Workplace Violence in Healthcare Settings: Work-Related Predictors of Violence Behaviours
Abstract
:1. Introduction
2. Materials and Methods
2.1. Participants
2.2. Measures
2.2.1. Demographics
2.2.2. Aggression and Violence at Work
2.2.3. Psychosocial Risk Factors
2.3. Procedures
2.4. Data Analysis
3. Results
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
- Liu, J.; Gan, Y.; Jiang, H.; Li, L.; Dwyer, R.; Lu, K.; Yan, S.; Sampson, O.; Xu, H.; Wang, C.; et al. Prevalence of workplace violence against healthcare workers: A systematic review and meta-analysis. Occup. Environ. Med. 2019, 76, 927–937. [Google Scholar] [CrossRef] [Green Version]
- Mento, C.; Silvestri, M.; Bruno, A.; Muscatello, M.; Cedro, C.; Pandolfo, G.; Zoccali, R. Workplace violence against healthcare professionals: A systematic review. Aggress. Violent Behav. 2020, 51, 1359–1789. [Google Scholar] [CrossRef]
- Antão, H.; Sacadura-Leite, E.; Manzano, M.; Pinote, S.; Relvas, R.; Serranheira, F.; Sousa-Uva, A. Workplace Violence in Healthcare: A Single-Center Study on Causes, Consequences and Prevention Strategies. Acta Med. Port. 2020, 33, 31–37. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Tian, Y.; Yue, Y.; Wang, J.; Luo, T.; Li, Y.; Zhou, J. Workplace violence against hospital healthcare workers in China: A national WeChat-based survey. BMC Public Health 2020, 20, 582. [Google Scholar] [CrossRef] [PubMed]
- Vento, S.; Cainelli, F.; Vallone, A. Violence Against Healthcare Workers: A Worldwide Phenomenon with Serious Consequences. Public Health Front. 2020, 8, 570459. [Google Scholar] [CrossRef] [PubMed]
- Civilotti, C.; Berlanda, S.; Iozzino, L. Hospital-Based Healthcare Workers Victims of Workplace Violence in Italy: A Scoping Review. Int. J. Env. Res. Public Health 2021, 29, 5860. [Google Scholar] [CrossRef]
- Lanctôt, N.; Guay, S. The aftermath of workplace violence among healthcare workers: A systematic literature review of the consequences. Aggress. Violent Behav. 2014, 19, 492–501. [Google Scholar] [CrossRef]
- Watson, A.; Jafari, M.; Seifi, A. The persistent pandemic of violence against health care workers. Am. J. Manag. Care 2020, 26, e377–e379. [Google Scholar] [CrossRef]
- Dahlberg, L.; Krug, E. Violence a global public health problem. Ciênc. Saúde Colet. 2006, 11, 277–292. [Google Scholar] [CrossRef] [Green Version]
- Krug, E.; Mercy, J.; Dahlberg, L.; Zwi, A. The world report on violence and health. Lancet 2002, 360, 1083–1088. [Google Scholar] [CrossRef] [Green Version]
- Mitton, K. Public health and violence. Crit. Public Health 2019, 29, 135–137. [Google Scholar] [CrossRef] [Green Version]
- Kapadia, F. Violence and the COVID-19 pandemic: A public health of consequence. Am. J. Public Health 2022, 112, 706–708. [Google Scholar] [CrossRef]
- Lim, M.; Jeffree, M.; Saupin, S.; Giloi, N.; Lukman, K. Workplace violence in healthcare settings: The risk factors, implications and collaborative preventive measures. Ann. Med. Surg. 2022, 78, 103727. [Google Scholar] [CrossRef]
- Dupré, K.; Dawe, K.; Barling, J. Harm to Those Who Serve: Effects of Direct and Vicarious Customer-Initiated Workplace Aggression. J. Interpers. Violence 2014, 29, 2355–2377. [Google Scholar] [CrossRef]
- Lu, L.; Dong, M.; Wang, S.; Zhang, L.; Ng, C.; Ungvari, G.; Li, J.; Xiang, Y. Prevalence of Workplace Violence Against Health-Care Professionals in China: A Comprehensive Meta-Analysis of Observational Surveys. Trauma Violence Abus. 2020, 21, 498–509. [Google Scholar] [CrossRef]
- National Institute for Occupational Safety and Health. Violence: Occupational Hazards in Hospitals. 2002. Available online: http://www.cdc.gov/niosh/docs/2002-101/ (accessed on 11 February 2022).
- Occupational Safety and Health Administration (OSHA). Guidelines for Preventing Workplace Violence for Healthcare and Social Service Workers. 2016. Available online: https://www.osha.gov/Publications/osha3148.pdf (accessed on 11 February 2022).
- Occupational Safety and Health Administration (OSHA). Workplace Violence in Healthcare: Understanding the Challenge. 2015. Available online: https://www.osha.gov/sites/default/files/OSHA3826.pdf (accessed on 4 March 2022).
- Baig, L.; Ali, S.; Shaikh, S.; Polkowski, M. Multiple dimensions of violence against healthcare providers in Karachi: Results from a multicenter study from Karachi. J. Pak. Med. Assoc. 2018, 68, 1157–1165. [Google Scholar]
- Einarsen, S.; Nielsen, M. Workplace bullying as an antecedent of mental health problems: A five-year prospective and representative study. Int. Arch. Occup. Environ. Health 2015, 88, 131–142. [Google Scholar] [CrossRef]
- Dadfar, M.; Lester, D. Workplace violence (WPV) in healthcare systems. Nurs. Open 2021, 8, 527–528. [Google Scholar] [CrossRef]
- Bartlett, J.; Bartlett, M. Workplace Bullying: An Integrative Literature Review. Adv. Dev. Hum. Resour. 2011, 13, 69–84. [Google Scholar] [CrossRef]
- Ferri, P.; Silvestri, M.; Artoni, C.; Di Lorenzo, R. Workplace violence in different settings and among various health professionals in an Italian general hospital: A cross-sectional study. Psychol. Res. Behav. Manag. 2016, 23, 263–275. [Google Scholar] [CrossRef] [Green Version]
- Giménez-Lozano, J.; Martínez-Ramón, J.; Morales-Rodríguez, F. Doctors and Nurses: A Systematic Review of the Risk and Protective Factors in Workplace Violence and Burnout. Int. J. Environ. Res. Public Health 2021, 22, 3280. [Google Scholar] [CrossRef] [PubMed]
- Norton, P.; Costa, V.; Teixeira, J.; Azevedo, A.; Roma-Torres, A.; Amaro, J.; Cunha, L. Prevalence and Determinants of Bullying Among Health Care Workers in Portugal. Workplace Health Saf. 2017, 65, 188–196. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Otachi, J.; Robertson, H.; Okoli, C. Factors associated with workplace violence among healthcare workers in an academic medical center. Perspect Psychiatr. Care 2022, 6, 1–11. [Google Scholar] [CrossRef] [PubMed]
- U.S Bureau of Labour Statistics (USBLS). Workplace Violence in Healthcare. 2018. Available online: https://www.bls.gov/iif/oshwc/cfoi/workplace-violence-healthcare-2018.htm (accessed on 4 March 2022).
- Baylina, P.; Barros, C.; Fonte, C.; Alves, S.; Rocha, A. Healthcare Workers: Occupational Health Promotion and Patient Safety. J. Med. Syst. 2018, 42, 159. [Google Scholar] [CrossRef] [Green Version]
- Feijó, F.; Gräf, D.; Pearce, N.; Fassa, A. Risk Factors for Workplace Bullying: A Systematic Review. Int. J. Environ. Res. Public Health 2019, 31, 1945. [Google Scholar] [CrossRef] [Green Version]
- Rogers, K.; Kelloway, E. Violence at work: Personal and organizational outcomes. J. Occup. Health Psychol. 1997, 2, 63–71. [Google Scholar] [CrossRef]
- Schat, A.; Kelloway, E. Workplace aggression. In Handbook of Work Stress; Sage Publications: Toronto, Canada, 2005; pp. 189–218. [Google Scholar]
- Berlanda, S.; Pedrazza, M.; Fraizzoli, M.; Cordova, F. Addressing Risks of Violence against Healthcare Staff in Emergency Departments: The Effects of Job Satisfaction and Attachment Style. Biomed. Res. Int. 2019, 5430870. [Google Scholar] [CrossRef]
- Gillespie, G.; Gates, D.; Miller, M.; Howard, P. Workplace violence in healthcare settings: Risk factors and protective strategies. Rehabil. Nurs. 2010, 35, 177–184. [Google Scholar] [CrossRef]
- Hahn, S.; Müller, M.; Hantikainen, V.; Kok, G.; Dassen, T.; Halfens, R. Risk factors associated with patient and visitor violence in general hospitals: Results of a multiple regression analysis. Int. J. Nurs. Stud. 2013, 50, 374–385. [Google Scholar] [CrossRef]
- LeBlanc, M.; Kelloway, E.K. Predictors and outcomes of workplace violence and aggression. J. Appl. Psychol. 2002, 87, 444–453. [Google Scholar] [CrossRef] [Green Version]
- Ferrinho, P.; Biscaia, A.; Fronteira, I.; Craveiro, I.; Antunes, A.; Conceição, C.; Flores, I.; Santos, O. Patterns of perceptions of workplace violence in the portuguese health care sector. Hum. Resour. Health 2003, 1, 11. [Google Scholar] [CrossRef] [Green Version]
- Loeppke, R.; Boldrighini, J.; Bowe, J.; Braun, B.; Eggins, E.; Eisenberg, B.; Grundy, P.; Hohn, T.; Hudson, T.; Kannas, W.J.; et al. Interaction of Health Care Worker Health and Safety and Patient Health and Safety in the US Health Care System: Recommendations From the 2016 Summit. Occup. Environ. Med. 2017, 59, 803–813. [Google Scholar] [CrossRef]
- Marques, D.; Silva, I.S. Violência no trabalho: Um estudo com enfermeiros/as em hospitais portugueses. Rev. Psicol. Organ. E Trab. 2017, 17, 226–234. [Google Scholar] [CrossRef]
- Barros, C.; Cunha, L.; Oliveira, A.; Baylina, P.; Rocha, A. Development and Validation of a Health and Work Survey Based on the Rasch Model among Portuguese Workers. J. Med. Syst. 2017, 41, 79. [Google Scholar] [CrossRef]
- Barros, C.; Fonte, C.; Alves, S.; Baylina, P. Can psychosocial work factors influence psychologists’ positive mental health? Occup. Med. 2019, 69, 204–210. [Google Scholar] [CrossRef]
- Correia, J.; Barros, C.; Baylina, P. The influence of psychosocial risk factors on the development of musculoskeletal disorders. Psicol. Saúde Doenças 2021, 22, 530–536. [Google Scholar] [CrossRef]
- Havaei, F. Does the Type of Exposure to Workplace Violence Matter to Nurses’ Mental Health? Healthcare 2021, 9, 41. [Google Scholar] [CrossRef]
- Schat, A.; Kelloway, E. Reducing the adverse consequences of workplace aggression and violence: The buffering effects of organizational support. J. Occup. Health Psychol. 2003, 8, 110–122. [Google Scholar] [CrossRef]
- Brown, V.; Loh, J.; Marsh, N. Moderators of Workplace Aggression: The Influences of Social Support and Training. Australas. J. Organ. Psychol. 2012, 5, 32–42. [Google Scholar] [CrossRef] [Green Version]
- World Health Organization (WHO). Preventing Violence Against Health Workers. 2022. Available online: https://www.who.int/activities/preventing-violence-against-health-workers (accessed on 18 April 2022).
High Demands and Work Intensity | % Yes |
---|---|
Intense work pace | 93.8 |
Depend on colleagues to do my work | 80.1 |
Depend on direct clients’ requests | 84.8 |
Have to deal with contradictory instructions | 78.6 |
Exposed to frequent interruptions | 81.9 |
Exposed to hyper-solicitation | 83.7 |
Working Hours | % Yes |
Having to go beyond normal working hours | 85.1 |
Having to sleep at unusual hours because of work | 60.9 |
Have to “skip” or shorten a meal or not have a break | 83.7 |
Have to maintain permanent availability | 61.6 |
Lack of Autonomy | % Yes |
Have no freedom to decide how to do my work | 55.1 |
Restricted schedule without any possibility of change | 42.4 |
Restricted work break without any choice | 48.9 |
Not be able to participate in decisions concerning my work | 59.4 |
Work Relationships | % Yes |
Needing help from colleagues and not having it | 43.8 |
Not having the possibility to exchange experiences with colleagues | 33.3 |
My opinion being disregarded for the service’s functioning | 44.6 |
Not having recognition by colleagues | 42.0 |
Not having anyone I can trust | 30.1 |
Don’t feel comfortable in my workspace | 42.8 |
Impossible to express myself | 39.5 |
Employment Relations | % Yes |
Lack of means to carry out my work | 65.6 |
In general, I feel exploited | 61.6 |
There are employment conditions that shake my dignity | 47.5 |
Emotional Demands | % Yes |
Have to deal with situations of tension with the public | 91.3 |
Being exposed to the suffering of the others | 93.1 |
Have to simulate good mood and/or empathy | 80.8 |
Have to hide emotions | 74.6 |
Ethical and Value Conflicts | % Yes |
Have to do things I disapprove | 54.7 |
My professional conscience is shaken | 46.4 |
The things I do are considered unimportant | 48.6 |
Lack the means to do the job well done | 64.1 |
Violence Dimensions | M (SD) | Min.–Max. |
---|---|---|
Physical violence | 1.26 (0.98) | 0–3 |
Psychological violence | 1.54 (1.06) | 0–3 |
Vicarious violence | 0.52 (0.59) | 0–3 |
Psychosocial Risk Factors | Violence Dimensions | |||||
---|---|---|---|---|---|---|
Physical | Phychological | Vicarious | ||||
R | p | R | p | R | p | |
High Demands and Work Intensity | ||||||
Intense work pace | 0.166 | 0.006 | 0.270 | <0.001 | 0.251 | <0.001 |
Depend on colleagues to do my work | 0.194 | 0.001 | 0.197 | <0.001 | 0.149 | 0.013 |
Have to deal with contradictory instructions | 0.265 | <0.001 | 0.358 | <0.001 | 0.256 | <0.001 |
Exposed to frequent interruptions | 0.281 | <0.001 | 0.408 | <0.001 | 0.311 | <0.001 |
Exposed to hyper-solicitation | 0.246 | <0.001 | 0.243 | <0.001 | 0.175 | 0.004 |
Working Hours | ||||||
Having to go beyond normal working hours | 0.109 | 0.071 | 0.129 | 0.033 | 0.156 | 0.009 |
Having to sleep at unusual hours because of work | 0.338 | <0.001 | 0.357 | <0.001 | 0.372 | <0.001 |
Have to “skip” or shorten a meal or not have a break | 0.195 | 0.001 | 0.200 | <0.001 | 0.211 | <0.001 |
Have to maintain permanent availability | 0.246 | <0.001 | 0.184 | 0.002 | 0.187 | 0.002 |
Lack of Autonomy | ||||||
Have no freedom to decide how to do my work | 0.299 | <0.001 | 0.291 | <0.001 | 0.286 | <0.001 |
Restricted schedule without any possibility of change | 0.312 | <0.001 | 0.213 | <0.001 | 0.217 | <0.001 |
Restricted work break without any choice | 0.274 | <0.001 | 0.264 | <0.001 | 0.228 | <0.001 |
Not be able to participate in decisions concerning my work | 0.310 | <0.001 | 0.352 | <0.001 | 0.271 | <0.001 |
Work Relationships | ||||||
Needing help from colleagues and not having it | 0.371 | <0.001 | 0.317 | <0.001 | 0.227 | <0.001 |
Not having the possibility to exchange experiences with colleagues | 0.302 | <0.001 | 0.187 | 0.002 | 0.112 | 0.042 |
My opinion being disregarded for the service’s functioning | 0.315 | <0.001 | 0.318 | <0.001 | 0.229 | <0.001 |
Not having recognition by colleagues | 0.184 | 0.002 | 0.153 | 0.011 | 0.105 | 0.044 |
Not having anyone I can trust | 0.227 | <0.001 | 0.199 | <0.001 | 0.136 | 0.030 |
Don’t feel comfortable in my workspace | 0.280 | <0.001 | 0.258 | <0.001 | 0.161 | 0.008 |
Impossible to express myself | 0.247 | <0.001 | 0.248 | <0.001 | 0.126 | 0.038 |
Employment Relations | ||||||
Lack of means to carry out my work | 0.273 | <0.001 | 0.381 | <0.001 | 0.346 | <0.001 |
In general, I feel exploited | 0.273 | <0.001 | 0.381 | <0.001 | 0.346 | <0.001 |
There are employment conditions that shake my dignity | 0.364 | <0.001 | 0.360 | <0.001 | 0.328 | <0.001 |
Emotional Demands | ||||||
Being exposed to the suffering of the others | 0.134 | 0.035 | 0.289 | <0.001 | 0.187 | 0.002 |
Have to simulate good mood and/or empathy | 0.241 | <0.001 | 0.344 | <0.001 | 0.270 | <0.001 |
Have to hide emotions | 0.268 | <0.001 | 0.345 | <0.001 | 0.271 | <0.001 |
Ethical and Value Conflicts | ||||||
Have to do things I disapprove | 0.210 | <0.001 | 0.318 | <0.001 | 0.236 | <0.001 |
My professional conscience is shaken | 0.278 | <0.001 | 0.364 | <0.001 | 0.306 | <0.001 |
The things I do are considered unimportant | 0.253 | <0.001 | 0.330 | <0.001 | 0.219 | <0.001 |
Lack the means to do the job well done | 0.275 | <0.001 | 0.357 | <0.001 | 0.315 | <0.001 |
Psychosocial Risk Factors vs. Violence Dimensions | Unstandardised Coefficients | Standardised Coefficients | t Value | p | 95.0% Confidence Interval for β | ||
---|---|---|---|---|---|---|---|
β | Std. Error | Beta | Lower Bound | Upper Bound | |||
Physical | |||||||
Having to sleep at unusual hours because of work | 0.189 | 0.087 | 0.155 | 2.182 | 0.030 | 0.018 | 0.360 |
Needing help from colleagues and not having it | 0.219 | 0.093 | 0.183 | 2.345 | 0.020 | 0.035 | 0.403 |
There are employment conditions that shake my dignity | 0.171 | 0.096 | 0.144 | 1.785 | 0.046 | −0.018 | 0.359 |
Psychological | |||||||
Exposed to frequent interruptions | 0.599 | 0.196 | 0.218 | 3.053 | 0.003 | 0.213 | 0.986 |
Having to sleep at unusual hours because of work | 0.415 | 0.145 | 0.191 | 2.868 | 0.004 | 0.130 | 0.700 |
Needing help from colleagues and not having it | 0.334 | 0.156 | 0.156 | 2.141 | 0.033 | 0.027 | 0.641 |
Vicarious | |||||||
Having to sleep at unusual hours because of work | 0.450 | 0.139 | 0.224 | 3.232 | 0.001 | 0.176 | 0.725 |
Needing help from colleagues and not having it | 0.255 | 0.150 | 0.129 | 1.697 | 0.048 | −0.041 | 0.551 |
Lack of means to carry out my work | 0.343 | 0.166 | 0.166 | 2.068 | 0.040 | 0.016 | 0.669 |
There are employment conditions that shake my dignity | 0.318 | 0.154 | 0.162 | 2.067 | 0.040 | 0.015 | 0.621 |
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Barros, C.; Meneses, R.F.; Sani, A.; Baylina, P. Workplace Violence in Healthcare Settings: Work-Related Predictors of Violence Behaviours. Psych 2022, 4, 516-524. https://doi.org/10.3390/psych4030039
Barros C, Meneses RF, Sani A, Baylina P. Workplace Violence in Healthcare Settings: Work-Related Predictors of Violence Behaviours. Psych. 2022; 4(3):516-524. https://doi.org/10.3390/psych4030039
Chicago/Turabian StyleBarros, Carla, Rute F. Meneses, Ana Sani, and Pilar Baylina. 2022. "Workplace Violence in Healthcare Settings: Work-Related Predictors of Violence Behaviours" Psych 4, no. 3: 516-524. https://doi.org/10.3390/psych4030039