Violence In Nursing Research Articles

Poor Work Ability Is Associated with Workplace Violence in Nurses: A Two-Wave Panel Data Analysis.

Healthcare personnel must deal with two problems of growing importance: violence in the workplace and the loss of work ability due to the aging of the workforce. Our objective was to evaluate, with a two-wave perspective design, the relationships of work ability, social support, and occupational stress with workplace violence in nurses. In an Italian public health company, we asked nurses to self-assess their work ability using the Work Ability Index (WAI) and we analyzed the relationship between this indicator and the violence experienced in the previous and following years. A total of 321 out of 344 nurses (99.3%) participated. In a logistic regression model, the WAI score was a significant protective factor for violence experienced in the previous year (OR = 0.94 CI95% = 0.90; 0.98 p < 0.01) and in the following year (OR = 0.88 CI95% = 0.84; 0.92 p < 0.01). In a hierarchical logistic regression model, social support acted as a protective factor (OR = 0.87 CI95% = 0.79; 0.95 for violence experienced in the previous year), while occupational stress was a significant determinant of the risk of aggression (OR = 3.65 CI95% = 1.90; 7.03 in the previous year, OR = 3.54 CI95% = 1.801; 6.947 in the following year). The difficulties that nurses encounter in carrying out their growing work demands in an environment that is not promptly adapted to their changing physical and mental states can lead to an increased risk of violence. Prevention of workplace violence should include organizational and ergonomic measures that reduce stress and increase staff support and work ability.

Pathways linking workplace violence and suicidal ideation/non-suicidal self-injury among nurse staff: the mediating role of loneliness and depressive symptoms

BackgroundNurses face disproportionately high rates of suicidal ideation and non-suicidal self-injury (NSSI). The role of workplace violence, loneliness, and depressive symptoms in exacerbating these issues is poorly understood. This study aims to explore these relationships to inform interventions for improving nurses’ mental health.MethodsA cross-sectional study involving 1,774 Chinese nurse staff selected through convenient sampling methods was conducted. Workplace violence, depressive symptoms, and loneliness were assessed using the Chinese versions of the Workplace Violence Scale (WVS), the 9-item Patient Health Questionnaire (PHQ-9), and a three-item loneliness scale, respectively. Participants completed self-report questionnaires anonymously to ensure adherence to ethical standards. Statistical analysis utilized structural equation modeling (SEM) to examine the intricate relationships among variables, thereby elucidating the impact of workplace violence, loneliness, and depressive symptoms on nurses’ suicidal ideation/NSSI outcomes.ResultsNurse staff 165 (7.8%) were reported different level of suicidal ideation and 139 (7.8%) participants were reported different level of NSSI. And the final model of workplace violence on suicidal ideation shown a good model fit index (CMIN/DF = 3.482 NFI = 0.969 CFI = 0.977 TLI = 0.955 RFI = 0.938, RMSEA = 0.037 SRMR = 0.035). The pathway of workplace violence to loneliness (β = 0.163, P < 0.001), the indirect effect of workplace violence on suicidal ideation via loneliness and depressive symptoms were 0.100 (95%CI = 0.085, 0.121), the indirect effect of loneliness on suicidal ideation via depressive symptoms were 0.128 (95%CI = 0.100, 0.158). Similarly, the final model of workplace violence on NSSI shown a good model fit index (CMIN/DF = 3.482 NFI = 0.967 CFI = 0.976 TLI = 0.953 RFI = 0.935, RMSEA = 0.037 SRMR = 0.034), the pathways of workplace violence to NSSI (β = 0.115, P < 0.001), the indirect effect of workplace violence on NSSI via loneliness and depressive symptoms were 0.075 (95%CI = 0.055, 0.096), the indirect effect of loneliness on NSSI via depressive symptoms were 0.102 (95%CI = 0.076, 0.130).ConclusionOur study unveils the role of workplace violence in nurses’ suicidal ideation and NSSI, mediated by loneliness and depressive symptoms. Interventions targeting workplace violence are crucial for nurses’ well-being, potentially reducing loneliness and depressive symptoms and lowering the risk of suicidal ideation and NSSI. However, further research is needed to explore additional mediators and pathways, employing longitudinal designs to establish causality and develop tailored interventions for nurses affected by workplace violence.

The moderating role of perceived social support in relationship between workplace violence with post-traumatic stress disorder symptoms among nurses in Karbala

Introduction: The presence of violence in workplace is a threatening factor for nurses’ psychological health. Therefore, the present study was conducted with the aim of determining the moderating role of the perceived social support in relationship between workplace violence (physical, Verbal and sexual harassment) with Post Traumatic Stress Disorders symptoms) PTSD( among nurses in Karbala city, Iraq.&#x0D; Materials and Methods: Research method was descriptive correlation that is used in hierarchical regression analysis. The statistical population of the research included all the hospital nurses of the city of Karbala in Iraq in summer 2023, which among them, 349 nurses were selected by convenience sampling method. The data were collected using the violence in workplace questionnaire, Post Traumatic Stress Disorders symptoms checklist and perceived social support questionnaire. To analyze data, Pearson's correlation coefficient and hierarchical regression analysis statistical tests were used by SPSS software, 26 version.&#x0D; Results: The results revealed that the perceived social support moderates the relationship between the violence in workplace (physical, verbal and sexual harassment) with post-traumatic stress symptoms (p&lt;0.01). This means that, when the perceived social support is low, the hostility at workplace (physical, verbal and sexual harassment) has a stronger relationship with post-traumatic stress symptoms (p&lt;0.01).&#x0D; Conclusion: Based on the results of the present study, it can be concluded that the perceived social support in necessary variable to prevent the destructive effects of violence in nurses' work settings. Therefore, due to the role and importance of perception of social support among nurses, attention to this important finding should be taken into consideration by managers and policy makers of healthcare organizations.

Correlation between Nurse Altruism Attitudes and Levels of Workplace Violence in Nurses at the Agroindustrial Regional Hospital in Jember Regency

Correlation between Nurse Altruism Attitudes and Levels of Workplace Violence in Nurses at the Agroindustrial Regional Hospital in Jember Regency

Educational intervention to prevent gender violence in university nursing students: Design

Introduction: This study provides the PRE-VIOGEN educational program developed by seven Mexican public educational institutions with multimedia technology in distance mode, designed to prevent gender-based violence in nursing. Objective: Design an educational intervention to prevent gender violence in nursing students. Methodology: Descriptive design based on basic methodological recommendations from INSALUD, gender theories, feminism, Bourdieu, Ausubel, and Bandura. First, an analysis of the situation was carried out, the problem was defined, a diagnosis of the student's situation and contextualization of the conditions for educational intervention. For the systematization and integration of the content, a format was created and the themes were distributed. For implementation, the application method was systematized, piloting was carried out with a sample of convenience. For the selection, students from the 4th-10th semester with availability of a computer and internet were invited. On the Moodle platform, they were given informed consent, aspects of their participation and resolution time: distance, self-administered and asynchronous modality. For the evaluation, a satisfaction survey was applied. Results: Sample made up of 54 students, mostly women, heterosexuals, interns, with a partner between 20 and 28 years old. The interactive PRE-VIOGEN educational program consists of 18 mixed pedagogy themes that are addressed from a gender perspective around equality, social justice, respect for diversity and exercise of human rights, distributed in 5 units. Includes guided readings, infographics, discussion forums, interactive videos, learning activities, and self-assessments. The duration is 20 hours, approximately 2 weeks. In the satisfaction survey applied, the students reported feeling very satisfied. Conclusions: The design of the PRE-VIOGEN study program is a contribution to nursing education. It is taken in the short term, offers an emotional, social and humanities learning experience in a tele-educational-interactive mode, with the capacity to offer combined pedagogical materials: texts, sound, gamification, animation, and videos, which can be taken in the students' free time. It will contribute to evaluating the effect of educational intervention to prevent gender-based violence.

Prevalence of gender-based violence in university nursing students: Multi-centric Mexican study

Introduction. This study provides crucial information from seven Mexican educational institutions about the experience of gender violence experienced by nursing students during their university education that has not been emphasized in the Mexican scientific literature. Its purpose is to develop an educational strategy to prevent violence in nursing. Objective: To compare the prevalence of gender violence and its characteristics, experienced in the university environment by nursing students from seven Mexican educational entities. Method: Cross-sectional quantitative design, based on the construction and validation of a multidimensional content instrument to measure perception, attitudes, knowledge, and gender-based violence in nursing university students in Mexico that was self-administered online. The 1345 sample was calculated with a confidence level of 0.95% and a probability of 0.5%. The selection was by non-probabilistic convenience sampling. The data were processed in SPSS-21 statistical software and analyzed using descriptive statistics. Informed consent was requested for risks, benefits, and data protection. Approved by the research and ethics committees of the various universities. Results: The prevalence of gender violence in university nursing students is moderately high (49.3%) with high typologies. Physical (76.7%) and sexual violence (64.61%) predominated. Violence is experienced both in the classroom and in clinical practices, with college colleagues being the main perpetrators, especially affecting the emotional health of the victims: stress, depression, anguish, and low self-esteem. By educational institution, the highest prevalence level was obtained by the UADY, 61.05%, followed by the FESZ, 53.13%, and the UV, 51.22%. There is a lack of knowledge among the students of the presence of a department that provides services, 73.5%, and of the protocol for the care of gender violence, 64%. Discussion. Consistency was found in the results of this study regarding the high prevalence of gender violence in the international context. As is the high persistence of sexual violence, as is the case of nursing students in Taiwan, Nigeria, Brazil, and Ecuador, perhaps due to the common denominator of the highest percentage of female students, which shows that a good percentage of Nursing student women in different spaces and moments have gone through an act of sexual assault or harassment. Conclusion. In general, the prevalence of gender-based violence in Mexican nursing schools is moderately high with high typologies. Future research should provide strategies to counteract this problem. The universities must propose policies and legislation also in the clinical environments of the students.

Prevalence of gender-based violence in university nursing students: Multi-centric Mexican study

Introduction. This study provides crucial information from seven Mexican educational institutions about the experience of gender violence experienced by nursing students during their university education that has not been emphasized in the Mexican scientific literature. Its purpose is to develop an educational strategy to prevent violence in nursing. Objective: To compare the prevalence of gender violence and its characteristics, experienced in the university environment by nursing students from seven Mexican educational entities. Method: Cross-sectional quantitative design, based on the construction and validation of a multidimensional content instrument to measure perception, attitudes, knowledge, and gender-based violence in nursing university students in Mexico that was self-administered online. The 1345 sample was calculated with a confidence level of 0.95% and a probability of 0.5%. The selection was by non-probabilistic convenience sampling. The data were processed in SPSS-21 statistical software and analyzed using descriptive statistics. Informed consent was requested for risks, benefits, and data protection. Approved by the research and ethics committees of the various universities. Results: The prevalence of gender violence in university nursing students is moderately high (49.3%) with high typologies. Physical (76.7%) and sexual violence (64.61%) predominated. Violence is experienced both in the classroom and in clinical practices, with college colleagues being the main perpetrators, especially affecting the emotional health of the victims: stress, depression, anguish, and low self-esteem. By educational institution, the highest prevalence level was obtained by the UADY, 61.05%, followed by the FESZ, 53.13%, and the UV, 51.22%. There is a lack of knowledge among the students of the presence of a department that provides services, 73.5%, and of the protocol for the care of gender violence, 64%. Discussion. Consistency was found in the results of this study regarding the high prevalence of gender violence in the international context. As is the high persistence of sexual violence, as is the case of nursing students in Taiwan, Nigeria, Brazil, and Ecuador, perhaps due to the common denominator of the highest percentage of female students, which shows that a good percentage of Nursing student women in different spaces and moments have gone through an act of sexual assault or harassment. Conclusion. In general, the prevalence of gender-based violence in Mexican nursing schools is moderately high with high typologies. Future research should provide strategies to counteract this problem. The universities must propose policies and legislation also in the clinical environments of the students.

Design and validation of a measurement instrument for gender violence in university Nursing

Introduction: This work is part of the UNAM-DGAPA-PAPIIT Project IN304521, ENEO No124 entitled "Educational intervention to prevent gender violence in university nursing students: design and evaluation", which was approved by the ethics and research committee of the ENEO-UNAM. Objective: Build and validate a documentary measurement instrument for gender violence in nursing university students. Methodology: Based on the Supo taxonomy. Design and validation of instruments type documentary measurement, of multidimensional content to measure the perception, attitudes, knowledge and gender violence in Mexican university nursing students. The content was built from a literary search on the web, the last 10 years. The content validation was through rational validity and judging of 8 gender experts. The metric properties were determined by Variances and Cronbach's Alpha from the application of a pilot test with 80 students from various nursing schools and semesters, they were selected by non-probabilistic convenience sampling. The sample was calculated with a confidence level of 0.95% and a probability of 0.05%. The collection method was remote. Informed consent was requested, including clarification of doubts, associated risks and benefits, as well as data protection. Processing in statistical software SPSS 21. Results: The judges evaluated the content as sufficient (95.10%), clear (96.57%), pertinent (96.90%) Relevant (85.13%) and with applicability (95.93%). By general consensus the content validity was 93.93%. The construct validity was ratified with the strength of heterogeneity of the variances other than zero in all dimensions. The instrument obtained very high reliability (Cronbach .945). The conclusive instrument was constructed with 80 items distributed in four dimensions: perception, attitudes, knowledge and gender violence with 5 likert-type response options; an inventory with 5 additional questions and a section for the characterization of the sample. Approximate reasonable application time of 15 min. Conclusions: Based on the test theory, the documentary measurement instrument has a high precision to measure the gender violence variable.

Experiences of Aggressive Behavior Patient after Physical Restraint in Mental Hospital, A Qualitative Study

Aims. The prevalence of Violence in nurses and patients is an important issue today. One of the handlings of violent patients in mental hospitals is restraint. Restraint becomes a difficult choice for nurses in mental hospitals. This choice is still made with ethical considerations to prevent a worse risk. Restraints can violate patient rights. But if not done can threaten the environment. After physical restraint the patient has special experiences that need to be evaluated by the mental health nurse. Purpose. The purpose of this study was to describe the experience of patients with physical violence after restraint at the Mental Hospital, West Java. Methods. The informant selection technique used in this study was purposive sampling. The number of informants in this study was six patients. Patients were selected based on two inclusion criteria, first; have ever done physical violence, secondly, have experienced physical restraint. Patients have been selected by the head of the ward and approved by the nursing ethics board. Data was collected through focus group discussions (FGD). Data was recorded using an audiovisual camera. The discussion was conducted over three sessions, in three days, each for 60 minutes. The collected data is typed verbatim. The thematic analysis used in this study refer to six steps qualitative analysis. Result. There are six themes that arise in the client's response to violent behavior during physical restraint. It includes ignoring the patient's basic needs, Feelings of anger and irritation, thinking that there is no perceived positive influence, controlling his behavior for fear of the next physical restraint, Surrender to the conditions experienced, Feelings of relief and joy after not undergoing physical restraint, there is a feeling of revenge and want to take revenge. Conclusion. The patient's experience with physical violence after the act of restraint reveals the occurrence of neglect of basic human needs, the emergence of feelings of anger and irritation and thinking that restraint is of no benefit. After going through the angry phase, there is a sense of resignation to the patient and the informant's efforts to control his behavior for fear of getting physical restraint again. However, there is also a feeling of resentment that is triggered by the experience of being treated inhumanely.

Prevalence of horizontal violence of nurses in their first year of practice: A systematic review

<h2>ABSTRACT</h2><h3>Background</h3> ‘Horizontal violence' refers to hostile, aggressive, or harmful behaviour between peers. Nurse educators and managers who support newly qualified nurses should be aware of horizontal violence in the workplace when directed towards this professional group. The prevalence of horizontal violence in newly qualified nurses has not been subject to a systematic review. <h3>Aim</h3> The aim of this systematic review was to estimate prevalence of horizontal violence in newly qualified nurses in their first year of practice. <h3>Methods</h3> A systematic search was undertaken with the following databases on October 2018: AMED, CINAHL, CENTRAL, EMBASE, MEDLINE, ERIC and PsychINFO. An updated search was undertaken on August 12, 2020. Observational and experimental studies were included. Two researchers independently completed title, abstract and full-text screening. Nine studies were finally included in the review. Risk of bias was determined using the Joanna Briggs Institute critical appraisal tool. <h3>Findings.</h3> Included studies were cross-sectional in design and horizontal violence was determined using nine different self-report measures. Reported rates of horizontal violence ranged from 7% to 73%. All included studies were rated as having a moderate risk of bias. <h3>Discussion</h3> The broad range of prevalence estimates is likely explained by the use of different measures in included studies and the sources of bias. It is unclear if horizontal violence is common in nurses in their first year of practice. Further research that addresses the sources of bias we have identified is justified. <h3>Conclusion</h3> There is considerable variation in prevalence estimates of horizontal violence in nurses in their first year of practice

Lateral Violence of Nurses in the Hospital Environment: The Need for Caring

Abstract Nurses today are plagued with doing more with less and are forced to work in high-stress situations. These conditions lead to a stressful situation and contribute to lateral violence. While lateral violence has the potential to be present in any setting, it is more prevalent in healthcare. The adage of “nurses eat their young” is still in effect today. With a change in focus from a to-do list with a focus on genuine caring, not only the nurse but the patient as well will benefit. The purpose of this analytical review of research literature was to evaluate the prevalence of lateral violence experienced by nurses, determine ways to identify and eradicate it and educate the medical community on the incidence and eradication of lateral violence. Jean Watson’s Theory of Human Caring was determined to be the most comprehensive approach for guiding this review. For nurses to provide optimal care to patients, nurses must be able to work in a positive team-like atmosphere. Future strategies for improving lateral violence in the hospital environment include more educational workshops and nursing residency programs. Scholars suggested educating nursing students early in their nursing curriculum on lateral/horizontal violence to reduce the effects of lateral/horizontal violence for the future.

Frequency and barriers of reporting workplace violence in nurses: An online survey in China

ObjectivesThis study aimed to explore the reporting of workplace violence against nurses and the reasons why they did not reported. MethodsA self-designed questionnaire regarding workplace violence and reporting was used to conduct a cross-sectional survey on nurses who submitted a manuscript to a Chinese nursing journal from 2016 to 2017. A total of 324 nurses agreed to participate in this study and 266 participants from 165 hospitals in 72 cities returned questionnaires. ResultsA total of 172 nurses (64.7%) experienced violent incidents during the past year. Of these incidents, 45.5% were reported; and the reporting rate of physical assaults (69.0%) was higher than those of verbal abuse (36.9%), threatening behavior (51.7%), and sexual harassment (60.0%). Formal reporting accounted for 25.4% (15.4% in written form and 10.0% through a computer-assisted reporting system). Almost half of the nurses (49.6%) stated that the hospital had no reporting system or they were uncertain about the reporting system. For reasons of not reporting, 51.9% of the nurses were unware of how and what types of violence to report, and 50.6% of the nurses believed that the hospital paid greater attention to patients rather than staff. ConclusionsA clear definition of workplace violence and reporting procedures, establishment of a facile system for reporting, and supervisory support following a reporting are urgently required.

Psychosocial safety climate, workplace violence and self-rated health: A multi-level study among hospital nurses.

To validate the Chinese version Psychosocial Safety Climate scale (PSC-12), and examine the associations between PSC, workplace violence and self-rated health (SRH). Psychosocial safety climate moderates the negative effect of workplace violence on health. To address workplace violence experienced by nurses across the Asia-Pacific region, it is important to develop and apply a Chinese language version of the tool. We conducted a two-part study. In the first part, the Chinese version PSC-12 was developed and tested for its validity in 405 nurses. In the second part, a total of 1690 nurses from 73 hospitals filled a questionnaire concerning their work and health conditions. Multi-level modelling was used to examine the association between PSC, workplace violence and SRH. A comparable validity and reliability of the Chinese version PSC-12 with the original PSC was found. PSC scores were negatively associated with workplace violence. In the hierarchical linear model, participants from hospitals with the lowest PSC score had twofold risks of having poor SRH. The Chinese version PSC-12 is a valid tool. Hospital-level PSC was associated with poor health status in female nurses. Psychosocial safety climate should be evaluated and promoted to prevent workplace violence in nurses.

Lateral violence in nursing: a review of the past three decades.

The author of this article reviews the literature on lateral violence in nursing. This concept was first discussed over three decades ago. Bullying and incivility are concepts similar to lateral violence that have become increasingly utilized in nursing research and scholarly writing. The research on these concepts suggests that the behavior still exists in the nursing workplace, and that few interventions have been developed to change the behaviors or the power dynamics that cause them. Suggestions are included to change practice and scholarship in this area.

Evaluating an educational intervention on lateral violence.

Lateral violence involves disruptive behaviors that lead to toxic work environments. The purpose of this project was to determine the effects of an educational intervention to increase awareness and teach cognitive rehearsal to combat lateral violence. A one-time pretest-posttest evaluation design was used to evaluate the effects of a 1.5-hour educational intervention. Participants were nurses on two nursing units; 29 respondents participated in the pretest, and 25 respondents participated in the posttest. Positive trends were related to the decreasing frequency of lateral violence behaviors experienced and observed after the intervention. Participants were better able to identify causes of lateral violence in their work units, suggesting the educational intervention was successful in creating a healthier work environment and decreasing the incidence of lateral violence behaviors. Further evaluation is needed to determine whether the intervention would be effective over time. This project was limited by design and sample size.

Unreported workplace violence in nursing.

Workplace violence occurs on a frequent basis in nursing. Most violent acts remain unreported. Consequently, we do not know the actual frequency of the occurrence of workplace violence. This requires research of nurses' actions following workplace violence and identification of reasons why most victims do not report violent acts in the appropriate manner. To explore violence in nursing as experienced by nurses in Slovenia. A survey was carried out with a representative sample of nurses in Slovenia. The questionnaire Workplace Violence in Nursing was submitted to 3756 nurses, with 692 completing the questionnaire. A total of 61.6% of the nurses surveyed had been exposed to violence in the past year. Most victims were exposed to psychological (60.1%) and economic violence (28.9%). Victims reported acts of violence in formal written form in a range from 6.5% (psychological violence) to 10.9% (physical violence). The largest share of victims who did not report violence and did not speak to anyone about it were victims of sexual violence (17.9%). The main reason for not reporting the violence was the belief that reporting it would not change anything, followed by the fear of losing one's job. Only a small share of the respondents reported violence in written form, the main reason being the victims' belief that reporting it would not change anything. This represents a severe criticism of the system for preventing workplace violence for it reveals the failure of response by leadership structures in healthcare organizations. Professional associations and the education system must prepare nurses for the prevention of violence and appropriate actions in the event of violent acts. Healthcare organizations must ensure the necessary conditions for enabling and encouraging appropriate actions following violent acts according to relevant protocols.

The Bully Within and Without: Strategies to Address Horizontal Violence in Nursing

Pervasive horizontal violence in the nursing profession has bred the aphorism "nurses eat their young." Nurses must make a concerted effort to advocate for change in the existing professional culture. Such change can begin with embracing helpful tips in overcoming bullying and modeling successful positive behaviors. This paper defines horizontal violence in nursing and explores strategies to address it based upon shared information. Multiple workshops across the country have allowed nurses to exchange information about their experiences with horizontal violence. Nurses have examined their roles as bystander, perpetrator, and victim in discussing contemporary perspectives, employing methods of engagement, promoting debate, and using practical resource advice in dealing with the experience and prevention of horizontal violence. Workshops, evaluated through pretests/posttests and written evaluations, revealed increased knowledge about concepts of horizontal violence and their application to the workplace, recognition of horizontal violence, and methods of dealing with horizontal violence in nursing. Across the profession, nurses need exposure to practical approaches to curtailing horizontal violence in nursing. A similar workshop approach could be adapted across educational programs and workplaces based on the individual needs of each environment.

Breakaway and physical restraint techniques in acute psychiatric nursing: Results from a national survey of training and practice

The survey examined training and practice in the prevention and management of violence in nurses working in acute in-patient psychiatric services throughout the UK. Out of 2,152 questionnaires sent out, 771 completed responses were returned (36%). While the response rate was low, there were no obvious biases affecting it, and a high level of statistical power was attained. The study is the largest survey of training in the prevention and management of violence in this population conducted so far. Most respondents reported an acceptable ratio of theoretical input to practical skills training, although some important theoretical aspects received insufficient attention. The use of wrist flexion and pain compliance elements in the restraining holds taught were frequently reported. In clinical practice, breakaway techniques were reported as more frequently used than has been suggested in earlier research. Some redundancies in restraint training were also found, with some commonly-taught techniques being seldom or never used. Respondents were not particularly confident in their ability to use their skills safely or effectively. Training sessions were generally considered to have been safely and well run. The need for national standards in training that the findings suggest, and directions for further research are discussed.

Quarter violence of nurses endured at work last year

Quarter violence of nurses endured at work last year

Violence in Nursing – International Perspectives

Violence is not a concept one associates with nursing. Nevertheless, violence against nurses and by nurses in a variety of work settings has become an international problem. The exploration of this problem is at different stages in different countries. In some areas research has done much to identify and describe the factors in the victim, perpetrators and situations which lead to violence. In others research on this topic is still in its infancy. Similarly in some countries prevention and containment strategies in some areas of practice have seen substantial development over the last decade, while in other settings of countries, very little has been done. This volume has brought together the empirical and management data from a variety of settings in nine countries to describe the current state of practice in this field. Contents: M. Habermann: Introductory Remarks: Violence in Nursing - International Perspectives - P. Powers: Workplace Violence in U.S. Nursing Literature - A Discourse Analysis - M. Valimaki/J. Taipale/A. Pitkanen: Violence in Health Care: A Finnish Nursing Perspective - L. R. Uys/R. S. Gcaba: Violence in Nursing in two African Countries - D. Richter: Violence in Psychiatric Care: German Experiences - R. D. Hirsch: Violence against Elderly People and its Prevention in Nursing Care Institutions in Germany - R. Gallinagh: Physical Restraint in Gerontology in Ireland - D. M. Gates: Violence against Caregivers in Nursing Homes in the USA - B. Taylor: Identifying and Reducing Nurse-Nurse Horizontal Violence and Bullying through Reflective Practice and Action Research in an Australian Hospital - J. Noak/S. Wright: The Content and Development of Management of ViolencePolicies in Inpatient Psychiatric Settings - V. Sjogreen/A. Jensen/P. Kielberg: Education for Violence Prevention in A Danish Example.