Extent and risk factors of psychological violence towards physicians and Standardised Residency Training physicians: a Northern China experience

Huiying Fang,Yapeng Fu,Hong Qiao,Kexin Jiang,He Liu,Qunhong Wu,Haonan Jia,Peng Li,Mingli Jiao,Jingfu Mao,Yuze Li,Lifeng Wei,Siqi Zhao

doi:10.1186/s12955-020-01574-y

Abstract

PurposePhysicians and Standardised Residency Training physicians (SRTPs) have relatively high exposure to psychological violence. Its adverse effects are far greater than those of physical violence. However, no previous research has paid attention to the problem of psychological violence among them. This study aims to evaluate the extent, characteristics, and risk factors of psychological violence among SRTPs in comparison to physicians, and also to highlight the psychological violence experienced by SRTPs and suggest preventive measures.MethodsA cross-sectional survey was conducted in northern China. 884 physicians and 537 SRTPs completed a questionnaire which compiled by the ILO, ICN, WHO and PSI in 2003 to measure violence in the workplace. Descriptive statistics and logistic regression analysis were used to analyse results.ResultsThe effective response rates of physicians and SRTPs were 63.1%(884/1400) and 86.3%(537/622) respectively. 73.0%(645/884) of physicians and 24.8%(133/537) of SRTPs suffered psychological violence in the past year. Compared to physicians (29/645, 4.5%), SRTPs (42/133, 31.6%) experience more internal violence. Further, after experiencing psychological violence, physicians are willing to talk to family and friends, but SRTPs generally take no action. Shift work was a risk factor for both physicians (OR 1.440, 95% CI 1.014–2.203) and SRTPs (OR 1.851, 95% CI 1.217–2.815) suffering from psychological violence. In contrast, no anxiety symptoms protected physicians (OR 0.406, 95% CI 0.209–0.789) and SRTPs (OR 0.404, 95% CI 0.170–0.959) against psychological violence.ConclusionsSRTPs and physicians in northern China have a high risk of experiencing psychological violence, and physicians experience more. Meanwhile, there are obvious differences in responses to psychological violence and risk factors between them. Therefore, medical institutions should pay more attention to psychological violence, especially among SRTPs, such as supporting the reporting of psychological violence, strengthening team relationships, and providing psychological comfort and counselling.Trial registration number (Project Identification Code: HMUIRB20160014), Registered May 10, 2016.

Highlights

On September 21, 2017, a young Standardised Residency Training physician (SRTP) at a hospital in Shandong Province, China, committed suicide in the hospital lounge as a result of suffering from workplace violence
Shift work was a risk factor for both physicians and SRTPs suffering from psychological violence
SRTPs and physicians in northern China have a high risk of experiencing psychological violence, and physicians experience more

Summary

Introduction

On September 21, 2017, a young Standardised Residency Training physician (SRTP) at a hospital in Shandong Province, China, committed suicide in the hospital lounge as a result of suffering from workplace violence. This is not the only workplace violence incident involving resident physicians: resident Wang Hao died by accident in 2012, Chen Weixiang was forced to leave his post under threat in 2015, etc. In 2012, the average number of workplace violence was 27.3 in per hospital, far higher than 20.6 in 2008 [2]. The perpetrators of psychological violence are patients and relatives, and hospital colleagues and supervisors, and it has been determined that internal violence can cause more serious psychological trauma than external violence [12, 13]

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