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.
Highlights
IntroductionHealth professionals taking care of persons with mental disturbances are often exposed to patient aggression [2]
Patient aggression toward health professionals is a serious global concern [1,2]
We found that nurses working in psychiatric settings have experienced at least one type of patient aggression within the previous 12 months more often than nurses in medical and surgical settings
Summary
Health professionals taking care of persons with mental disturbances are often exposed to patient aggression [2]. Aggression can be defined as a range of behaviors or actions that has the potential to harm, hurt or injure another person, either physically or verbally, regardless of whether or not harm is sustained or the intention is clear [3]. Patient aggression in these settings is associated with healthcare workers’ wellbeing [4,5,6]. Longitudinal studies have shown that the relationship between workplace aggression and the wellbeing of employees seems bidirectional; those who experience aggression are more likely to report occupational stress, and those who report occupational stress are at a higher risk of workplace aggression [11,12]
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