Characteristics of aggressive incidents in emergency primary health care described by the Staff\xa0Observation Aggression Scale \u2013 Revised Emergency (SOAS-RE)

Grethe E Johnsen,Knut Rypdal,Ingrid Hjulstad Johansen,Tom Palmstierna,Valborg Baste,Tone Morken

doi:10.1186/s12913-019-4856-9

Abstract

BackgroundWorkplace violence in emergency primary health care is prevalent, but longitudinal studies using validated assessment scales to describe the characteristics of workplace violence in these settings are lacking. The aim of the present study was to determine the characteristics of aggressive incidents in emergency primary health care clinics in Norway.MethodsIncidents of workplace violence were reported with the Staff Observation Aggression Scale – Revised Emergency (SOAS-RE). The study was conducted in ten emergency primary health care clinics over a period of one year.ResultsA total of 320 aggressive incidents were registered. The mean overall SOAS-RE score for reported aggressive incidents was 9.7 on a scale from 0 to 22, and 60% of the incidents were considered severe. Incidents of verbal aggression accounted for 31.6% of all reported incidents, threats accounted for 24.7%, and physical aggression accounted for 43.7%. Verbal aggression was most often provoked by long waiting time. Physical aggression was most often provoked when the patient had to go through an involuntary assessment of health condition. Almost one third of the aggressors were females, and nurses were the most frequent targets of all aggression types. No differences in psychological stress were found between types of aggression.ConclusionsThis study shows that workplace violence in emergency primary health care clinics is a severe problem. Patterns in provocation and consequences of aggressive incidents can be used to improve our understanding of and prevention and follow-up procedures of such incidents.

Highlights

Workplace violence in emergency primary health care is prevalent, but longitudinal studies using validated assessment scales to describe the characteristics of workplace violence in these settings are lacking
The six columns are recorded as follows: 1) The provocation that lead to the aggressive incident, e.g. “the patient had to wait”; 2) The means used by the patient during the incident, e.g. “verbal aggression” or “hand”; 3) The target of the aggression, e.g. “objects” or “patients”; 4) The consequences for victims, e.g. “pain” or “needed treatment by a physician”; 5) The measures taken to stop or control the aggressive behaviour, e.g. “talking to the patient” or “restraining the patient by force”; and 6) Persons involved in stopping the aggression, e.g. “physician”, “nurse”, or “police”
Verbal aggression was reported in 31.6% (n = 100) of the events, threats were reported in 24.7% (n = 78) of the events, and physical aggression was reported in 43.7% (n = 138) of the events

Summary

Introduction

Workplace violence in emergency primary health care is prevalent, but longitudinal studies using validated assessment scales to describe the characteristics of workplace violence in these settings are lacking. The aim of the present study was to determine the characteristics of aggressive incidents in emergency primary health care clinics in Norway. Workplace violence spans a spectrum from verbal aggression to physically violent acts and is a threat to the safety and wellbeing of health care workers and patients. It negatively impacts on the ability to perform professional medical work. Research has shown that health care workers in emergency primary health care services are exposed to considerable verbal aggression, threats, and violence from patients and/or visitors [1]. Studies of the characteristics of aggressive incidents in emergency primary health care are sparse. In order to expand our understanding of the aggressive incidents within primary health care, there is a need for structured measurement where different aspects of the aggressive behaviour are examined

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