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Int. J. Environ. Res. Public Health 2017, 14(10), 1245; doi:10.3390/ijerph14101245

Patient Aggression and the Wellbeing of Nurses: A Cross-Sectional Survey Study in Psychiatric and Non-Psychiatric Settings

1
Department of Nursing Science, University of Turku, 20520 Turku, Finland
2
Finnish Institute of Occupational Health, 00250 Helsinki, Finland
3
Department of Epidemiology and Public Health, University College London, London WC1E 7HB, UK
4
Clinicum, Faculty of Medicine, University of Helsinki, 00290 Helsinki, Finland
5
Department of Public Health, University of Turku, 20520 Turku, Finland
6
Turku University Hospital, 20521 Turku, Finland
7
School of Nursing, Hong Kong Polytechnic University, Hong Kong, China
*
Author to whom correspondence should be addressed.
Received: 4 September 2017 / Revised: 6 October 2017 / Accepted: 14 October 2017 / Published: 18 October 2017
(This article belongs to the Section Occupational Safety and Health)
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Abstract

Wellbeing of nurses is associated with patient aggression. Little is known about the differences in these associations between nurses working in different specialties. We aimed to estimate and compare the prevalence of patient aggression and the associations between patient aggression and the wellbeing of nurses in psychiatric and non-psychiatric specialties (medical and surgical, and emergency medicine). A sample of 5288 nurses (923 psychiatric nurses, 4070 medical and surgical nurses, 295 emergency nurses) participated in the study. Subjective measures were used to assess both the occurrence of patient aggression and the wellbeing of nurses (self-rated health, sleep disturbances, psychological distress and perceived work ability). Binary logistic regression with interaction terms was used to compare the associations between patient aggression and the wellbeing of nurses. Psychiatric nurses reported all types of patient aggression more frequently than medical and surgical nurses, whereas nurses working in emergency settings reported physical violence and verbal aggression more frequently than psychiatric nurses. Psychiatric nurses reported poor self-rated health and reduced work ability more frequently than both of the non-psychiatric nursing groups, whereas medical and surgical nurses reported psychological distress and sleep disturbances more often. Psychiatric nurses who had experienced at least one type of patient aggression or mental abuse in the previous year, were less likely to suffer from psychological distress and sleep disturbances compared to medical and surgical nurses. Psychiatric nurses who had experienced physical assaults and armed threats were less likely to suffer from sleep disturbances compared to nurses working in emergency settings. Compared to medical and surgical nurses, psychiatric nurses face patient aggression more often, but certain types of aggression are more common in emergency settings. Psychiatric nurses have worse subjective health and work ability than both of the non-psychiatric nursing groups, while their psychiatric wellbeing is better and they have less sleep problems compared to medical and surgical nurses. Psychiatric nurses maintain better psychiatric wellbeing and experience fewer sleep problems than non-psychiatric nurses after events of exposure to patient aggression. This suggest that more attention should be given to non-psychiatric settings for maintaining the wellbeing of nurses after exposure to patient aggression. View Full-Text
Keywords: psychiatric nurses; non-psychiatric nurses; occupational health; psychological distress; self-rated health; sleep disturbance; work ability; patient aggression psychiatric nurses; non-psychiatric nurses; occupational health; psychological distress; self-rated health; sleep disturbance; work ability; patient aggression
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. (CC BY 4.0).

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MDPI and ACS Style

Pekurinen, V.; Willman, L.; Virtanen, M.; Kivimäki, M.; Vahtera, J.; Välimäki, M. Patient Aggression and the Wellbeing of Nurses: A Cross-Sectional Survey Study in Psychiatric and Non-Psychiatric Settings. Int. J. Environ. Res. Public Health 2017, 14, 1245.

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