Staff Victims Research Articles

An explorative qualitative study of cyberbullying and cyberstalking in a higher education community

The literature suggests an increased risk of cybervictimisation during the COVID-19 pandemic. This paper explores student and staff experiences in a higher education community as victims of cyberbullying and cyberstalking during the COVID-19 lockdowns. An online semi-structured questionnaire was administered to self-identified students and staff victims within a higher education context. By analysing victim responses, within a qualitative framework, this research identifies perceptions, impacts and support mechanisms. The findings offer insights for the development of effective practices and policies to mitigate risk factors and foster resilience. This research addresses the need for comprehensive understanding in the face of emerging digital challenges and future traumatic events.

Understanding Nursing Workplace Violence Trends for Safer Clinical Oncology Settings.

Workplace violence (WPV) against nursing professionals by patients and visitors occurs frequently, and rates of WPV increased during the COVID-19 pandemic. All nursing teams, including oncology nursing professionals, are at risk for WPV and need current WPV-related information applicable to their clinical experiences. This overview aims to increase awareness of trends and personal safety issues related to clinical oncology nursing practice and provide strategies and resources to enhance personal safety in nursing practice. This overview used literature reviews, publicly reported sources, other scholarly resources, and real-world examples to identify and synthesize WPV trends related to clinical nursing. This overview's findings suggest that the COVID-19 pandemic contributed to the increased rate of WPV and subsequent harm to nursing staff victims. Oncology nursing professionals can implement best practices to reduce their risk of being harmed, and healthcare institutions can operationalize best practices by having systems and resources in place that prevent and mitigate WPV.

The Team Is Not Okay: Violence in Emergency Departments Across Disciplines in a Health System.

Healthcare workers, particularly those in the emergency department (ED), experience high rates of injuries caused by workplace violence (WPV). Our goal was to establish the incidence of WPV among multidisciplinary ED staff within a regional health system and assess its impact on staff victims. We conducted a survey study of all multidisciplinary ED staff at 18 Midwestern EDs encompassing a larger health system between November 18-December 31, 2020. We solicited the incidence of verbal abuse and physical assault experienced and witnessed by respondents over the prior six months, as well as its impact on staff. We included responses from 814 staff (24.5% response rate) for final analysis with 585 (71.9%) indicating some form of violence experienced in the preceding six months. A total of 582 (71.5%) respondents indicated experiencing verbal abuse, and 251 (30.8%) indicated experiencing some form of physical assault. All disciplines experienced some type of verbal abuse and nearly all experienced some type of physical assault. One hundred thirty-five (21.9%) respondents indicated that being the victim of WPV has affected their ability to perform their job, and nearly half (47.6%) indicated it has changed the way they interact with or perceive patients. Additionally, 132 (21.3%) indicated experiencing symptoms of post-traumatic stress, and 18.5% reported they have considered leaving their position due to an incident. Emergency department staff suffer violence at a high rate, and there is no discipline that is spared. As health systems seek to prioritize staff safety in violence-prone areas such as the ED, it is imperative to recognize that the entire multidisciplinary team is impacted and requires targeted efforts for improvement in safety.

Characteristics of International Staff Victims of Psychiatric Patient Assaults: Review of Published Findings, 2017-2022.

Psychiatric patient assaults on staff are a worldwide occupational hazard for health care staff that results in medical injury, human suffering, and dollar cost expense. International research through 2000-2017 documented the continued frequency of these assaults and a continuing high risk for nursing personnel. This present paper reviewed the international published literature on staff victims of patient assaults during the next five-year period of 2017-2022. There were 39,034 assaults on 34,679 employee victims. The findings indicate that assaults on staff remain a serious worldwide issue as it has been since the 1990s and that nursing personnel continued to be at greater risk. Aggression management approaches, post-incident interventions, and an updated methodological inquiry are presented.

356 Workplace Violence in the Emergency Department: Staff and Law Enforcement Disagreement on Reportable Crimes

Violence in the emergency department (ED) is a common and serious threat to staff and remains underreported. According to a recent survey at our institution, 37.2% of ED staff experienced physical assault in the 6-months prior, with only 26.2% of non-security staff victims indicating they had formally reported the incident. Incident reporting processes can be cumbersome, and staff often may not know what acts constitute reportable violence. To identify barriers in reporting, we hypothesized that ED staff may not fully understand reportable crimes and their understanding may differ from those of law enforcement officers (LEO). An anonymous REDCap survey with four hypothetical case scenarios (Table 1) was sent to ED staff at our academic medical center, as well as LEO at the local police department. Respondents were asked to indicate whether they considered any of the scenarios to be reportable as a crime if it occurred in the ED. Chi-square analysis was used for comparison. The study was deemed exempt by Mayo Clinic Institutional Review Board. 77 LEO and 261 ED staff completed the survey. Both groups were equally likely to believe that a reportable crime occurred in scenario 1 (LEO: 26.0%, ED: 32.2%, p =.37) and in scenario 2 (LEO: 97.4%, ED: 95.4%, p = .65). However, the two groups differed in scenarios 3 and 4. In scenario 3, only 20.8% of LEO believed it represented a reportable crime, compared to 43.7% of ED staff (p <.001). Similarly, more ED staff believed that a reportable crime occurred in scenario 4 compared to LEO (LEO: 66.2%, ED: 81.2%, p =.009). There was disagreement between ED staff and LEO on what actions in the ED constitute a reportable crime. Additionally, there was variability among both groups’ answers in three of the four scenarios. While the scenarios were hypothetical, they are not unrealistic in our specialty. Improvement interventions could be targeted at ED staff around the law and for LEOs to understand the unique environment of the ED and patient responsibilities. As health systems seek to improve workplace safety, it is important to consider the barriers to reporting violent incidents, including staff understanding of what acts may even constitute a crime.Table 1Case scenariosScenario 1: An 85-year-old man with known dementia is transferred to the ED from his nursing home for back pain and is not oriented to the year or his present location. He becomes agitated and punches a nurse attempting to obtain his vitals.Scenario 2: A 25-year old man is brought into the ED by EMS with the complaint of broken teeth after getting into an altercation and he appears to be intoxicated. He spits blood-tinged saliva into the face of the phlebotomist performing venipuncture.Scenario 3: A 70-year-old female comes into the ED for abdominal pain. After a lengthy workup and prolonged stay, she begins showing signs of delirium and makes threats to find her doctor’s house upon discharge and harm him.Scenario 4: A 1-year old is brought into the ED by his parents for a fever, rash, and upper respiratory symptoms. Upon hearing that a viral infection is the likely culprit and no further diagnostic studies will be ordered or antibiotics prescribed, the mother becomes increasingly angry and eventually throws a chair in the room, narrowly missing the medical student. Open table in a new tab

The Assaultive Staff Action Program (ASAP): Thirty Year Program Analysis.

The Assaulted Staff Action Program (ASAP) is a voluntary, system-wide, peer-help, crisis intervention program to address the psychological sequellae in staff victims of patient assaults. Its functions and service provisions have been reported in previous five-year intervals. ASAP has been associated with providing quality counseling services to employee victims of these patient assaults as well as declines in assaults facility-wide in some agencies after an ASAP team was fielded. The present paper presents a summary of both its most recent five-year interval (2015-2020) and an overview of its 30years of service during which it has responded to 10,651 patient assaults on staff.

Patient-on-Staff Assaults: Perspectives of Mental Health Staff at an Acute Inpatient Psychiatric Teaching Hospital in the United States.

Physical assaults perpetrated by patients in psychiatric hospitals against mental health staff (MHS) is a serious concern facing psychiatric hospitals. Assaulted staff reports physical and psychological trauma that affects their personal and professional lives. There is a dearth of literature exploring this phenomenon. To explore MHS perspectives of assault by psychiatric patients. A transcendental phenomenological qualitative design was used to explore and analyze the perspectives of a purposeful sample of 120 MHS perspectives at an acute inpatient psychiatric hospital. Participants' age ranged from 22 to 63 years (mean age = 32.4). Moustakas' theoretical underpinnings guided the study. Two patterns, 8 themes, and 19 subthemes were identified: (a) Psychological impacts revealed four themes-increase of anxiety/fear level, helplessness and hopelessness, flashbacks/burnout, and doubting own competency. (b) Physiosocial impacts revealed four themes-unsupportive superiors, stigmatization of staff victim, failure to report the incident, and environmental safety. Participants verbalized that assaults by patients have instilled fear and trauma in them. Most of the assaults occurred when staff were performing their routine job functions and setting limits to patient's behavior. The study allowed MHS opportunities to narrate their lived experiences of being assaulted by patients and provided validation of their perspectives. Findings illuminated the phenomenon and may help to support policy changes in psychiatric hospitals.

Workplace Violence Toward Hospital Staff and Volunteers: A Survey of an Italian Sample

ABSTRACTInterest in the phenomenon of workplace violence has increased in recent years because such violence is evident in the healthcare sector. The prevalence and consequences of victimization among healthcare professionals have been well-investigated but not in volunteers who have direct and prolonged contact with patients and visitors. The aim of this study was to investigate the prevalence of physical and psychological workplace violence, the psychological and emotional consequences for hospital staff and volunteers, and the coping strategies that they adopted. In the current study, both of these groups worked with patients suffering from chronic diseases in a hospital in northern Italy. The participants included 108 hospital staff and 96 volunteers in cardiology and oncology units. The results revealed that for the staff victims of physical or psychological violence, the increase in depressive and anxiety symptoms (both state and trait) corresponded to a greater use of coping strategies to avoid facing the event. For the volunteer victims of physical violence, an increase in state anxiety was associated with an attempt to cope with the discharge of emotion, whereas trait anxiety was associated with a coping strategy that represents a positive interpretation of life events. A worrisome finding was the number of staff and volunteer victims of physical and psychological violence who did not report these occurrences: only one third of staff and volunteers reported these events to management or to the police.

Characteristics of International Staff Victims of Psychiatric Patient Assaults: Review of Published Findings, 2013-2017.

Psychiatric patient assaults on staff are a worldwide occupational hazard for health care staff that results in human suffering and dollar cost expense. International research through 2012 documented the frequency of these assaults and a continuing high risk for nursing personnel. This present paper reviewed the international published literature on staff victims of patient assaults during the next five year period of 2013-2017. The findings indicate that assaults on staff remain a serious worldwide issue as it has been since the 1990s, even with new policy initiatives in place meant to reduce such violence. Nursing personnel continued to be at greater risk. The findings by continents and an updated methodological inquiry are presented.

Crime victims in limbo: the importance of collaboration between the municipal social services and victim support organisations

Becoming a victim of crime can be a traumatic experience, which calls for post-victimisation psychosocial support. In Sweden, this kind of support is offered by both governmental, for example, municipal social services (MSS), and nongovernmental organisations such as Victim Support (VS). The present study investigates (a) how many municipalities have a written agreement to collaborate with other organisations, and what kind of services they offer within their own organisation, (b) if there are differences between what support the MSS offer to victims depending on collaboration and (c) how do MSS staff, VS staff and crime victims describe the actual collaboration and support? Publicly available information from the National Board of Health and Welfare was analysed, in addition to a case study of three municipalities’ work with victims of crime. The case study consists of nine interviews with social workers from MSS, crime victim coordinators from VS and crime victims. The results from the survey indicate that collaboration between the MSS and VS is occurring in some municipalities to access missing competence or to outsource services from the MSS. However, results show that collaboration does not exist in every municipality, and one reason for this, according to interview information, is to protect the confidentiality of the clients. The challenges and advantages of collaboration between the MSS and VS are discussed together with practical implications for the crime victim field.

The Assaultive Staff Action Program (ASAP): 25 Year Program Analysis.

The Assaulted Staff Action Program (ASAP) is a voluntary, system-wide, peer-help, crisis intervention program to address the psychological sequelae in staff victims of patient assaults. It has been associated with cost-effective, quality support services to staff victims of patient assaults and declines in assaults facility-wide in several facilities, after an ASAP was fielded. ASAP's functions and service provisions have been reported in previous 5-year intervals. The present paper reports on its most recent 5-year interval as ASAP complete its 25th year of service. The 5-year summary and the basic strengths and limitations of the program over this 25 year period are examined.

Characteristics of international staff victims of psychiatric patient assaults: review of published findings, 2000-2012.

Psychiatric patient assaults on staff are a worldwide occupational hazard that results in human suffering and dollar cost expense. International research in the 1990s documented the frequent occurrence of these assaults. This present paper reviewed the published, international literature on staff victim assaults during the first decade of the new century. The findings indicate assaults on staff remain a serious worldwide issue as it was in the 1990s, even with new policy initiatives in place meant to reduce such violence. The findings by continents and a detailed methodological inquiry are presented.

Serious assaults on prison staff: A descriptive analysis

Objective The current study sought to illuminate the patterns associated with serious inmate-on-staff assaults, as well as the characteristics of perpetrators and victims. Material and methods This study examined 79 assaults on prison staff requiring more than first aid treatment, perpetrated by 96 inmates, in a large state correctional department during a 14-month period (September 1, 2007 through October 31, 2008). Results These assaults were both infrequent (53 per 100,000 inmates annually) and progressively more infrequent as the severity increased (hospitalization for non-life threatening injury or required reconstructive surgery = 2.2 per 100,000 inmates annually; hospitalization for life-threatening injury = 0.5 per 100,000 inmates annually). Among staff victims, Black and female correctional officers were underrepresented. Inmate perpetrators who were younger, Black, prison gang members, and/or serving sentences for violent offenses were disproportionately represented among assailants. Conclusions The low overall rate of serious staff assaults attests to the level of professionalism and training in modern corrections departments. Nonetheless, situational factors uncovered in the current analysis suggest that particular circumstances increase the likelihood of staff assaults, hence the need for continued training and vigilance on the part of correctional staff that come in direct contact with inmates.

Psychiatric Patient Assaults and the Staff Victims: An Introduction.

This brief paper presents an introductory overview of three papers on psychiatric patient assailants. The papers include the characteristics of patient assailants, precipitants to such assaults, and the characteristics of the staff victims of these assaults. The flexibility of the Assaulted Staff Action Program (ASAP) to address staff victims' post-incident psychological needs is discussed.

Characteristics of Staff Victims of Psychiatric Patient Assaults: 20-Year Analysis of the Assaulted Staff Action Program

Psychiatric patient assaults on healthcare staff are a worldwide occupational hazard. This present 20-year, retrospective study examined the characteristics of these staff victims in one public-sector, health care system and assessed the psychological support provided to these victims by the post-incident Assaulted Staff Action Program (ASAP). An additional analysis compared the victim characteristics in this same health care system at 10-, 15-, and 20-year intervals. The findings were consistent with earlier, worldwide studies. Staff victims tend to be younger, less formally educated, less experienced, and less trained mental health workers, residential house counselors, and trainees of differing disciplines. ASAP provided needed support to staff victims. Risk management strategies for safety, methodological issues, and the problem of denial in fielding a post-incident crisis intervention program for staff victims were discussed.

Coercion in psychiatry

This paper highlights issues in the field of coercion in psychiatry which have gained importance in 2007. Reviews on 'involuntary hospital admission' demonstrated negative and positive consequences on various outcome domains. Papers on 'coercion and the law' identified cross-national differences of legal regulations, or addressed justice and equality issues. Studies on the 'patient's perspective', and 'family burden of coercion' showed that involuntariness is associated with feeling excluded from participation in the treatment. A review on 'outpatient commitment' recommended the evaluation of a range of outcomes if this specific legislation is introduced. 'Coercion in special (healthcare) settings and patient subgroups' needs to be assessed in detail. This refers to somatic hospitals, establishments for mentally retarded patients, prisons, forensic settings, and coercion mechanisms for addiction treatment, eating disorders, and minors. Empirical findings in other areas focused on attitudes towards involuntary treatment; decision variables for involuntary commitment; guidelines on the use of coercive measures; and intervention programs for staff victims of patient assaults. Coercion in psychiatry is an important area for future clinical and research initiatives. Because of the linkages with legal, human rights and ethical issues, a huge number of individual questions needs to be addressed.

Operationalizing risk: The influence of measurement choice on the prevalence and correlates of prison violence among incarcerated murderers

A retrospective review was performed on the disciplinary records of 1,659 convicted murderers who had been admitted to the Texas Department of Criminal Justice between February 2001 and November 2003. Institutional violence was disaggregated by type of infraction, inmate or staff victim, extent of injury, and weapon usage to determine baseline prevalence and rates. Characteristics of the perpetrators, including younger age, more serious murder conviction, and longer sentence were associated with a higher incidence of prison assaults. Logistic regression analysis of a restricted sample of 1,440 male, non-death row inmates resulted in modestly predictive models for potentially violent acts (AUC = .668), assaults (AUC = .700), and assaults resulting in serious injury (AUC = .750). The findings suggest that the choice of measure used when operationalizating prison violence is crucial in determining baselines, but may have a more limited effect on identifying correlates and predicting outcomes.

Psychiatric Patient Assault and Staff Victim Gender: Fifteen-year Analysis of the Assaulted Staff Action Program (ASAP)

Extensive, largely cross-sectional research has documented the continued occurrence of patient assaults on male and female staff. Different studies report either male or female staff to be at highest risk. Studies of same/different gender assaults which might more fully answer this question have been few. In these latter studies both male and female staff were at high risk for same gender assaults. In community settings males were at risk from same gender assaults but females were at risk from assaults by both patient genders. The present 15-year longitudinal retrospective study examined same/different gender assaults over time. Since the health care system under study experienced several major policy changes during these years, data were also examined at 5-year intervals to assess the stability of findings across time. Male and female staff were at increased risk from same gender assaults over time in both inpatient and community settings. The findings and their implications are discussed. In addition, a cost-effective, comprehensive risk management strategy for containing assaults is outlined.

Characteristics of Staff Victims of Pschiatric Patient Assaults: 15-Year Analysis of the Assaulted Staff Action Program (ASAP)

Psychiatric patient assaults on staff victims are a worldwide occupational hazard. This paper reports on a 15-year study of the characteristics of staff victims of patient assaults and a crisis intervention procedure to ameliorate the aftermath of theses incidents. The debate on the efficacy of early interventions is outlined and the present 15-year findings are presented, findings demonstrating remarkable consistency in victim characteristics over time. The crisis intervention procedures were associated with sharp declines in disrupted victim functioning. The validity of the study's findings are noted and the implications for enhanced risk management training and staff victim crisis intervention procedures are discussed.

Characteristics of Assaultive Psychiatric Patients: Fifteen-Year Analysis of the Assaulted Staff Action Program (ASAP)

This study reports on a fifteen-year longitudinal analysis of the characteristics of assaultive patients in one public-sector mental health care system. The data were gathered within the context of the Assaulted Staff Action Program (ASAP), a crisis intervention service for staff victims. The fifteen-year findings were consistent with previous worldwide research on assaultive patients and included both older male patients with schizophrenia and younger personality-disordered patients as high-risk assailants. Both groups had appreciable histories of violence toward others, personal victimization, and substance use disorders. The role of these three clinical variables in association with subsequent assaults, the role of trauma in female assailants, and the consistency of the fundamental characteristics of assaultive patients during several service system initiatives were examined. Implications for research and intervention are discussed.