Vascular Surgery, Health Agency of Trento, 38100 Trento, Italy;
| | - Vito Cerabona
- Department of Public Health and Infectious Disease, “Sapienza” University of Rome, 00185 Rome, Italy;
| | - Franco Arturi
- Department of Medical and Surgical Sciences, University of Catanzaro, 88100 Catanzaro, Italy; (N.G.); (F.A.); (M.P.)
| | - Michele Provenzano
- Department of Medical and Surgical Sciences, University of Catanzaro, 88100 Catanzaro, Italy; (N.G.); (F.A.); (M.P.)
| | - Raffaele Serra
- Interuniversity Center of Phlebolymphology (CIFL), International Research and Educational Program in Clinical and Experimental Biotechnology, University Magna Graecia of Catanzaro, Viale Europa, 88100 Catanzaro, Italy; (D.C.); (E.B.)
- Department of Medical and Surgical Sciences, University of Catanzaro, 88100 Catanzaro, Italy; (N.G.); (F.A.); (M.P.)
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Arafa A, Shehata A, Youssef M, Senosy S. Violence against healthcare workers during the COVID-19 pandemic: a cross-sectional study from Egypt. ARCHIVES OF ENVIRONMENTAL & OCCUPATIONAL HEALTH 2021; 77:621-627. [PMID: 34590540 DOI: 10.1080/19338244.2021.1982854] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Workplace violence (WPV) is a serious endemic phenomenon in healthcare settings, and it has been escalating during the COVID-19 pandemic. In this cross-sectional study, healthcare workers (HCWs) (105 physicians and 104 nurses) working at two public hospitals accepting patients with COVID-19 in Egypt were included. Using a self-administered questionnaire distributed in January 2021, data about HCWs' sociodemographic and occupational characteristics and their exposure to psychological and physical WPV during the past six months were collected. The results showed that the prevalence of psychological and physical WPV was 42.6% and 9.6%, respectively. Relatives of patients were the perpetrators in most WPV incidents. HCWs did not report 57.3% of psychological and 10.0% of physical WPV incidents. Female sex, having physical contact with patients, and working rotational shifts were associated with the increased exposure to psychological and physical WPV. In conclusion, this study showed a high prevalence of WPV against HCWs in Egyptian public hospitals during the COVID-19 pandemic.
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Affiliation(s)
- Ahmed Arafa
- Department of Public Health, Faculty of Medicine, Beni-Suef University, Beni-Suef, Egypt
- Public Health, Department of Social Medicine, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Ahmed Shehata
- Faculty of Medicine, Beni-Suef University, Beni-Suef, Egypt
| | | | - Shaimaa Senosy
- Department of Public Health, Faculty of Medicine, Beni-Suef University, Beni-Suef, Egypt
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Xu X, Manzoor F, Jiang S, Mumtaz A. Unpacking the Mental Health of Nurses during COVID-19: Evidence from Pakistan. J Clin Med 2021; 10:jcm10163546. [PMID: 34441841 PMCID: PMC8396823 DOI: 10.3390/jcm10163546] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Revised: 08/06/2021] [Accepted: 08/10/2021] [Indexed: 01/19/2023] Open
Abstract
The prime objective of the present study is to test the effect of COVID-19 fear on the mental condition of nurses in the public health sector of Pakistan. This study seeks to measure the psychological distress, anxiety, and psychological well-being of nurses due to fear of COVID-19 and exposure to COVID-19. This research further reveals the moderating role of “social support” in the link between COVID-19 fear, exposure and mental health. Through a convenient sampling technique, 250 sample contributors were chosen from 12 public hospitals. The results were obtained by applying multiple regression and moderation analysis by SPSS and the Hayes process. The outcomes indicated that fear of exposure to COVID-19 affects the mental health of nurses. The findings also discovered that social support is not very constructive in the pandemic. However, we suggested that social support is the best weapon to encourage nurses to relieve their fear and minimize negative emotions.
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Affiliation(s)
- Xinxing Xu
- Legislation Research Institution of Zhejiang University, Legislation Research Institution of Zhejiang, Zhejiang University Guanghua Law School, Hangzhou 310008, China;
| | - Faiza Manzoor
- Department of Agricultural Economics and Management, School of Public Affairs, Zhejiang University, Hangzhou 310058, China; or
| | - Shaoping Jiang
- Guanghua Law School, Zhejiang University, Zhijiang Road, Hangzhou 310008, China
- Correspondence: (S.J.); or (A.M.)
| | - Ayesha Mumtaz
- College of Public Administration, Zhejiang University, Hangzhou 310058, China
- Correspondence: (S.J.); or (A.M.)
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Lall MD, Bilimoria KY, Lu DW, Zhan T, Barton MA, Hu YY, Beeson MS, Adams JG, Nelson LS, Baren JM. Prevalence of Discrimination, Abuse, and Harassment in Emergency Medicine Residency Training in the US. JAMA Netw Open 2021; 4:e2121706. [PMID: 34410392 PMCID: PMC8377562 DOI: 10.1001/jamanetworkopen.2021.21706] [Citation(s) in RCA: 48] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
IMPORTANCE The prevalence of workplace mistreatment and its association with the well-being of emergency medicine (EM) residents is unclear. More information about the sources of mistreatment might encourage residency leadership to develop and implement more effective strategies to improve professional well-being not only during residency but also throughout the physician's career. OBJECTIVE To examine the prevalence, types, and sources of perceived workplace mistreatment during training among EM residents in the US and the association between mistreatment and suicidal ideation. DESIGN, SETTING, AND PARTICIPANTS In this survey study conducted from February 25 to 29, 2020, all residents enrolled in EM residencies accredited by the Accreditation Council for Graduate Medical Education (ACGME) who participated in the 2020 American Board of Emergency Medicine computer-based In-training Examination were invited to participate. A multiple-choice, 35-item survey was administered after the examination asking residents to self-report the frequency, sources, and types of mistreatment experienced during residency training and whether they had suicidal thoughts. MAIN OUTCOMES AND MEASURES The types and frequency of workplace mistreatment and the sources of the mistreatment were identified, and rates of self-reported suicidality were obtained. Multivariable logistic regression models were used to examine resident and program characteristics associated with suicidal thoughts. RESULTS Of 8162 eligible EM residents, 7680 (94.1%) responded to at least 1 question on the survey; 6503 (79.7%) completed the survey in its entirety. A total of 243 ACGME-accredited residency programs participated, and 1 did not. The study cohort included 4768 male residents (62.1%), 2698 female residents (35.1%), 4919 non-Hispanic White residents (64.0%), 2620 residents from other racial/ethnic groups (Alaska Native, American Indian, Asian or Pacific Islander, African American, Mexican American, Native Hawaiian, Puerto Rican, other Hispanic, or mixed or other race) (34.1%), 483 residents who identified as lesbian, gay, bisexual, transgender, queer, or other (LGBTQ+) (6.3%), and 5951 residents who were married or in a relationship (77.5%). Of the total participants, 3463 (45.1%) reported exposure to some type of workplace mistreatment (eg, discrimination, abuse, or harassment) during the most recent academic year. A frequent source of mistreatment was identified as patients and/or patients' families; 1234 respondents (58.7%) reported gender discrimination, 867 (67.5%) racial discrimination, 282 (85.2%) physical abuse, and 723 (69.1%) sexual harassment from patients and/or family members. Suicidal thoughts occurring during the past year were reported by 178 residents (2.5%), with similar prevalence by gender (108 men [2.4%]; 59 women [2.4%]) and race/ethnicity (113 non-Hispanic White residents [2.4%]; 65 residents from other racial/ethnic groups [2.7%]). CONCLUSIONS AND RELEVANCE In this survey study, EM residents reported that workplace mistreatment occurred frequently. The findings suggest common sources of mistreatment for which educational interventions may be developed to help ensure resident wellness and career satisfaction.
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Affiliation(s)
- Michelle D. Lall
- Department of Emergency Medicine, Emory University, Atlanta, Georgia
| | | | - Dave W. Lu
- Department of Emergency Medicine, University of Washington, Seattle
| | - Tiannan Zhan
- Department of Surgery, Northwestern University, Chicago, Illinois
| | | | - Yue-Yung Hu
- Department of Surgery, Northwestern University, Chicago, Illinois
| | | | - James G. Adams
- Department of Emergency Medicine, Northwestern University, Chicago, Illinois
| | - Lewis S. Nelson
- Department of Emergency Medicine, Rutgers University, New Brunswick, New Jersey
| | - Jill M. Baren
- Department of Emergency Medicine, University of Pennsylvania, Philadelphia
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Nam SH, Lee DW, Seo HY, Hong YC, Yun JY, Cho SJ, Lee N. Empathy With Patients and Post-Traumatic Stress Response in Verbally Abused Healthcare Workers. Psychiatry Investig 2021; 18:770-778. [PMID: 34404121 PMCID: PMC8390940 DOI: 10.30773/pi.2021.0066] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2021] [Revised: 05/05/2021] [Accepted: 06/07/2021] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVE The current study examined the differential empathic capacity, post-traumatic symptoms, and coping strategies in healthcare workers (HCWs) according to the exposure of verbal or physical workplace violence (WPV). METHODS Using online survey, a total of 422 HCWs employed at a training general hospital of South Korea participated and completed self-reporting questionnaires including the WPV questionnaire with coping strategy, the Jefferson Scale of Physician Empathy. RESULTS Those who experienced either only verbal violence or both physical and verbal violence had lower Jefferson Scale of Physician Empathy scores (p<0.05). Posttraumatic stress symptom severity was higher among people who experienced verbal violence than physical violence. HCWs' exposure to verbal violence was associated with severe posttraumatic symptoms and a low level of empathy with patients (p<0.05). More than half of the victims of verbal violence responded that they did not take any action, receive organizational protection, or peer support, while most physically-abused HCWs received institutional intervention or help from others. CONCLUSION Our findings highlight the critical importance of reducing verbal violence, which may represent a larger psychological burden compared to physical violence, by actively implementing effective strategies and policies at the institutional level.
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Affiliation(s)
- Soo-hyun Nam
- Human Rights Center, Seoul National University Hospital, Seoul, Republic of Korea
| | - Dong-Wook Lee
- Department of Preventive Medicine, College of Medicine, Seoul National University, Seoul, Republic of Korea
| | - Hwa-yeon Seo
- Public Health Medical Service, Seoul National University Hospital, Seoul, Republic of Korea
| | - Yun-Chul Hong
- Department of Preventive Medicine, College of Medicine, Seoul National University, Seoul, Republic of Korea
| | - Je-Yeon Yun
- Department of Psychiatry, Seoul National University Hospital, Seoul, Republic of Korea
| | - Sung-jun Cho
- Department of Psychiatry, Kangbuk Samsung Hospital, Seoul, Republic of Korea
| | - Nami Lee
- Human Rights Center, Seoul National University Hospital, Seoul, Republic of Korea
- Department of Psychiatry, Seoul National University Hospital, Seoul, Republic of Korea
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Aljohani B, Burkholder J, Tran QK, Chen C, Beisenova K, Pourmand A. Workplace violence in the emergency department: a systematic review and meta-analysis. Public Health 2021; 196:186-197. [PMID: 34246105 DOI: 10.1016/j.puhe.2021.02.009] [Citation(s) in RCA: 117] [Impact Index Per Article: 29.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Revised: 11/25/2020] [Accepted: 02/06/2021] [Indexed: 02/07/2023]
Abstract
OBJECTIVES Emergency departments (EDs) currently face a widely acknowledged issue of workplace violence (WPV) against healthcare workers (HCWs). WPV in the ED occurs in different forms and from different types of instigators; its prevalence also varies in different regions of the world. This study investigates the incidence of WPV among ED staff and identifies the types of instigators involved. STUDY DESIGN Systematic review and meta-analysis. METHODS Using PubMed and SCOPUS databases, a search for WPV against ED physicians and nurses was conducted, yielding 301 articles. Studies were excluded if measuring violence between HCWs or against prehospital personnel. Studies assessing WPV not in the ED, such as domestic violence that occurred before arrival to the ED, and studies investigating violence involving alcohol/drug use or individuals with a psychiatric diagnosis were also excluded. This study used a random-effects meta-analysis to examine the prevalence of WPV in the ED, including types of violence, instigators, and professions of the victims. RESULTS In total, 26 articles were selected for this study. There were 9072 cases of WPV in the ED; 6575 (72%) cases involved verbal violence and 1639 (18%) related to physical abuse. Among the ED workers involved, 2112 (36.5%) were physicians, 3225 (55.7%) were nurses and 455 (7.8%) other ED staff. There were 2578 instigators, of whom 1340 (52%) were family members, 700 (27%) were patients and 538 (21%) were other relatives/friends. The overall prevalence of verbal violence was 0.77 (95% confidence interval [CI]: 0.72-0.82, I2 = 87%), suggesting 77% of ED staff reported exposure to WPV. The prevalence of violence from patients as instigators was 0.24 (95% CI: 0.18-31, I2 = 93%). CONCLUSIONS WPV in the ED is a serious issue as most nurses and physicians are significantly exposed to verbal and/or physical abuse. Further studies should focus on factors influencing the different types of WPV, which ED professions are most at risk and interventions to prevent WPV in the ED.
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Affiliation(s)
- B Aljohani
- Department of Emergency Medicine, George Washington University School of Medicine and Health Sciences, Washington DC, USA; Department of Emergency Medicine, King Abdullah Medical City, Makkah, Saudi Arabia
| | - J Burkholder
- Department of Emergency Medicine, George Washington University School of Medicine and Health Sciences, Washington DC, USA
| | - Q K Tran
- Department of Emergency Medicine, University of Maryland School of Medicine, Baltimore, MD, USA; Program in Trauma, The R Adams Cowley Shock Trauma Center, University of Maryland School of Medicine, Baltimore, MD, USA
| | - C Chen
- Department of Epidemiology and Biostatistics, Milken Institute School of Public Health, George Washington University, Washington, DC, USA
| | - K Beisenova
- Department of Emergency Medicine, George Washington University School of Medicine and Health Sciences, Washington DC, USA
| | - A Pourmand
- Department of Emergency Medicine, George Washington University School of Medicine and Health Sciences, Washington DC, USA.
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Alharbi FF, Alzneidi NA, Aljbli GH, Morad SA, Alsubaie EG, Mahmoud MA, Al-Dubai SA, Nakshabandi FA, Bin Saleh S. Workplace Violence Among Healthcare Workers in a Tertiary Medical City in Riyadh: A Cross-Sectional Study. Cureus 2021; 13:e14836. [PMID: 34123608 PMCID: PMC8191849 DOI: 10.7759/cureus.14836] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Introduction Workplace violence is a common problem that is encountered by healthcare workers worldwide; however, it is still under-studied in Saudi Arabia. This study aims to determine the prevalence of workplace violence and to explore reasons for not reporting it among healthcare workers in a tertiary medical city in Riyadh. Methods This cross-sectional study was conducted among 404 healthcare workers who had direct contact with patients or their relatives in a tertiary care medical city in Riyadh, Saudi Arabia. Data were analyzed using Statistical Analysis Software Package (SPSS; IBM, Armonk, NY, USA). Results Most participants (81.4%) had experienced verbal, physical, academic, or sexual violence. Approximately 39.6% of those who experienced workplace violence did not report the incident, and the most common reason for not reporting was identified as “reporting would not accomplish anything” (49.4%). About 27.5% of violence victims did not know how to report the incidents. Patients or their relatives were the main sources of violence across all violence categories except academic violence, in which consultant physicians were the main source. Conclusions The prevalence of workplace violence in the population studied was higher than anticipated compared to similar studies both in Saudi Arabia and globally. Almost half of those who were subjected to violence did not report the incident, believing that reporting would not change anything. There is arguably an urgent need to develop strategies that reduce workplace violence and facilitate reporting it in hospitals. Moreover, awareness programs regarding the negative impacts of violence against healthcare workers on the quality of care are necessary.
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Affiliation(s)
- Fares F Alharbi
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, SAU.,Department of Mental Health, Ministry of the National Guard Health Affairs, Riyadh, SAU.,Department of Research Office, King Abdullah International Medical Research Center, Riyadh, SAU
| | - Nowar A Alzneidi
- Department of Family Medicine, King Khalid University Hospital, Riyadh, SAU
| | - Ghaida H Aljbli
- Department of Plastic Surgery, Ministry of the National Guard Health Affairs, Riyadh, SAU
| | - Sarah A Morad
- Department of Pediatrics, King Fahad Medical City, Riyadh, SAU
| | - Ettab G Alsubaie
- Department of Mental Health, Ministry of the National Guard Health Affairs, Riyadh, SAU.,Department of Research Office, King Abdullah International Medical Research Center, Riyadh, SAU
| | - Mahmoud A Mahmoud
- Department of Public Health, Imam Muhammad Ibn Saud Islamic University, Riyadh, SAU
| | - Sami A Al-Dubai
- Joint Program of Preventive Medicine Post Graduate Studies, Saudi Ministry of Health, Medina, SAU
| | - Firas A Nakshabandi
- Department of Psychiatry and Behavioral Neuroscience, The University of Chicago, Chicago, USA.,Mental Health Department, Empathic Resonance, LLC, Chicago, USA
| | - Saleh Bin Saleh
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, SAU.,Department of Medicine, Ministry of the National Guard Health Affairs, Riyadh, SAU.,Department of Research Office, King Abdullah International Medical Research Center, Riyadh, SAU
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Brunero S, Lamont S, Dunn S, Varndell W, Dickens GL. Examining the utility of the Violence Prevention Climate scale: In a metropolitan Australian general hospital. J Clin Nurs 2021; 30:2399-2408. [PMID: 33872428 DOI: 10.1111/jocn.15780] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2020] [Revised: 02/16/2021] [Accepted: 03/18/2021] [Indexed: 12/22/2022]
Abstract
AIM AND OBJECTIVES To evaluate and examine the utility of the Violence Prevention Climate scale by generalist healthcare professionals. BACKGROUND Workplace violence in general hospital settings remains a challenge for healthcare organisations. High rates of violence are still being reported towards healthcare workers, despite organisational violence prevention strategies being implemented. There is a major challenge to healthcare organisation in the measurement of the effectiveness of these interventions, traditionally completed via the reporting and monitoring of workplace violent incidents. A novel approach to measuring workplace violence is by studying hospital atmosphere or climate. DESIGN A cross-sectional survey using the STARD guidelines was used. METHODS The Violence Prevention Climate scale was completed by 194 healthcare staff working in the emergency department, medical/surgical wards, respiratory/infectious disease, spinal care, renal unit, corrections health, and rehabilitation and community services of a major Australian tertiary referral hospital. The Violence Prevention Climate scale has previously been validated and used in mental health settings, but not general hospital settings. A content analysis of an open-ended question on violence prevention management strategies was also conducted. RESULTS Comprising of 14 items with two factors (patients and staff), the study revealed a 9-item staff factor scale that can be used in the general hospital setting, the patient factor did not show adequate reliability. The content analysis revealed seven categories of staff identified violence prevention and management strategies. CONCLUSIONS The use of the 9-item scale across an organisation annually, or added to existing organisational workforce surveys, could prove to be practical way of measuring the social climate of violence in a general hospital setting. RELEVANCE TO CLINICAL PRACTICE The results of which could guide clinical practice, workplace safety, policy and educational initiatives for the prevention and management of workplace violence.
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Affiliation(s)
- Scott Brunero
- Prince of Wales Hospital, Randwick, New South Wales, Australia.,Western Sydney University, Penrith, New South Wales, Australia.,Southern Cross University, East Lismore, New South Wales, Australia
| | - Scott Lamont
- Prince of Wales Hospital, Randwick, New South Wales, Australia.,Southern Cross University, East Lismore, New South Wales, Australia
| | - Sarah Dunn
- CNC Respiratory, Prince of Wales Hospital, Randwick, New South Wales, Australia
| | - Wayne Varndell
- Emergency Department, Prince of Wales Hospital, Randwick, New South Wales, Australia.,School of Nursing and Midwifery, University of Technology Sydney, Ultimo, New South Wales, Australia
| | - Geoffrey L Dickens
- Department of Nursing, Midwifery and Health, Northumbria University, Newcastle-Upon-Tyne, UK
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Chang YC, Xiao X, Nkambule N, Ngerng RYL, Bullock A, Monrouxe LV. Exploring emergency physicians' professional identities: a Q-method study. ADVANCES IN HEALTH SCIENCES EDUCATION : THEORY AND PRACTICE 2021; 26:117-138. [PMID: 32383067 PMCID: PMC7900058 DOI: 10.1007/s10459-020-09973-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Accepted: 04/27/2020] [Indexed: 06/01/2023]
Abstract
Professional identities research in medical education has made significant contributions to the field. However, what comprises professional identities is rarely interrogated. This research tackles this relatively understudied component of professional identities research by understanding emergency medicine physicians' perspectives on the important elements that comprise their professional identities. Q-methodology was used to identify different clusters of viewpoints on professional identities; by extension, the core components that comprise emergency medicine physicians' professional identities are disclosed. Thirty-three emergency medicine physicians were recruited, through purposive sampling, from five hospitals across Taiwan. R software was used to analyse the Q-sorts, determine loadings on each viewpoint and formulate the viewpoint array. Analysis of interview data enhanced our understanding of these viewpoints. In total, twenty-five emergency medicine physicians loaded onto four distinct viewpoints, reflecting dominant perspectives of emergency medicine physicians' understanding of their professional identities. These distinct viewpoints demonstrated what emergency medicine physicians deemed significant in how they understood themselves. The viewpoints comprised: skills acquisition, capabilities and practical wisdom; coping ability and resilience; professional recognition and self-esteem; and wellbeing and quality of life. All viewpoints stressed the importance of trust between colleagues. These findings demonstrate the multitude of ways in which seemingly unified professional identities diverge across groups of individuals. An enhanced understanding of speciality work culture is gained. By understanding facets of professional identities, the development of future educational interventions and departmental initiatives, which might support key components of professional identities, can be explored.
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Affiliation(s)
- Yu-Che Chang
- Chang Gung Medical Education Research Centre (CGMERC), Chang Gung Memorial Hospital, Linkou, Taiwan (R.O.C.)
- Department of Emergency Medicine, Chang Gung Memorial Hospital, Linkou, Taiwan (R.O.C.)
- Chang Gung University College of Medicine, Taoyuan, Taiwan (R.O.C.)
| | - Xaviera Xiao
- Chang Gung Medical Education Research Centre (CGMERC), Chang Gung Memorial Hospital, Linkou, Taiwan (R.O.C.)
| | - Nothando Nkambule
- Chang Gung Medical Education Research Centre (CGMERC), Chang Gung Memorial Hospital, Linkou, Taiwan (R.O.C.)
| | - Roy Y L Ngerng
- Risk Society and Policy Research Center, National Taiwan University, Taipei, Taiwan (R.O.C.)
| | - Alison Bullock
- Cardiff Unit for Research and Evaluation in Medical and Dental Education (CUREMeDE), School of Social Sciences, Cardiff University, Cardiff, Wales, UK
| | - Lynn V Monrouxe
- The Faculty of Medicine and Health, School of Health Sciences, The University of Sydney, Sydney, NSW, Australia.
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Converso D, Sottimano I, Balducci C. Violence exposure and burnout in healthcare sector: mediating role of work ability. LA MEDICINA DEL LAVORO 2021; 112:58-67. [PMID: 33635295 PMCID: PMC8023052 DOI: 10.23749/mdl.v112i1.9906] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Accepted: 09/25/2020] [Indexed: 11/17/2022]
Abstract
BACKGROUND One of the most difficult problems faced by health care professionals is experiencing verbal and physical abuse from patients and their family members. Some studies have shown that health care workers, especially nurses, are up to 16 times more likely to be subject to violence than other workers. AIMS The aim of this study was to analyze the relationship between exposure to violence, work ability and burnout. METHODS Data were collected through a questionnaire to investigate health care workers' exposure to violence (Violent Incident Form), burnout (Maslach Burnout Inventory) and work ability (Work Ability Index). A sample of 300 nurses was obtained for the study. RESULTS A total of 36% of nurses indicated that they had been a victim of violence in the past 12 months. The data analysis highlighted highly significant differences in work ability, emotional exhaustion and depersonalization between health care workers who had been victims of violence and those who had not experienced violence. Finally, work ability was shown to have a mediating effect on emotional exhaustion (indirect effect: b = 2.7, BCa CI: 1.37-4.33) and depersonalization (indirect effect: b = 1.1, BCa CI: 0.48-1.87). DISCUSSION This study is one of the first to consider the mediation effect of work ability between workplace violence experienced and burnout in the healthcare sector; it reports the complexity and severity of the consequences of workplace violence in this sector.
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Khan MN, Haq ZU, Khan M, Wali S, Baddia F, Rasul S, Khan S, Polkowski M, Ramirez-Mendoza JY. Prevalence and determinants of violence against health care in the metropolitan city of Peshawar: a cross sectional study. BMC Public Health 2021; 21:330. [PMID: 33568108 PMCID: PMC7877048 DOI: 10.1186/s12889-021-10243-8] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Accepted: 01/14/2021] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND Violence against healthcare personnel is a major public health problem. Healthcare personnel are at the frontline dealing with people in stressful and unpredictable situations. Therefore, this study was conducted to determine the prevalence and associated factors of violence against health care personnel. METHODS A cross sectional study was conducted in the district Peshawar. Healthcare personnel from public and private sectors working in both the primary and tertiary levels of healthcare were invited to participate. Violence was assessed through a structured questionnaire previously used in Pakistan and was defined as experiencing and/or witnessing any form of violence in the last 12 months. Mental health was assessed through the General Health Questionnaire. Logistic regression was used to estimate the association of violence against healthcare personnel with psychological distress and demographic characteristics. Data entry and analysis were conducted in STATA 14. RESULTS A total of 842 healthcare personnel participated in the study. The prevalence of violence experienced and/or witnessed by healthcare personnel in Peshawar was 51%. Verbal violence remained the predominant form of violence and almost half of the healthcare personnel (45%) were exposed to it. A quarter of the respondents (24%) reported physical violence alone or in combination with other forms of violence. In almost two third of the incidents the perpetrators were either attendants, relatives or the patients. The emergency unit and wards within healthcare facilities were the most common places where violent events took place. The major factors responsible for the violent incidents were communication failure, unreasonable expectations and perceived substandard care. No uniform policy/procedure existed to manage the incidents and the healthcare personnel adopted different responses in the wake of violent events targeting health care. Working in public healthcare facilities and having a larger number of co-workers/colleagues significantly increased the risk of violence in the healthcare settings while being a paramedic significantly reduced the risk as compared to physicians. CONCLUSIONS Violence against healthcare personnel is a serious public health issue and the prevalence is quite high. A holistic effort is needed by all stakeholders including healthcare community, the administration, lawmakers, law enforcement, civil society, and international organizations.
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Affiliation(s)
- Muhammad Naseem Khan
- Khyber Medical University, Institute of Public Health & Social Sciences (IPH&SS), Phase V, Hayatabad, Peshawar, Pakistan
- Department of Psychological Medicine, University of Liverpool, Liverpool, UK
| | - Zia Ul Haq
- Khyber Medical University, Institute of Public Health & Social Sciences (IPH&SS), Phase V, Hayatabad, Peshawar, Pakistan
| | - Mirwais Khan
- International Committee of the Red Cross, Geneva, Switzerland
| | - Sadia Wali
- Khyber Medical University, Institute of Public Health & Social Sciences (IPH&SS), Phase V, Hayatabad, Peshawar, Pakistan
| | - Faryal Baddia
- International Committee of the Red Cross, Geneva, Switzerland
| | - Shaista Rasul
- Khyber Medical University, Institute of Public Health & Social Sciences (IPH&SS), Phase V, Hayatabad, Peshawar, Pakistan
| | - Salman Khan
- International Committee of the Red Cross, Geneva, Switzerland
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