Violence In Healthcare Settings Research Articles

Partner violence in healthcare settings on breastfeeding mothers: a scientometric analysis

Background Partner violence is a significant issue affecting women’s health, particularly their breastfeeding practices in healthcare settings. Despite a considerable body of research on this topic, there is a need for a systematic overview of the existing literature to explore its thematic and structural developments. Methods This scientometric analysis covers a period of 45 years (1977-2022) and identifies 415 peer-reviewed articles published in English before 2023 from the Scopus database. The articles were included if they engaged with themes related to partner violence, healthcare settings, breastfeeding, and mothers, using predefined search terms and filters. Bibliometric data were decoded and visualized using VOSviewer and RStudio to analyze and visualize the scientific dialogue, trends, patterns, and networks in the literature regarding partner violence and its impact on breastfeeding mothers in healthcare settings. Results The study revealed a concentrated exploration of themes related to violence, healthcare provision, mental health, and women’s reproductive health. The co-occurrence network and thematic mapping illuminated seven pivotal clusters, revealing a complex narrative of interconnected research areas. Niche and emerging themes such as “Depression,” “HIV,” and “Covid-19” were identified, highlighting the evolving landscape of the research domain. Conclusions This analysis provides a panoramic overview of the existing literature, revealing intricate thematic structures and collaboration networks within the research on partner violence and breastfeeding mothers in healthcare settings. The study not only sheds light on the historical and current states of research but also pinpoints potential future directions, thereby assisting scholars and policymakers in navigating and prioritizing subsequent investigative endeavors.

Identifying quality indicators to measure workplace violence in healthcare settings: a rapid review

Structured summaryBackgroundWorkplace violence (WPV) in healthcare is a growing challenge posing significant risks to patient care and employee well-being. Existing metrics to measure WPV in healthcare settings often fail to provide decision-makers with an adequate reflection of WPV due to the complexity of the issue. This increases the difficulty for decision-makers to evaluate WPV in healthcare settings and implement interventions that can produce sustained improvements.ObjectiveThis study aims to identify and compile a list of quality indicators that have previously been utilized to measure WPV in healthcare settings. The identified quality indicators serve as tools, providing leadership with the necessary information on the state of WPV within their organization or the impact of WPV prevention interventions. This information provides leadership with a foundation for planning and decision making related to addressing WPV.MethodsOvid databases were used to identify articles relevant to violence in healthcare settings, from which 43 publications were included for data extraction. Data extraction produced a total of 229 quality indicators that were sorted into three indicator categories using the Donabedian model: structure, process, and outcome.ResultsA majority of the articles (93%) contained at least 1 quality indicator that possessed the potential to be operationalized at an organizational level. In addition, several articles (40%) contained valuable questionnaires or survey instruments for measuring WPV. In total, the rapid review process identified 84 structural quality indicators, 121 process quality indicators, 24 outcome quality indicators, 57 survey-type questions and 17 survey instruments.ConclusionsThis study provides a foundation for healthcare organizations to address WPV through systematic approaches informed by quality indicators. The utilization of indicators showed promise for characterizing WPV and measuring the efficacy of interventions. Caution must be exercised to ensure indicators are not discriminatory and are suited to specific organizational needs. While the findings of this review are promising, further investigation is needed to rigorously evaluate existing literature to expand the list of quality indicators for WPV.

Exploring nurses' emotional reactions to and reporting of patient-on-nurse workplace violence: A mixed-methods study

BackgroundWorkplace violence, including violent, intimidating, and disruptive acts, commonly occurs in healthcare settings. Type 2 workplace violence in nursing refers to patient/visitor behaviors directed toward clinicians, contributing to physical and psychological harm. Nurse victims often do not report these events to employers or law enforcement, making it challenging to address workplace violence. ObjectivesOur research examined nurse reactions to Type 2 workplace violence by identifying what behaviors they perceived as aggressive and reportable. Specific aims included: 1) developing and testing video vignettes to portray realistic patient aggression scenarios; 2) identifying nurse understandings of aggressive events that prompt affective reactions, and; 3) examining clinical characteristics related to the nurse victim's likelihood to report. DesignThrough a sequential mixed-methods design, we qualitatively developed novel video vignettes portraying Type 2 workplace violence to experimentally examine how nurses interpreted them within a quantitative repeated measures survey. MethodsTwo expert nurse research panels (n = 10) created five vignettes, from which nurses (n = 282) completed a survey with 1382 unique responses. Analyses included descriptive statistics and repeated measures ANOVA/regression models. ResultsVideo vignettes realistically portrayed workplace violence events, eliciting negative emotional responses among nurses that increased in magnitude with statistical significance as the level of displayed aggression escalated. Statistically significant factors influencing nurse reporting of workplace violence included; 1) the level of aggression displayed by the patient; 2) the level of harm received by the nurse; 3) whether the nurse felt the patient's actions were intentional, and; 4) the nurse's perceived frequency of exposure to workplace violence. ConclusionsResults suggested that nurse victims of Type 2 workplace violence experience depression, anger, fear, and anxiety, which may contribute to long-term mental health consequences. Findings also identified factors related to nurse reporting behaviors, which may help mitigate workplace violence in healthcare settings by informing research and promoting workplace practices that encourage reporting and safety. RegistrationNot registered. Tweetable abstractNurse reactions to workplace violence: Video vignettes reveal escalating aggression's impact on reporting. #EndNurseAbuse #WorkplaceViolence.

Workplace Violence and Emotional Intelligence among Nursing Professionals at a National Hospital in Northern Peru

Introduction: Workplace violence is identified as a growing challenge in the healthcare sector, negatively impacting both nursing professionals and the quality of patient care. In this context, emotional intelligence emerges as a key tool for mitigating the effects of workplace violence, facilitating effective stress management, and enhancing interpersonal relationships in the workplace. Method: The study employed a quantitative, correlational, cross-sectional design. The sample consisted of 183 nurses from a National Hospital in Chiclayo, Peru, selected through probabilistic sampling. Two instruments were used: the EVP-health questionnaire to assess workplace violence and the TMMS-24 scale to measure emotional intelligence. Results: Findings indicate that 45.3% of respondents experienced a high level of workplace violence, while 61.8% showed a low level of emotional intelligence. Additionally, a negative correlation between workplace violence and emotional intelligence was found, demonstrating that high levels of violence are associated with low levels of emotional intelligence. Conclusions: The study concludes that enhancing emotional intelligence in nurses could be crucial in reducing workplace violence in healthcare settings. The implementation of emotional intelligence training programs for healthcare staff is suggested, not only to improve the work environment but also to enhance the quality of care provided to patients. The research highlights the need to address these aspects to promote a safer and more efficient work environment in the healthcare sector.

Workplace violence inflicted by patients or their family members/visitors and its relationship with suicidal ideation among undergraduate medical students during clinical training in China

Background Workplace violence in healthcare settings is a significant public concern that profoundly impacts healthcare workers. However, there is a dearth of knowledge regarding the prevalence of workplace violence and its correlation with suicidal ideation among undergraduate medical students in China during their clinical training. The objective of this study was to evaluate the prevalence of workplace violence inflicted by patients or their family members/visitors and to assess its association with suicidal ideation among undergraduate medical students. Method The snowballing sampling technique was used to recruit Chinese medical students. A question designed by the research team was used to ask medical students about their encounters with workplace violence. Students’ basic demographic information and mental distresses (learning burnout, depression symptoms, anxiety symptoms, alcohol abuse/dependence, excessive daytime sleepiness and history of mental disorders) were also assessed. As appropriate, the data were analysed using descriptive statistics, chi-square tests, independent-sample t-tests and multiple logistic regression. Results Out of the 1402 undergraduate medical students who participated, 493 (35.2%) reported having experienced workplace violence inflicted by patients or their family members/visitors, of which 394 (28.1%) were verbal abuse, 14 (1.0%) were physical aggression, and 85 (6.1%) were suffered from both verbal abuse and physical aggression. Furthermore, students exposed to workplace violence were more likely to report suicidal ideation and had a higher prevalence of learning burnout, depression symptoms, anxiety symptoms, alcohol abuse/dependence and excessive daytime sleepiness. Depression symptoms, history of mental disorders, learning burnout and having a partner were significantly associated with suicidal ideation in this population. Conclusion The prevalence of workplace violence inflicted by patients or their family members/visitors was high among undergraduate medical students in China. This may be associated with their mental distress and suicidal ideation. Consequently, it is crucial to strengthen workplace safety measures and promptly implement interventions to mitigate the potentially serious consequences.

Police Violence in Health Care Settings in US Media Coverage

Hospitals do not collect or share data tracking their policing and security activities despite their reliance on police and security personnel, including armed officers. Thus, little is known about how hospital security is associated with patient and staff safety. To examine the harms exerted by health care-affiliated police and security personnel. For this qualitative study, data were collected using a systematic Media Cloud search for US news media coverage from January 2011 to May 2022. A total of 18 987 articles on policing and hospitals were screened and a content and thematic analysis of articles that met the search criteria was conducted, which involved incidents that revealed harm to patients, patients' families, and staff. Data were analyzed from October 2022 to April 2023. Incident year, incident location (hospital name, city, state), survivor and victim characteristics (race and ethnicity, presence of mental illness), and a narrative description of the incident focusing on outcomes of harm exerted by police and security personnel in the health care setting. A total of 48 unique stories across 25 US states were included. The median (range) year published was 2017 (2009-2022). Harms reported to have been perpetuated by health care-affiliated police and security personnel were identified within 5 domains from 48 unique incidents: (1) patients shot by police or security personnel (17 patients); (2) patients subject to excessive use of force (17 patients); (3) patients arrested (7 patients); (4) patients subject to sexual assault (2 patients); and (5) hospital personnel or those considered collateral damage shot, injured, or arrested (5 individuals). Most survivors and victims were Black, although the race and/or ethnicity of involved individuals was not routinely reported across the news stories. Mental illness was the most documented medical condition among patients injured or killed by health care-affiliated police and security personnel. This qualitative study of US news media found that police and security personnel in hospitals were reported to have perpetuated harm via excessive force, sexual assaults, injuring patients and health care workers, and fatal shootings. Compounded by a lack of transparency and accountability mechanisms, this may represent an underrecognized manifestation of structural racism at the organizational level. Policy suggestions include introducing accountability measures, deescalation techniques, and removing arms from hospital security personnel to reduce harm and fulfill health care's healing mission.

Assessment of Nurses’ Knowledge Regarding the Workplace Violence at 250 Bedded Mohammad Ali Hospital, Bogura, Bangladesh

Background: Workplace violence in healthcare settings is a serious problem worldwide and in Bangladesh. It is becoming more common worldwide, and the recent trends confirm a high prevalence of occupational violence against nurses and physicians [1]. The International Labor Office, International Council of Nurses, World Health Organization, and Public Services International defined workplace violence as using physical or nonphysical power against another person or group that could harm the victims physically, mentally, spiritually, sexually, morally, or socially. About 1.6 million people died worldwide due to workplace violence, and many more became injured or suffered from physical and nonphysical health problems [3]. Objective: The aim was to assess nurses' knowledge regarding workplace violence at 250 Bedded Mohammad Ali Hospital, Bogura. Methodology: This was a descriptive cross-sectional study design used, and a sample size of 110 that was a purposive sampling technique followed those who met the inclusion criteria and assessed the nurses' knowledge regarding workplace violence. The study was conducted from July 2021 to December 2021. The instruments for data collection were a semi-structured questionnaire composed of two parts: Demographic variables and knowledge- based information on workplace violence. Results: The findings of the present study revealed that the highest age group, 40.91% were within 30-40 years, 86.36% were female, 4.55% were Muslim, 93.64% were married, and 47.27% were Diploma in nursing educational qualification among respondents. The average knowledge score of 68% was a good level of knowledge regarding workplace violence. It may be due to their cooperation. Conclusion: Workplace violence among nurses is a major problem in the workplace. It is also a common global problem, including Bangladesh. The major findings of 68% were good level of knowledge. The government plays an important role in minimizing workplace violence using different approaches.

Health professionals who have worked in COVID-19 immunization centers suffer the effects of violence.

The phenomenon violence against health professionals has received increasing attention in recent years because of its frequency and significant impact on victims' mental health and disruption of health services. Despite this attention, little is known about the incidence of workplace violence in the highly politicized immunization services. Therefore, we decided to examine the prevalence of workplace violence in the COVID-19 immunization campaign, the risk and protective factors, and the impact on victims' mental health. Between March and April 2022, we conducted an anonymous online survey among health professionals working in COVID-19 vaccination centers in the Friuli-Venezia Giulia Region (Italy). We used the Questionnaire for Workplace Violence in Healthcare Settings and the Impact of Event Scale-Revised. Of the 200 participants, 93 (46.5%) reported being victims of an act of violence during the vaccination campaign, 60 of them verbally and 7 physically. In 35.5% of cases, the IES score indicated a possible post-traumatic stress reaction in the victim. Opinions on measures to prevent violence and support workers in the workplace differed according to the sex of the health professional, with women emphasizing the need for self-defense training and improvement of security arrangements (p < 0.001). One-third of health professionals involved in the COVID-19 immunization campaign reported that their mental health was affected by workplace violence. Public health professionals dealing with politicized and debated issues such as immunization should receive more attention, as should the implementation of a more structured and multidisciplinary approach to the problem within healthcare organizations.

Homicides of psychologists, physicians, nurses, pharmacists, social workers, and other health professionals: National Violent Death Reporting System data 2003-2020.

Homicide is the extreme endpoint along the continuum of interpersonal violence. Violence in healthcare settings and directed toward healthcare workers has been a growing concern. Analysis of health professionals' homicides is needed to inform prevention interventions. Decedent numbers, age, and sex in the National Violent Death Reporting System are reported for 10 types of health professionals: advance practice registered nurses, dentists, nurses, pharmacists, physicians, physician assistants, psychiatrists, psychologists, social workers, and veterinarians. Between 2003 and 2020, 944 homicides of these professionals were reported to the NVDRS. Nearly 80% of victims were women; 53% of homicides involved guns. Nurses, social workers, physicians, and pharmacists comprised the most victims. In 2020, nurses, social workers, pharmacists, and psychologists had the highest homicide rates relative to their workforce size. Few of these homicides were related to professionals' work. The number of homicides within these professions correlated highly with the size of professions' workforces. Health professionals' homicides constitute a small proportion of US homicides generally at lower rates than seen in the general population. Age is likely one of the protective factors. Future, more comprehensive data will provide greater insights into emerging trends to inform strategies to mitigate homicide risk in health professionals. Prevention needs to go beyond healthcare settings and address societal roots of violence.

Rehabilitation professionals’ perspectives and experiences with the use of technologies for violence prevention: a qualitative study

BackgroundThere is growing public policy and research interest in the development and use of various technologies for managing violence in healthcare settings to protect the health and well-being of patients and workers. However, little research exists on the impact of technologies on violence prevention, and in particular in the context of rehabilitation settings. Our study addresses this gap by exploring the perceptions and experiences of rehabilitation professionals regarding how technologies are used (or not) for violence prevention, and their perceptions regarding their efficacy and impact.MethodsThis was a descriptive qualitative study with 10 diverse professionals (e.g., physical therapy, occupational therapy, recreation therapy, nursing) who worked across inpatient and outpatient settings in one rehabilitation hospital. Data collection consisted of semi-structured interviews with all participants. A conventional approach to content analysis was used to identify key themes.ResultsWe found that participants used three types of technologies for violence prevention: an electronic patient flagging system, fixed and portable emergency alarms, and cameras. All of these were perceived by participants as being largely ineffective for violence prevention due to poor design features, malfunction, limited resources, and incompatibility with the culture of care. Our analysis further suggests that professionals’ perception that these technologies would not prevent violence may be linked to their focus on individual patients, with a corresponding lack of attention to structural factors, including the culture of care and the organizational and physical environment.ConclusionsOur findings suggest an urgent need for greater consideration of structural factors in efforts to develop effective interventions for violence prevention in rehabilitation settings, including the design and implementation of new technologies.

Effect of workplace violence on health workers injuries and workplace absenteeism in Bangladesh

BackgroundWorkplace violence (WPV) is an emerging problem for health workers (HWs) and a global concern in health systems. Scientific literatures infer that WPV against HWs is often attributed to workplace injuries and absenteeism, leading to a series of adverse consequences. Therefore, this study aimed to investigate the prevalence of workplace injuries and absenteeism due to WPV among Bangladeshi HWs and its association with factors related to health facilities, work environments, and rotating shift work.MethodsThis study used participants who had experienced WPV, including medical doctors, nurses, or any form of medical staff. A total of 468 victim HWs were added in the analytical exploration. Participants were generated from our previous cross-sectional study of 1081 Bangladeshi HWs. A logistic regression model was used to find the association between workplace injuries and absenteeism due to WPV among HWs and associated factors.ResultsThe prevalence of workplace injuries and absenteeism due to WPV among HWs were 14.10% (95% CI 11.23–7.57) and 22.44% (95% CI 18.87–26.45), respectively. Injury incidence was higher among males (17.67%) and young HWs (20.83%). Workplace absenteeism was more common among male HWs (25%) and those working in public hospitals (23.46%). The magnitude of injuries and absenteeism varied significantly by hospital departments. Workplace injury was significantly higher among HWs who worked in the emergency (AOR = 21.53, 95% CI 2.55–181.71), intensive care (AOR = 22.94, 95% CI 2.24–234.88), surgery (AOR = 17.22, 95% CI 1.96–151.39), and gynecology & obstetrics departments (AOR = 22.42, 95% CI 2.25–223.07) compared with other departments. The burden of work-related absenteeism was significantly associated with HWs who worked in the emergency (AOR = 4.44, 95% CI 1.56–12.61), surgery (AOR = 4.11, 95% CI 1.42–11.90), and gynecology and obstetrics departments (AOR = 5.08, 95% CI 1.47–17.50).ConclusionsThis study observed a high prevalence of workplace injuries and absenteeism among HWs due to WPV across hospital departments, including emergency, surgery, intensive care and gynecology & obstetrics units. Policymakers should incorporate suitable strategies into Bangladesh’s national health policy to combat violence in healthcare settings.

Violence in the Emergency Department: What Can We Do?

Violence in healthcare settings is a problem around the world, with hospital emergency departments (EDs) being the most common sites. The most important step in preventing violence is to determine the causes and characteristics of the problem. However, there is not enough information in the literature about the particular areas of EDs in which violence occurs. We aim to produce results that can contribute to violence prevention activities by gathering detailed information about violent incidents in EDs and the intensity of this violence. Our study was planned as a retrospective and descriptive study at a tertiary emergency medicine clinic. Our data include "code white" data between January 1, 2015, and December 31, 2019. The characteristics and types of violence were recorded and categorized. We evaluated 141 incidences of severe violence reported during the study period. We determined that 55.2% of the violence was directed at physicians and 21.3% at nurses. Verbal violence was by far the most common type of violence, comprising 98.6% of the cases. We found that the violence cases occurred in examination rooms, observation areas, and triage units of the ED (58.2%, 24.1%, and 11.3%, respectively). We determined that violence in the ED is most common after standard working hours, and the most frequent exposure to violence is in examination rooms, observation areas, and triage areas. These findings may be useful in determining preventive measures in EDs, where violence is most common.

"If Not Me, Then Who?": Exploring the Challenges Experienced by Front-Line Clinicians Screening for, and Communicating About, Domestic Violence in the Emergency Department.

Screening for domestic violence in healthcare settings increases detection. The emergency department (ED) is one setting where victims frequently attend with injuries and illnesses sustained from violence. However, screening rates remain suboptimal. There is little research about how formal screening occurs, or how less structured interactions are negotiated within the ED context. This article explores this important, but non-mandatory procedure within the context of clinician-patient interactions in Australia. A descriptive qualitative study was undertaken with 21 clinicians across seven EDs in Australia. Thematic analysis was undertaken by two researchers. Results indicate a lack of confidence around DV screening, and tensions in clinicians initiating conversation while managing their own emotional stressors. No participants expressed knowledge of formal screening processes in their workplaces. Successful DV screening programs must provide clinicians with the tools to minimize perceived discomfort in initiating and sustaining conversations while accepting patient preferences regarding disclosure.

Psychological impact of workplace violence towards nurses in the emergency department

IntroductionGrowing attention has been drawn to workplace violence in healthcare settings and toward healthcare workers. Emergency departments have always been vulnerable to workplace violence since its is usually associated to working with people in extreme distress. Healthcare workers facing numbers of situation with either verbal or physical abuse may face an impact on their mental health.ObjectivesDescribe the psychological impact of workplace violence towards nurses in the emergency departmentMethodsThis is a questionnaire-based cross-sectional study including nurses working in the emergency department of different hospitals of Tunis. The respondents’ data were collected from March 2022 to September 2022.ResultsWe included 164 nurses. They were mainly women (Sex ratio of 0.6) with a median of age was 30.7±7.6 years. Nineteen nurses had history of one or more mental disorders such as anxiety disorder (12 cases) and depressive disorder (11 cases). All nurses were victim of workplace violence, while most (104 nurses) were witness to at least one act of violence. Study population had different degrees of concern about safety in workplace, 29.8% had little to no concern while 29,9% were mildly concerned and 40.2% were severely concerned for which they felt their security compromised (14.6% often and 12.2% always). Violence in workplace had consequences on the quality of their service for 26.8% of nurses. Many (49.4%) felt prejudice on their mental health contrasting with little resort (14%) to mental health providers. Number of nurses presented nightmares (44 cases), avoidance (56 cases) or flashbacks (48 cases) about workplace violence. Psychosomatic symptoms were described by most of the study population (58.5%) such as throbbing (46 cases), nervousness (56 cases), aches (23 cases), fatigue (29 cases) or non-specific digestive signs (17 cases).ConclusionsWorkplace violence in emergency departments, first interface of the care chain, is a real problem with serious consequences. Healthcare workers are forced to provide care in situations that compromise their health and safety. Implementing a national action plan is essential in order to address this dangerous phenomenon.Disclosure of InterestNone Declared

Short-term risk assessment in the long term: A scoping review and meta-analysis of the Brøset Violence Checklist.

INTRODUCTION: Existing literature on the Brøset Violence Checklist (BVC) is examined in the context of usability, implementation and validity to provide evidence-based recommendations on its application and identify opportunities for future development. To identify current knowledge on the BVC and guide clinicians and researchers toward the next steps in using this tool in clinical practice to prevent violence in healthcare settings. A scoping review approach with a meta-analysis supplement was adopted to broadly identify and map available evidence on the BVC and provide specific estimates of predictive validity in different contexts. Sixty-two studies conducted in 23 countries addressed the implementation of the BVC across various settings. Many studies adapted the original BVC, and the clinical utility was noted as an important feature. A meta-analysis of the original BVC format estimated a pooled area under the curve at 0.83 (95% CI 0.78-0.87) in a subset of 15 studies. The BVC combines high predictive validity and good clinical utility across a wide range of settings and cultures. It should continue to be incorporated into routine practice in mental health services focused on preventing violence and coercion. Development of collaborative approaches with service users involved in assessing their own risk of future violence.

Violence in the pain clinic: the hidden pandemic

Workplace violence is any physical assault, threatening behavior or other verbal abuse directed toward persons at work or in the workplace. The incidence of workplace violence in healthcare settings in...

Workplace Violence in Healthcare Settings: A Cross-Sectional Survey among Healthcare Workers of North India.

Workplace violence (WPV) is a significant problem in both developed and developing countries, especially among healthcare workers. It has widespread implications for their overall health and well-being. The study was conducted to assess the problem of violence among doctors and other healthcare workers in healthcare settings. A cross-sectional survey was conducted using a validated questionnaire from August 21 to September 18, 2021, based on purposive and snowball-sampling techniques for data collection. Appropriate statistical methods were applied to study the association between sociodemographics and characteristics of violence. A total of 601 responses were analyzed. The results showed that approximately 75% of the participants experienced violence in some form at their workplace. These episodes lead to a significant impact on the physical and mental health of these workers. Around one-third of the participants felt uncomfortable reporting these incidents. Some of the most common risk factors and mitigation strategies were also reported by the participants. The findings of this study can be used by the legislators, administrators, and policymakers to develop strategies that can help in mitigating these episodes of violence for the better functioning of the healthcare system.

Impact of Behavioral Health Training to Public Health Assistant Working in an Acute Psychiatric Setting in Reducing Patient-Led Workplace Violence

Workplace violence in healthcare settings is increasing worldwide. The risk of verbal and physical aggression towards healthcare workers is especially higher in psychiatry emergency settings. Public safety assistants are integral members of the psychiatry emergency department, who are frequently first responders to those with mental health issues. There is limited evidence discussing the patient-led workplace violence faced by public safety assistants. The purpose of this project is to explore the prevalence of physical and verbal patient-led violence faced by Public Safety Assistants (PSAs) working in psychiatry emergency settings and explore the impact of basic behavioral health education on PSAs in reducing patient-led workplace violence.

Violence Against Physicians in the Workplace: Trends, Causes, Consequences, and Strategies for Intervention.

Violence against healthcare professionals has become an emergency in many countries. Literature in this area has mainly focused on nurses while there are less studies on physicians, whose alterations in mental health and burnout have been linked to higher rates of medical errors and poorer quality of care. We summarized peer-reviewed literature and examined the epidemiology, main causes, consequences, and areas of intervention associated with workplace violence perpetrated against physicians. We performed a review utilizing several databases, by including the most relevant studies in full journal articles investigating the problem. Workplace violence against doctors is a widespread phenomenon, present all over the world and related to a number of variables, including individual, socio-cultural, and contextual variables. During the COVID-19 pandemic, incidence of violence has increased. Data also show the possible consequences in physicians' deterioration of quality of life, burnout, and traumatic stress which are linked to physical and mental health problems, which, in a domino effect, fall on patients' quality of care. Violence against doctors is an urgent global problem with consequences on an individual and societal level. This review highlights the need to undertake initiatives aimed at enhancing understanding, prevention, and management of workplace violence in healthcare settings.

Workplace Violence in Healthcare Settings: A Scoping Review of Guidelines and Systematic Reviews.

Workplace violence in healthcare settings is alarmingly common and represents significant financial and human cost. The aim of this scoping review was to identify and summarize evidence on strategies to prevent and/or manage workplace violence in healthcare settings. Searches were limited to evidence-based clinical practice guidelines and systematic reviews published between 2015 and 2021. Multiple databases were searched and screened. Quality of the included guidelines and reviews was also assessed. Three guidelines and 33 systematic reviews were included. Both the Occupational Safety and Health Administration 2015 and Registered Nurses' Association of Ontario 2019 guidelines provided useful recommendations for building a comprehensive prevention program. Evidence-based risk assessment, prevention and management, and education and training are all central components. Regular reassessment and adjustment is required. Included reviews (n = 33) were grouped into five main categories: violence toward nurses (n = 10); violence toward healthcare workers in general (n = 8); violence in the emergency department (n = 5); violence related to mental health (n = 5); and measurement related to workplace violence (n = 5). Multicomponent interventions were often more effective than those applied in isolation. We found consistent support for certain strategies including education and training, post-incident debriefing, multidisciplinary rapid response teams, and environmental modifications; however, the strength of evidence and certainty of conclusions were limited across reviews. This scoping review found that strong leadership that cultivates and enforces a culture of inclusivity, support, and respect is a prerequisite for a successful workplace violence prevention program. Rigorous comparative effectiveness research testing interventions are needed.