Violence In Hospitals Research Articles

Evaluation of Gender Violence in the Military Central Hospital of Mexico

Introduction. Gender violence is a public health problem. The Ministry of National Defense has done strong efforts to educate their personnel about the topic and requires more evaluation of the problem.
 Objectives. Evaluate the frequency of thoughts that favor the exercise of gender violence, and the experience of people that have suffered it.
 Material & methods. In the Military Central Hospital, using the SurveyMonkey® platform, staff was evaluated by the digital application of two clinimetrical instruments. The Scale Inventario de Pensamientos Distorsionados Contra la Mujer (Distorted Thoughts Against Women Inventory) was applied to 1,128, and the scale Uso de Violencia revisado y el Tamizaje de violencia de Género (Gender and Use of Violence Screening Revised Scale) was applied to 1,488.
 Results. The Distorted Thoughts Against Women Inventory results consisted in 84.8% (956) non-violent, and 15.2% (172) possible violent. From the Gender and Use of Violence Screening Revised Test, 98.2% (1,462) are at low risk, 1.3% (20) at moderate risk, and 0.5% (7) at high risk of having suffered or experiencing gender violence.
 Conclusions. In the Military Central Hospital there is a low percentage of personnel prone to generate or suffer gender violence, nevertheless, it is required to continue educating all the personnel about the importance of preventing and reporting any gender violence behavior.

A tool to evaluate proportionality and necessity in the use of restrictive practices in forensic mental health settings: the DRILL tool (Dundrum restriction, intrusion and liberty ladders)

BackgroundPrevention of violence due to severe mental disorders in psychiatric hospitals may require intrusive, restrictive and coercive therapeutic practices. Research concerning appropriate use of such interventions is limited by lack of a system for description and measurement. We set out to devise and validate a tool for clinicians and secure hospitals to assess necessity and proportionality between imminent violence and restrictive practices including de-escalation, seclusion, restraint, forced medication and others.MethodsIn this retrospective observational cohort study, 28 patients on a 12 bed male admissions unit in a secure psychiatric hospital were assessed daily for six months. Data on adverse incidents were collected from case notes, incident registers and legal registers. Using the functional assessment sequence of antecedents, behaviours and consequences (A, B, C) we devised and applied a multivariate framework of structured professional assessment tools, common adverse incidents and preventive clinical interventions to develop a tool to analyse clinical practice. We validated by testing assumptions regarding the use of restrictive and intrusive practices in the prevention of violence in hospital. We aimed to provide a system for measuring contextual and individual factors contributing to adverse events and to assess whether the measured seriousness of threating and violent behaviours is proportionate to the degree of restrictive interventions used. General Estimating Equations tested preliminary models of contexts, decisions and pathways to interventions.ResultsA system for measuring adverse behaviours and restrictive, intrusive interventions for prevention had good internal consistency. Interventions were proportionate to seriousness of harmful behaviours. A ‘Pareto’ group of patients (5/28) were responsible for the majority (80%) of adverse events, outcomes and interventions. The seriousness of the precipitating events correlated with the degree of restrictions utilised to safely manage or treat such behaviours.ConclusionObservational scales can be used for restrictive, intrusive or coercive practices in psychiatry even though these involve interrelated complex sequences of interactions. The DRILL tool has been validated to assess the necessity and demonstrate proportionality of restrictive practices. This tool will be of benefit to services when reviewing practices internally, for mandatory external reviewing bodies and for future clinical research paradigms.

Relationships between nurses' experiences of workplace violence, emotional exhaustion and patient safety.

BackgroundThe rising rate of workplace violence in hospitals is a serious concern. While leading organisations recommend implementing interventions to address workplace violence, little is known about the workplace violence relationship between patients and visitors, and how it affects nurses’ emotional exhaustion and their perceptions of patient safety.AimsThe study’s purpose was to understand the status of workplace violence in hospitals and the relationships between nurses’ experiences of workplace violence, emotional exhaustion, and perceptions of patient safety.MethodsThis cross-sectional analysis used data from a survey conducted at a large academic medical centre using the Agency for Healthcare Research and Quality Hospital Survey on Patient Safety Culture plus additional measures of workplace violence and emotional exhaustion.ResultsNurses reported more occurrences of verbal violence than physical violence. Nurses’ experiences of workplace violence negatively affect nurses’ emotional exhaustion and patient-safety perceptions. Moreover, nurses’ emotional exhaustion mediated the relationship between verbal abuse and patient-safety perceptions.ConclusionsInterventions to reduce nurses’ emotional exhaustion and strengthen resilience can mitigate the negative effects of verbal abuse and to some extent the effects of physical violence.

What is the impact of restricted access policy on workplace violence in general hospital? A before-after study in a CHINESE tertiary hospital

BackgroundTo evaluate the impact of a restricted access policy on workplace violence in a healthcare setting.MethodsWe surveyed healthcare workers before and after the implementation of a restricted-access policy at a tertiary hospital in north-eastern China. Data were collected in April 2017 and January 2019. Fisher’s exact test were used to compare the difference in workplace violence prevalence between responses to two surveys. Survey 1 (S1) collected data from 345 healthcare professionals who had worked in the inpatient ward for at least 12 months. Survey 2 (S2) included 338 healthcare workers from the same ward who had been employed for more than two years. The effective response rates for the two studies was 79.31 and 83.25%, respectively. All 18 female security guards were included in the investigation in S2.ResultsThe prevalence of psychological violence was 62.03% in S1 and 34.62% in S2, the difference in prevalence showing statistical significance (P = 0.000), while the prevalence of physical violence was 3.77 and 4.73% respectively, showing no statistical significance (P = 0.573). The change in the rate of injury caused by physical violence was also statistically significant at 76.92 and 31.25% (P = 0.025), respectively. Security guards were at high risk of workplace violence under the policy. Most healthcare professionals thought this policy ameliorated treatment order, the sense of security, anxiety about workplace violence, and so forth, but one-third of the respondents thought that it caused patient dissatisfaction.ConclusionWhile the restricted access policy may be effective for healthcare professionals in avoiding or dealing with violence, such policy could contribute to new problems regarding the safety of security guards and the potential dissatisfaction of patients. The policy should be further developed to alleviate this phenomenon.

Coercion and violence in the provision of psychiatric care: legal and ethical aspects (cross-regional study)

In accordance with international principles for the protection of persons with mental disorders, physical restraint and isolation of the patient are used only in compliance with the approved regulations of the psychiatric hospital in cases where this is the only available way to prevent direct harm to the patient or other persons. Nevertheless, in real practice, there are often cases of applying measures of physical restraint, feeding and administering drugs against the will of the patient. The attitude of psychiatrists of psychiatric hospitals of the Belgorod, Volgograd and Voronezh Regions to coercion and violence in the provision of psychiatric care was studied. It was found that the majority of psychiatrists (91.6%) consider coercion of people with mental disorders to be justified, and 60% delegate this right to nurses. More than 90% of psychiatrists consider justified the use of physical restraint to a patient admitted to hospital treatment on a voluntary basis, in the case of psychomotor agitation with heteroagression, and 20% allow their personal participation in its implementation. Almost 47% of psychiatrists allow other patients to be involved in a forced injection to a patient who refuses therapy. The majority of psychiatrists (71%) consider it common practice to force patients with mental disorders who tend to “lie in bed” to clean the ward, department, hospital grounds, regarding it as “rehabilitation” and “labor therapy”. To prevent the use of violence and coercion in a psychiatric hospital, a transition from the paternalistic to the contractual model of psychiatric care is necessary. It is important to develop standards for the provision of psychiatric care in involuntary hospitalization, taking into account the compliance, and also to increase the legal competence of psychiatrists.

Exposition aux violences professionnelles à l’hôpital chez les jeunes médecins : l’étude nationale MESSIAEN

BackgroundHospital professional violence is defined as hostile and aggressive behavior exerted by health professionals on other health professionals. No quantitative study has been carried out to date on French hospital professional violence among young physicians, while recent qualitative studies have suggested a potential high frequency. The main objective was to determine the prevalence of exposure of young doctors to hospital violence. The secondary objective was to determine their characteristics and consequences as well as to determine if students and young physicians (resident and young MD) differed. MethodsThe study was a national cross-sectional observational epidemiological study that included 4th-year medical students and young physicians (MD for less than 2 years). Thirty-seven French faculties of medicine were contacted for email recruitment of participants. Social networks were used to increase the visibility of the study. The questionnaire was developed after exhaustive review of the international literature dealing with professional violence in hospitals, its characteristics and its consequences in terms of mental health, addiction, personal and professional life. The report of these events was also explored. ResultsIn total, 2003 participants have been included. More than nine out of ten participants were exposed to hospital violence at least once and nearly 42% to moral harassment as defined by the French law. This violence does not differ between the students and the residents/young MDs, suggesting that working time in the hospital does not seem to affect this risk. Nearly 80 % of interns and young MDs reported working more than the legal time. The perpetrators of violence include in almost all cases at least one man, often a senior doctor, but students reported the presence of at least one woman among the perpetrators in ¾ of cases. The victims are as often men as women. Compared to the undergraduate medical students, residents and young MDs more frequently reported poor outcomes on their mental health, addictive behavior, personal and professional lives. The majority of victims reported the event to a peer but fewer than 10% to the head of the department, a professor or an instance that could have acted. In almost all cases, participants reported the continuation of abusive behavior after the event. In total, 42% of students think that this is simple part of medical studies that they must endure. ConclusionThese results suggest the need to develop specific information and prevention programs for professional hospital violence in France.

Use of coercion prevention tools in Finnish psychiatric wards

Inpatient violence is a widespread problem in psychiatric wards and has often serious consequences. Literature indicates that de-escalation techniques are the recommended first-line intervention for managing violence, are widely used to reduce it, and restrictive practices in mental health settings. However, these techniques and models are not used at the optimum frequency and/or important factors are limiting their use and effectiveness. We aimed to determine what kind of de-escalation methods are used to reduce violence and coercion in Finnish psychiatric hospitals. Descriptive qualitative research using semi-structured questionnaires and Framework Analysis was used. The results of the study are reported in quantitative terms. A survey of psychiatric wards (N = 65) in Finland's hospital districts (n = 16) was conducted in the Autumn of 2019 to find out which de-escalation models are used. Finnish psychiatric wards use both the Safewards and Six Core Strategies models to reduce violence and the use of restrictive practices. Half of the hospitals used interventions and strategies from both models. Violence preventive methods are widely used in mental health settings in Finland. These interventions and models cover the organization, leadership, and patient perspectives to improve safety and decrease coercion actions in psychiatric wards.

High rate of burnout among residents under standardized residency training in a tertiary teaching hospital of middle China: Results from a cross-sectional survey.

Burnout has been commonly observed in health care workers. Though research has been conducted involving burnout among doctors in China, few studies have focused on residents during standardized residency training (SRT). The professional status of the residents during SRT remains largely unclear. The present study was conducted in order to clarify the prevalence and potential risk factors of burnout in residents during SRT.An electronic questionnaire comprised 2 parts. The first part was designed to collect some basic characteristic information. Maslach Burnout Inventory-Human Services Survey was included in the second part.As many as 71.05% residents had at least 1 scale of burnout. Emotional exhaustion (EE) was found in 55.6% residents, depersonalization (DP) in 29.7% and reduced personal accomplishment (RPA) in 41.6%. Being older than 27, senior SRT year, working time more than 60 hours per week and poor sleeping quality was independently associated with at least on scale of burnout. Being unable to receive timely supervisor support significantly increased the probability of DP and EE. Not having friends at work or feeling cared for by the hospital were independently related to all 3 symptoms of burnout as well as overall burnout.Burnout rate is high in residents under SRT from middle part of China. Organizational, professional, and social support was demonstrated critical by the potential roles in protecting against burnout. Residents with burnout were prone to considering turnover. Strategies for managing burnout related factors among residents should be focused in future studies.

I do not even tell my partner: Nurses' perceptions of verbal and physical violence against nurses working in a regional hospital.

To examine nurses' perceptions of physical and verbal violence perpetrated by patients and visitors and to investigate themes surrounding gender and the incidence of violence. The prevalence of violence towards nurses is a concern for nurses and hospital administrators. However, nurses who work in acute care and mental healthcare settings are particularly at high risk. This study examines the occurrence, type of violence and gender issues in a regional public hospital of Queensland Australia. An exploratory, qualitative design. Focus group interviews with 23 nurses from Emergency Department (ED), Intensive Care Unit (ICU) and Psychiatry Department (PD) working in Queensland regional public hospital, Australia. Qualitative data were transcribed and thematically analysed manually and by NVivo. COREQ research reporting checklist followed. Participants reported frequent incidents of verbal and physical violence on a daily basis. Severe incidence included punching, kicking, biting and scratching, as well as threats of using weapons, such as knives. Patients were more likely to exhibit physical violence, especially towards male nurses, while hospital visitors including patient's family were more likely to exhibit verbal violence. Allocating male nurses in volatile areas and to care for violent patients raises concerns that the male nurses may be seen by their patients as "bodyguards" and not as a professional nurse. Findings indicate that staff believe that violence is increasing, feel the burden to accept that violence as part of the job and that the bureaucratic processes of the organisation make it difficult to address violence or get support. Organisations need to be vigilant in ensuring assistance is accessible and simplified. This study contributes new knowledge to the discussion concerning of gender issues. Identifying gender issues could assist in developing the necessary interventions to reduce workplace violence.

Strategies for Assessing and Preventing Inpatient Violence in Forensic Hospitals: A Call for Specificity

Abstract. Violence within inpatient forensic hospitals is a significant and enduring problem that leads to harm to staff and patients and causes significant expenditures. This paper provides comprehensive recommendations for developing and implementing violence reduction strategies within forensic settings that are predicated on appropriate evaluation for violence risk. This paper posits that proper strategies must take into account subtypes of violence and classifying risk with systematic and continuous evaluations. Treatment interventions should be geared to patients most at-risk for violence. By recognizing the dynamic nature of violence, hospital administrators can work closely with institution staff to provide support for improving the environment of forensic hospitals. By employing empirically based treatment interventions on both acute and long-term units, forensic hospitals can provide a safer environment.

Violence against healthcare workers and other serious responses to medical disputes in China: surveys of patients at 12 public hospitals

BackgroundWorkplace violence against healthcare workers is a global issue that is on the rise, with Chinese healthcare workers facing growing challenges with hospital violence. Attacks on medical staff have increased in recent years with no clear resolution. Prior research focused on policies to improve the doctor-patient relationship and better protect clinicians, but few studies addressed the patient perspective. This paper examines patients’ choices when facing a medical dispute and identifies groups who are more likely to respond to conflict with violence or other serious actions.MethodsPatient survey responses were collected in 12 leading public hospitals in five Chinese provinces with 5556 participants. The survey asked sociodemographic information, patients’ attitudes (e.g., general optimism, trust in their physicians, perceived healthcare quality), and their primary response to a medical dispute. From least to most severe, the options range from “complaining within the family” to “violence.” We used t-tests and Chi-square tests to explore the relationships between reactions and patient characteristics. We also performed multivariable logistic regressions to determine the impact of sociodemographics and provider trust on the seriousness of responses.ResultsThe primary response of a third of respondents was complaining to hospital or health department officials (32.5%). Seeking legal help (26.3%) and direct negotiation with doctors (19.6%) were other frequent responses. More serious responses included 83 stating violence (1.5%), 9.7% expressing a desire to expose the issue to the news media, and 7.4% resorting to seeking third-party assistance. Patients who were more likely to report “violence” were male (OR = 1.81, p < .05), high-income earners (OR = 3.71, p < .05), or reported lower life satisfaction (OR = 1.40, p < .05). Higher trust scores were associated with a lower likelihood of a serious response, including violence (OR = 0.80, p < .01).ConclusionMost respondents reported mild reactions when facing a medical dispute. Among those who reported the intent of serious reactions, some sociodemographic characteristics and the trust of physicians could be predictive. To prevent future hospital violence, this work helps identify the characteristics of patients who are more likely to seek severe approaches to medical dispute resolution, including resorting to violence. From these results, hospitals will be better able to target specific groups for interventions that build patient-provider trust and improve general patient satisfaction.

Factors associated with physical injury or police involvement during incidents of workplace violence in hospitals: Findings from the first year of California's new standard.

Workplace violence in healthcare settings is known to be a costly and often underreported problem. In California, hospitals are required to report incidents of violence towards workers to the California Occupational Safety and Health Administration (CalOSHA) using an online reporting system that went into effect in 2017. Reports submitted to CalOSHA from July 2017 to September 2018 pursuant to this new requirement were analyzed using descriptive methods and logistic regression. Four hundred eight hospitals submitted reports using the new incident reporting system. Behavioral health units had 1.82 times the odds of the reported incident resulting in physical injury compared to inpatient medical units, and investor-owned facilities had 2.43 times the odds of the reported incident resulting in physical injury compared to city or county-owned facilities. Inpatient and behavioral health units had significantly reduced odds of a reported incident resulting in police involvement when compared to other locations within the hospital. These findings indicate that protections for healthcare workers deserve ongoing attention from stakeholders and legislators and provide insight into how healthcare facilities report incidents of violence towards workers.

Representaciones y categor�as de la violencia en el cine: un recorrido hist�rico y contextual

El art�culo se aproxima a la violencia como elemento central en el cine del siglo XX y XXI, determinado hist�ricamente por las condiciones sociales. Se trabaja sobre las formas de representaci�n social, siguiendo la relaci�n de los sujetos consigo mismos y la naturaleza. Est� relaci�n se observa cr�ticamente, como construcci�n social y pr�ctica discursiva, dado la importancia del cine y sus implicaciones con la violencia; se reconoce que el ingrediente de la violencia en el arte cinematogr�fico se ha manifestado de m�ltiples formas y a lo largo de la historia.De igual forma se sistematizan algunas de las diferentes aristas presentes en las diversas tramas que a lo largo de m�s de cien a�os del arte cinematogr�fico trabajando sobre producciones de distintas partes del mundo. Se detiene a problematizar con ejemplos cinematogr�ficos de variadas cinematograf�as, c�mo el ingrediente de violencia de muy diversos grados, formas, matices y niveles es omnipresente en el hecho cinematogr�fico. El cine sin violencia es m�s excepci�n que regla. Lo que no resulta un asunto menor, dadas las repercusiones sociales y �ticas de los diversos films en la realidad social. Por lo anterior el cap�tulo se restringe y limita a analizar cuatro categor�as espec�ficas: a) La Acci�n/violencia visto como g�nero cinematogr�fico, particularmente la evoluci�n reciente del cine b�lico, en las �ltimas dos d�cadas y sus reminiscencias y diversos tratamientos y manifestaciones en las cinematograf�as principalmente la alemana y norteamericana. Nos interesa aqu� ver el tratamiento de la violencia en el cine posterior a la ca�da al muro de Berl�n; b) La violencia intrafamiliar en el cine, sobre todo a partir de los a�os noventa del siglo pasado y con la irrupci�n internacional de los derechos humanos (infantiles, derechos de la mujer, ambiente sano, etc.) el an�lisis se centra en pel�culas espa�olas, inglesas y norteamericanas, tambi�n de las �ltimas veinte a�os; c) Instituciones sociales y violencia, ejemplos en el cine y la violencia en c�rceles, hospitales y escuelas y ; d) la violencia sobre los recursos naturales: la violencia como raz�n de acumulaci�n y no de sustentabilidad en los documentales ambientales. Se avanza en algunas reflexiones finales que integran los seis asuntos tratados.

Examining violence among Not Guilty by Reason of Insanity state hospital inpatients across multiple time points: the roles of criminogenic risk factors and psychiatric symptoms.

Institutional violence in state hospitals is a public health problem that has been severely understudied. Given the personal (ie, staff and patients) and fiscal harms associated with institutional violence, more research into contributing factors for violence is needed. The overarching aim of this study then was to examine associations among psychiatric symptoms, criminal risk factors, and institutional violence. Participants were 200 male, female, and transgender forensic mental health inpatients adjudicated Not Guilty by Reason of Insanity and committed to the California Department of State Hospitals. Participants completed a psychiatric symptom measure, and measures of and associated with criminal risk. Institutional violence was recorded from file review and includes physical violence toward staff or patients for 6-months prior to and post patient participation in this study. After adjusting for previous institutional violence, results indicated that psychiatric symptoms were not associated with follow-up institutional violence; however, criminal risk was associated with follow-up institutional violence. Unexpectedly, 2 aspects of criminal risk, antisocial cognitions and associates, were not associated with follow-up institutional violence after adjusting for previous institutional violence. Results also provided a tentative cutoff score on the Self-Appraisal Questionnaire for predicting follow-up institutional violence. These results have important implications for treating and managing patients at risk for institutional violence, including the need to assess criminogenic risk and leverage treatments that target these risk factors as a best practice approach.

Workplace Violence in Healthcare: A Single-Center Study on Causes, Consequences and Prevention Strategies.

Workplace violence is one of the main risk factors in the professional world. Healthcare workers are at higher risk whencompared to other sectors. Our study aimed to characterize physical and verbal violence in a public hospital and to define occupationalhealth prevention and surveillance strategies. Single center observational cross-sectional study, carried amongst healthcare workers in a public hospital inLisbon. A qualitative survey was carried out through six in-depth interviews. A quantitative survey was carried through questionnairesdelivered to 32 workers. A significance level of 5% was accepted in the assessment of statistical differences. The Mann-Whitney testand the Fisher's exact test were used to calculate p values. The main results are: (1) 41 violence incidents were reported in the quantitative phase; (2) 5/21 [23.81%] victims notifiedthe incident to the occupational health department; (3) 18/21 [85.71%] victims reported a permanent state of hypervigilance; (4) 22/28[78.57%] participants self-reported poor or no familiarity with internal reporting procedures; (5) 24/28 [85.71%] participants believed itis possible to minimize workplace violence. Workplace violence is favored by unrestricted access to working areas, absence of security guards and police officersor scarce intervention. The low notification rate contributes to organizational lack of action. The state of hypervigilance reported in ourstudy reflects the negative effects of threatening occupational stressors on mental health. Our results show that workplace violence is a relevant risk factor that significantly impacts workers' health in a noxiousmanner, deserving a tailored occupational health approach whose priority areas and strategies have been determined.

Study on mitigation of workplace violence in hospitals

BackgroundA workplace is any location, permanent or temporary, where an employee performs work-related duty. Workplace violence includes threats, beating, stabbing, shooting, psychological trauma, suicides, near suicides, and harassment of any kind. We can see slow changes in attitude of care providers when they encounter violent behavior and incidents. It is a world-wide issue. Of late, in developing countries where out of pocket payment mode is the main healthcare financing option for a family, the medical professionals are being demonized as professional pick-pocketers by few sections of the society. Hence, we explored to garner opinion of the employees regarding what constitutes violence in hospital setting and identified the factors among doctors, nurses, environmental duty workers, which are contributing toward work-place violence by patients and visitors. The aim was to improve the work environment for healthcare givers. MethodsDescriptive, cross-sectional study with a close-ended questionnaire under sections of physical environment factors, patient processes, equipment factors, and types of events taking place was administered. A sample size was 540, including 120 doctors, 240 nurses, and 180 environment health workers. About 127 patients were also interviewed to understand their opinion about event leading to attacks on doctors and nurses. ResultsPatient attendants yelling at healthcare personnel, verbal threats of violence, and using offensive language against staff are the perceptions of hospital staff as incidents of workplace violence. Non-communicative staff, sudden death of patients, and non-satisfactory treatment lead to aggressive behavior as opined by patient families. ConclusionIn the process of providing safe work environment, each potential contributing factor needs to be addressed independently by administrators. The hospital has training programs to nurses on customer relationship management, interpersonal relations trainings.

The weakness of the strong: Examining the squeaky-wheel effect of hospital violence in China

Hospital violence has become a worldwide issue that disturbs health care systems. China is in a particular dilemma between meeting the healthcare demand of 1.39 billion residents and ensuring the safety of 12.3 million health professionals. Drawing on data from an administrative survey, we presented the types and distribution of disruptive behaviors, as well as the summary statistics of 225 medical disputes that took place from 2012 to 2013 in Z city. Logit and OLS regression analyses show that disruptive behaviors, characterized by the number of protest participants and the length of protest, can significantly predict whether the claimant receives compensation and the amount of compensation. All else equal, a one-person increase in the number of participants is associated with 3.94% higher odds of getting compensated, whereas a one-day increase in the length of protest is associated with a 1.03% increase in the odds of receiving compensation. Further analyses show that the link between disruptive behaviors and compensation outcomes is due to the involvement of the state, which tends to press hospitals to pay when substantial violence is present. Chinese government's overwhelming emphasis on social stability gives protestors leverage against hospitals, which can be summarized as “the squeaky wheel gets the grease.” Ironically, the sensitivity of Chinese government towards social stability becomes a weakness of its own. Government's active intervention to reach a peace-oriented goal will incentivize patients to resort to violence in pursuit of compensation. This study has implications for understanding the Chinese government's logic of addressing social problems that range from hospital violence, labor disputes, land disputes to demolition compensation and civil petitions.

The effects of skill-based team learning curriculum in workplace violence prevention for nurses

Abstract Background Workplace violence, faced by health care workers, is a severe occupational safety and health hazard, and has received global attentions in research and in practice. The aim of this study was to design, implement, and evaluate a skill-based team learning curriculum of violence prevention for clinical nurses. Methods 78 clinical nurses were purposively selected including 41 nurses of treatment group, and 37 nurses of control group. Each treatment group received the training curriculum which included three sessions: (1) 50-minutes workplace violence lecture and video to illustrate the various workplace violence situations, (2) 50-minute team group discussion to design effective violence prevention skills for a hospital violence situation, (3) 60-minute interactive skills training curriculum focusing on role play, rehearsal and feedback. The control group only received a self-learning violence prevention manual. Generalized Estimating Equation (GEE) model was used to examine the program effects. Results The results for the GEE statistics indicated a significant time effect. The pretest-posttest and after the posttest results that treatment group showed significant improvement in preventive skills (β = 1.828, β=1.330; p&amp;lt;0.001) and self-efficacy(β = 4.123, β=5.363; p&amp;lt;0.001) compared to the control group. Besides, the experimental group significantly decreased incidents of verbal violence (β=-1.140, p &amp;lt; 0.05) compared to the control group. Conclusions The study showed integration of skill-based teamwork learning in clinical nursing training provides an additional venue to prevent and reduce workplace violence. This shall be a feasible module and significant reference in junior or pre-service health care workers training in the future. Key messages The study demonstrates the feasibility of implementing the team learning curriculum for clinical nurses. The present study provides empirical evidence of the skill-based team learning training curriculum in workplace violence program for clinical nurses.

The deteriorating patient-physician relationship in India: Is it time to look within?

The patient-physician relationship in India is in a state of rapid decline with fresh incidents of violence highlighting the scale of the problem. The medical fraternity needs to reflect on certain issues plaguing its conduct with patients and colleagues and embark on steps to address them. In this article, I highlight some major points which could help us arrest the deteriorating trust and heightened violence in hospitals.

Workplace Violence in Chinese Hospitals: The Effects of Healthcare Disturbance on the Psychological Well-Being of Chinese Healthcare Workers.

Healthcare disturbance is a form of workplace violence against healthcare workers perpetrated by patients, their relatives, and gangs hired by them. It is a prevalent phenomenon in China, where evidence suggests that it impacts on the job satisfaction of healthcare workers. This study aims to examine the relationship between healthcare disturbance, surface acting as a response to emotional labour, and depressive symptoms in Chinese healthcare workers. The study adopted a cross-sectional design and used an online survey methodology. Data were collected from 418 doctors and nurses from one hospital in China. The results showed that frequency of healthcare disturbance was positively related to surface acting and depressive symptoms, respectively; surface acting was also positively related to depression, while deep acting showed no effect on symptoms of depression. Furthermore, surface acting in response to emotional labour mediated the relationship between healthcare disturbance and depressive symptoms. The results highlight the importance of preventing healthcare disturbance and of training healthcare staff in strategies for managing emotional demands in reducing depressive symptoms in Chinese healthcare staff.