Workplace violence and its aftermath among health workers in Zhejiang province: a cross-sectional study

Abstract

BackgroundIn China, the reported incidence of workplace violence in hospitals has been increasing. Most research has focused on secondary and tertiary care facilities. We aimed to determine the incidence of workplace violence and its aftermath in county and township hospitals and community health centres in Zhejiang Province. MethodsA cross-sectional survey using stratified cluster sampling was carried out at 18 hospitals (eight county hospitals and ten township hospitals or community health centres) in Zhejiang Province from July 27, 2016 to Jan 20, 2017. Questionnaires were distributed to all health workers (including physicians, nurses, medical technicians, and administrative staff) present on the day of the survey. Ethical approval was obtained from Zhejiang University School of Public Health. Findings2018 out of 2303 participants completed questionnaires from 596 men and 1417 women. In the past year, 140 (7%) respondents had experienced physical attacks and 384 (19%) physical threats. Men experienced around twice as many physical attacks (59 [10%] vs 80 [6%] of women; p=0·001), and significantly more threats than females (132 [22%] vs 252 [18%]; p=0·025). Doctors were most likely to be victims of physical attacks, and the commonest location was the emergency department. Most respondents did not report the physical attack (117 [85%] respondents), mainly because they regarded it as pointless (70 [52%] respondents) or didn't know who to report to (32 [24%] respondents). Of all those attacked or threatened, 312 (61%) wanted to quit direct patient care. In terms of impact, 413 [80%] victims said they had repeated, disturbing memories of the attack, 498 [97%] said they had become highly vigilant, and 386 [75%] were fearful dealing with difficult cases. Only four [3%] were satisfied with the way the incident was handled. InterpretationWorkplace violence is common at lower-level health facilities. The lack of a formal response to workplace violence implies an institutional tolerance which is of great concern. Guidelines for management of workplace violence need to be instituted in primary care facilities. FundingZhejiang University Zijin Talent Programme.