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Original Article
Physical and verbal workplace violence against nurses in Jordan H. Al-Omari
RN, ARNP, PhD
Assistant Professor, Department of Community and Mental Health Nursing, School of Nursing, Hashemite University, Zarqa, Jordan
AL-OMARI H. (2015) Physical and verbal workplace violence against nurses in Jordan. International Nursing Review Aims: To explore the prevalence of physical and verbal workplace violence among nurses working in general hospitals in Jordan, and to investigate the relation between physical violence, verbal violence, anxiety about violence, and some certain demographic variables. Background: Violence against nurses at the workplace is an alarming problem in both developed and developing countries. This study explicates physical and psychological workplace violence and its relation to anxiety about violence at workplace and to some demographic variables. Methods: A cross-sectional correlational study was conducted on a convenience sample of nurses working in general hospitals in Jordan. Results: A total of 468 nurses completed the questionnaire, 52.8% of the participants reported that they were physically attacked, and 67.8% were verbally attacked in the last 12 months. Of those who were physically attacked, 26.5% reported a physical violence with a weapon. The logistic regression analysis revealed that female nurses were 0.5 times less likely to report being physically attacked and were 1.5 times more likely to report being verbally abused than male nurses. Discussion: Violence against nurses is highly prevalent in Jordan. More than half of the participants were victims of violence at their workplace during the last year. Verbal abuse was more common among females than males. Nursing Implications: Nurses are in the frontline of the healthcare system and their safety is a high priority. They need to be involved in the development and formulation of workplace violence policy decisions. Conclusions: Physical and verbal workplace violence in Jordan, like other countries, is a dangerous behavior that negatively affects general hospital nurses. Keywords: Jordan, Nurses, Workplace Violence
Correspondence address: Dr Hasan Al-Omari, School of Nursing, The Hashemite University, PO Box 150453, Zarqa 13115, Jordan; Tel: (+962) 5390-3333 (5464); Fax: (+962) 5390-3351; E-mail: [email protected].
Funding sources This study was funded by the Hashemite University, Zarqa, Jordan (Grant No. AM/16/13/10/1102033). Conflict of interest No conflict of interest has been declared by the author.
© 2015 International Council of Nurses
1
2
H. Al-Omari
Introduction Violence at work is one of the very dangerous acts that take place in the healthcare settings. It has become a universal problem across borders, work settings and occupational groups (International Labour Organization et al. 2002). Healthcare sector workers are the most vulnerable to violence as they confront patients and their families on a daily basis (Kamchuchat et al. 2008). Workplace violence occurs in both developed and developing countries. The World Health Organization (WHO) reported the percentage of workplace violence in the healthcare sector of various countries; for example, it is 75.8% in Bulgaria, 67.2% in Australia, 61% in South Africa, 37% in Portugal, 54% in Thailand and 46.7% in Brazil (Di Martino 2002). In the USA, the Bureau of Labor Statistics reported that healthcare workers were victims of approximately 11 370 assaults in 2010 (U.S. Department of Labor 2014). Nurses comprise the majority of workers in healthcare settings. Being in the front line of the healthcare system, nurses are more vulnerable to be attacked by patients, families and other co-workers (AbuAlRub & Al-Asmar 2011; Ahmed 2012; Albashtawy 2013; Ayranci 2005; Chen et al. 2008; Hesketh et al. 2003; Kwok et al. 2006; Lin & Liu 2005). In Jordan, recent media reports show an increase in the number of violent incidents against nurses in healthcare settings. This study is conducted to deeply and profoundly understand this phenomenon in the largest general hospitals of Jordan. Background
Workplace violence in healthcare settings occurs in many forms. According to the WHO, violence in work settings can be physical and/or psychological. Physical violence is the use of physical force, such as beating, kicking, slapping, stabbing, shooting, pushing, biting and pinching against another person or group, which causes harm to the victim. Psychological violence, on the contrary, includes verbal abuse, bullying/ mobbing, harassment and threatening against another person or group, which may harm the physical, mental, spiritual, moral and social development of the victim (World Health Organization 2002). Workplace violence against healthcare workers, including nurses, is a widespread problem in both developing and industrial countries (Di Martino 2002). In Australia, for example, the percentage of the nurses who experienced violence at their workplace was 50% (Hegney et al. 2003). In Turkey, more than 72% of the healthcare workers experienced a certain form of violence (Ayranci 2005). Likewise, in Minnesota, USA, of a sample of 6300 nurses, 38% nurses reported, at least, one episode of threat, sexual harassment or verbal abuse, and over 13% nurses reported, at least, one episode of physical assault
© 2015 International Council of Nurses
(Nachreiner et al. 2007). In Iraq, 49 of the 116 nurses who participated in a survey reported a physical attack at their workplace (AbuAlRub et al. 2007). In a previous report from Jordan, more than 37% of the respondents reported some kind of verbal abuse (Ahmed 2012). There are several factors that lead to violence against nurses. Most of the time, these factors are related to patients and to their families’ demands that their patients get what they need and receive proper medical treatment (Lin & Liu 2005). Some of these factors include the patient’s previous history of violent behaviour, substance abuse, stress, anxiety, frustration, increased waiting time, medical illness and mental illness (Chapman & Styles 2006; Hodge & Marshall 2007; Kamchuchat et al. 2008). Most previous empirical work reports concur that workplace violence is often associated with factors related to the patients or to the environment; however, factors such as nurses’ level of anxiety about violence, their skills and behaviour in specific volatile situations might be responsible for the occurrence of violence (Chen et al. 2008; Lyneham 2000; Pai & Lee 2011). Violence at workplace causes seriously negative psychological and physical consequences on nurses. The most common psychological consequences include distress, anger, rage, disappointment, helplessness, anxiety, sadness, self-doubt, insecurity and loss of confidence. The physical consequences, on the contrary, include visible and invisible physical injury and pain (Franz et al. 2010; Kamchuchat et al. 2008). Jordanian nurses are not an exception; like other nurses worldwide, they commonly experience violence at their workplace (AbuAlRub & Al-Asmar 2011; Ahmed 2012; Albashtawy 2013). Recent reports show that workplace violence among Jordanians is as high as 75% (Albashtawy 2013). The aims of this study were as follows: (1) to examine the prevalence of physical and verbal workplace violence among nurses working in general hospitals in Jordan, (2) to investigate the relationship between physical violence, verbal violence, being worried about violence and some demographic variables (such as age, level of education and years of experience). The lack of adequate knowledge about the factors causing violence, from both the patients’ side and the nurses’ side, will certainly limit the chances of success in controlling such aggressive behaviour.
Methods Design
A cross-sectional correlational design was used in the present study to determine the prevalence and predictors of physical and verbal violence. Two trained research assistants (RAs) collected data at one point in time.
Physical and verbal workplace violence in Jordan
Sample and settings
A convenience sample was used due to its practical feasibility and efficiency to the researcher. Nurses working in 11 Jordanian general hospitals (7 governmental, 2 private and 2 university general hospitals) were recruited. These 11 hospitals are the largest hospitals in the five major cities of Jordan. No sampling criterion was set up, except that nurses were working in a direct contact with patients. Nurses who were in administrative positions and were not in direct contact with patients’ care were excluded. Data collection
Two trained RAs collected the data. Through the nursing department managers, all nurses working in the targeted hospitals were approached to participate in the study. The trained RAs visited the different hospital departments to explain the purpose of the study and to invite nurses to voluntarily participate. Upon agreeing to participate, the participants were asked to read and sign the consent form and then complete the questionnaire. The RAs were available to answer questions when needed. It took the participants about 30 min to complete the questionnaire. Nurses were then asked to place the completed questionnaires in an envelope and leave them with their unit manager. The RAs approached the unit manager to collect the envelopes. A total of 468 nurses completed the questionnaire with a response rate of 93.6%. The data were collected between January 2013 and September 2013 and all the completed questionnaires were valid for use. Data analysis
Statistical Package of Social Science (SPSS) version 20.0 (SPSS Inc., Chicago, IL, USA) was used to conduct descriptive, correlation statistics and logistic regression tests. Ethical considerations
Before conducting the study, the researcher obtained approval from the Institutional Review Board at the Hashemite University, Jordan. Confidentiality was maintained throughout the study. Participants’ anonymity and confidentiality were ensured by not asking the participants to write any identifying information on the questionnaire. There was no potential risk to participate, and nurses were informed that they could quit at any time in case they preferred not to complete the questionnaire. Measures
The questionnaire used in the present study is derived from International Labour Office (ILO), International Council of Nurses (ICN), WHO and Public Services International (PSI) project ‘Workplace Violence in the Health Sector Country
© 2015 International Council of Nurses
3
Case Studies Research Instruments Survey Questionnaire’ (International Labour Organization et al. 2003). This Workplace Violence Questionnaire (WVQ) was previously used to examine workplace violence by researchers in Jordan (AbuAlRub & Al-Asmar 2011; Ahmed 2012) and in other countries, such as Taiwan (Chen et al. 2008) and Hong Kong (Kwok et al. 2006). The WVQ consists of five sections: (a) personal and workplace data, (b) physical workplace violence, (c) psychological workplace violence that include verbal abuse, bullying/ mobbing, sexual harassment and racial harassment, (d) health sector employer, and (e) opinions on workplace violence. In this study, personal and workplace data, physical workplace violence and verbal abuse information were used. As reported in a previous study (Ahmed 2012), the Cronbach’s alpha, for all the scales in the WVQ, was between 0.73 and 0.90. Permission to use the WVQ was obtained from the WHO prior to data collection. The personal and workplace data section of the questionnaire is a descriptive section inquiring about the participants’ demographic background; hence, the demographic variables of this study: age, marital status, years of experience, level of education, etc. The items with yes/no forms inquire about workplace information. For example, participants were asked if there were procedures for reporting violence at their workplace, and if they had been encouraged to report workplace violence. A five-point Likert-type question was also used to assess how worried the nurses were about violence in their current workplace (from 1 = not worried at all to 5 = very worried). The physical workplace violence section focuses on the use of physical force against another person or group, which may include beating, kicking, slapping, stabbing, shooting, pushing, biting and/or pinching, resulting in physical, sexual or psychological harm. It consists of a descriptive questionnaire with a yes/no form inquiring about the participant’s experience of a physical attack; and a five-point Likert-type subscale (four questions) to assess how bothered with such an experience the nurse was (from 1 = not bothered at all to 5 = extremely bothered). In this study, the Cronbach’s alpha for this subscale was 0.75. Similarly, the verbal abuse section is a descriptive questionnaire with a yes/no form inquiring about the verbal abuse experience, and a fivepoint Likert-type subscale (four questions) to assess how bothered with the incident of verbal abuse the nurse was (from 1 = not bothered at all to 5 = extremely bothered). The Cronbach’s alpha for this subscale, in this study, was 0.79. Reliability was not determined in other sections of the questionnaire in this study.
Findings Of the 500 nurses who participated in the study, a total of 468 completed the WVQ. Most of the participants are male (52.9%),
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H. Al-Omari
aged 30 years or younger (55.5%), married (60%), had a bachelor’s degree (69%) and had a work experience of less than 10 years (73.5%). The majority of the participants in this study worked as full time (78.1%), in public hospitals (81.2%) and worked in different shifts (88.6%). The sample consisted of predominately registered nurses (57.1%) who worked with both male and female patients (67.4%), and interacted with patients during their work (84.2%). The participants worked at different units, including general medicine (17.7%), general surgery (17.1%), emergency (16.7%), intensive care unit (14.7%), as well as other units, such as maternal/child, coronary care unit, specialized units, operation rooms, technical services and management, among others. The majority of the sample (95.9%) reported that they worked with other nurses and co-workers and did not work alone. Although the majority of the participants in this sample (63.2%) stated that there were procedures to report violence in their workplace, only 52% claimed that they were encouraged to report it. Many of the participants reported that they were moderately worried to very worried (17.9% and 11.7%, respectively) about violence in their workplace. Table 1 provides more information about the sample characteristics.
Physical workplace violence
Surprisingly, 52.8% of the sample stated that they were physically attacked at their workplace during the past 12 months. Although 26.5% of those who were physically attacked described it as ‘physical violence with a weapon’, 58.3% never took time off from work after the attack. The majority of the perpetrators were patients (84.5%); the attacks occurred inside the healthcare facility (53.6%) between afternoon time and early evening time (45%). The participants reported that the most common response to physical violence was to tell the person to stop it (40.6%), to report the incidence to the supervisor (29.7%) and/or to try a physical self-defense (28.5%). Very few of the respondents filled in an incident report and/or sought help from the Nursing Union (9.2% and 5.9%, respectively). The participants who reported being physically attacked during the previous year were asked to describe how bothered they have been since the time of the attack using a list of common problems and complaints people sometimes have in response to stressful life experiences. Most of them (33.2%) were a little bit bothered by repeated disturbing memories, thoughts or images of the attack, while 32.7% were moderately bothered by avoiding thinking or talking about the attack or avoiding the related feelings. Furthermore, 42.5% were moderately bothered by being super-alert or watchful and on guard,
© 2015 International Council of Nurses
Table 1 Demographic characteristics of the sample (n = 468)
Age (n = 467)* 19 years or under 20–29 years 30–39 years 40–49 years 50 years or over Gender (n = 465)* Male Female Marital status (n = 468)* Single Married Divorced Widow Living with partner Place of work (n = 467)* Public hospital University hospital Other Educational level (n = 468)* High school Diploma BSN degree MSN or higher Years of experience (n = 126)*
Original Article
Physical and verbal workplace violence against nurses in Jordan H. Al-Omari
RN, ARNP, PhD
Assistant Professor, Department of Community and Mental Health Nursing, School of Nursing, Hashemite University, Zarqa, Jordan
AL-OMARI H. (2015) Physical and verbal workplace violence against nurses in Jordan. International Nursing Review Aims: To explore the prevalence of physical and verbal workplace violence among nurses working in general hospitals in Jordan, and to investigate the relation between physical violence, verbal violence, anxiety about violence, and some certain demographic variables. Background: Violence against nurses at the workplace is an alarming problem in both developed and developing countries. This study explicates physical and psychological workplace violence and its relation to anxiety about violence at workplace and to some demographic variables. Methods: A cross-sectional correlational study was conducted on a convenience sample of nurses working in general hospitals in Jordan. Results: A total of 468 nurses completed the questionnaire, 52.8% of the participants reported that they were physically attacked, and 67.8% were verbally attacked in the last 12 months. Of those who were physically attacked, 26.5% reported a physical violence with a weapon. The logistic regression analysis revealed that female nurses were 0.5 times less likely to report being physically attacked and were 1.5 times more likely to report being verbally abused than male nurses. Discussion: Violence against nurses is highly prevalent in Jordan. More than half of the participants were victims of violence at their workplace during the last year. Verbal abuse was more common among females than males. Nursing Implications: Nurses are in the frontline of the healthcare system and their safety is a high priority. They need to be involved in the development and formulation of workplace violence policy decisions. Conclusions: Physical and verbal workplace violence in Jordan, like other countries, is a dangerous behavior that negatively affects general hospital nurses. Keywords: Jordan, Nurses, Workplace Violence
Correspondence address: Dr Hasan Al-Omari, School of Nursing, The Hashemite University, PO Box 150453, Zarqa 13115, Jordan; Tel: (+962) 5390-3333 (5464); Fax: (+962) 5390-3351; E-mail: [email protected].
Funding sources This study was funded by the Hashemite University, Zarqa, Jordan (Grant No. AM/16/13/10/1102033). Conflict of interest No conflict of interest has been declared by the author.
© 2015 International Council of Nurses
1
2
H. Al-Omari
Introduction Violence at work is one of the very dangerous acts that take place in the healthcare settings. It has become a universal problem across borders, work settings and occupational groups (International Labour Organization et al. 2002). Healthcare sector workers are the most vulnerable to violence as they confront patients and their families on a daily basis (Kamchuchat et al. 2008). Workplace violence occurs in both developed and developing countries. The World Health Organization (WHO) reported the percentage of workplace violence in the healthcare sector of various countries; for example, it is 75.8% in Bulgaria, 67.2% in Australia, 61% in South Africa, 37% in Portugal, 54% in Thailand and 46.7% in Brazil (Di Martino 2002). In the USA, the Bureau of Labor Statistics reported that healthcare workers were victims of approximately 11 370 assaults in 2010 (U.S. Department of Labor 2014). Nurses comprise the majority of workers in healthcare settings. Being in the front line of the healthcare system, nurses are more vulnerable to be attacked by patients, families and other co-workers (AbuAlRub & Al-Asmar 2011; Ahmed 2012; Albashtawy 2013; Ayranci 2005; Chen et al. 2008; Hesketh et al. 2003; Kwok et al. 2006; Lin & Liu 2005). In Jordan, recent media reports show an increase in the number of violent incidents against nurses in healthcare settings. This study is conducted to deeply and profoundly understand this phenomenon in the largest general hospitals of Jordan. Background
Workplace violence in healthcare settings occurs in many forms. According to the WHO, violence in work settings can be physical and/or psychological. Physical violence is the use of physical force, such as beating, kicking, slapping, stabbing, shooting, pushing, biting and pinching against another person or group, which causes harm to the victim. Psychological violence, on the contrary, includes verbal abuse, bullying/ mobbing, harassment and threatening against another person or group, which may harm the physical, mental, spiritual, moral and social development of the victim (World Health Organization 2002). Workplace violence against healthcare workers, including nurses, is a widespread problem in both developing and industrial countries (Di Martino 2002). In Australia, for example, the percentage of the nurses who experienced violence at their workplace was 50% (Hegney et al. 2003). In Turkey, more than 72% of the healthcare workers experienced a certain form of violence (Ayranci 2005). Likewise, in Minnesota, USA, of a sample of 6300 nurses, 38% nurses reported, at least, one episode of threat, sexual harassment or verbal abuse, and over 13% nurses reported, at least, one episode of physical assault
© 2015 International Council of Nurses
(Nachreiner et al. 2007). In Iraq, 49 of the 116 nurses who participated in a survey reported a physical attack at their workplace (AbuAlRub et al. 2007). In a previous report from Jordan, more than 37% of the respondents reported some kind of verbal abuse (Ahmed 2012). There are several factors that lead to violence against nurses. Most of the time, these factors are related to patients and to their families’ demands that their patients get what they need and receive proper medical treatment (Lin & Liu 2005). Some of these factors include the patient’s previous history of violent behaviour, substance abuse, stress, anxiety, frustration, increased waiting time, medical illness and mental illness (Chapman & Styles 2006; Hodge & Marshall 2007; Kamchuchat et al. 2008). Most previous empirical work reports concur that workplace violence is often associated with factors related to the patients or to the environment; however, factors such as nurses’ level of anxiety about violence, their skills and behaviour in specific volatile situations might be responsible for the occurrence of violence (Chen et al. 2008; Lyneham 2000; Pai & Lee 2011). Violence at workplace causes seriously negative psychological and physical consequences on nurses. The most common psychological consequences include distress, anger, rage, disappointment, helplessness, anxiety, sadness, self-doubt, insecurity and loss of confidence. The physical consequences, on the contrary, include visible and invisible physical injury and pain (Franz et al. 2010; Kamchuchat et al. 2008). Jordanian nurses are not an exception; like other nurses worldwide, they commonly experience violence at their workplace (AbuAlRub & Al-Asmar 2011; Ahmed 2012; Albashtawy 2013). Recent reports show that workplace violence among Jordanians is as high as 75% (Albashtawy 2013). The aims of this study were as follows: (1) to examine the prevalence of physical and verbal workplace violence among nurses working in general hospitals in Jordan, (2) to investigate the relationship between physical violence, verbal violence, being worried about violence and some demographic variables (such as age, level of education and years of experience). The lack of adequate knowledge about the factors causing violence, from both the patients’ side and the nurses’ side, will certainly limit the chances of success in controlling such aggressive behaviour.
Methods Design
A cross-sectional correlational design was used in the present study to determine the prevalence and predictors of physical and verbal violence. Two trained research assistants (RAs) collected data at one point in time.
Physical and verbal workplace violence in Jordan
Sample and settings
A convenience sample was used due to its practical feasibility and efficiency to the researcher. Nurses working in 11 Jordanian general hospitals (7 governmental, 2 private and 2 university general hospitals) were recruited. These 11 hospitals are the largest hospitals in the five major cities of Jordan. No sampling criterion was set up, except that nurses were working in a direct contact with patients. Nurses who were in administrative positions and were not in direct contact with patients’ care were excluded. Data collection
Two trained RAs collected the data. Through the nursing department managers, all nurses working in the targeted hospitals were approached to participate in the study. The trained RAs visited the different hospital departments to explain the purpose of the study and to invite nurses to voluntarily participate. Upon agreeing to participate, the participants were asked to read and sign the consent form and then complete the questionnaire. The RAs were available to answer questions when needed. It took the participants about 30 min to complete the questionnaire. Nurses were then asked to place the completed questionnaires in an envelope and leave them with their unit manager. The RAs approached the unit manager to collect the envelopes. A total of 468 nurses completed the questionnaire with a response rate of 93.6%. The data were collected between January 2013 and September 2013 and all the completed questionnaires were valid for use. Data analysis
Statistical Package of Social Science (SPSS) version 20.0 (SPSS Inc., Chicago, IL, USA) was used to conduct descriptive, correlation statistics and logistic regression tests. Ethical considerations
Before conducting the study, the researcher obtained approval from the Institutional Review Board at the Hashemite University, Jordan. Confidentiality was maintained throughout the study. Participants’ anonymity and confidentiality were ensured by not asking the participants to write any identifying information on the questionnaire. There was no potential risk to participate, and nurses were informed that they could quit at any time in case they preferred not to complete the questionnaire. Measures
The questionnaire used in the present study is derived from International Labour Office (ILO), International Council of Nurses (ICN), WHO and Public Services International (PSI) project ‘Workplace Violence in the Health Sector Country
© 2015 International Council of Nurses
3
Case Studies Research Instruments Survey Questionnaire’ (International Labour Organization et al. 2003). This Workplace Violence Questionnaire (WVQ) was previously used to examine workplace violence by researchers in Jordan (AbuAlRub & Al-Asmar 2011; Ahmed 2012) and in other countries, such as Taiwan (Chen et al. 2008) and Hong Kong (Kwok et al. 2006). The WVQ consists of five sections: (a) personal and workplace data, (b) physical workplace violence, (c) psychological workplace violence that include verbal abuse, bullying/ mobbing, sexual harassment and racial harassment, (d) health sector employer, and (e) opinions on workplace violence. In this study, personal and workplace data, physical workplace violence and verbal abuse information were used. As reported in a previous study (Ahmed 2012), the Cronbach’s alpha, for all the scales in the WVQ, was between 0.73 and 0.90. Permission to use the WVQ was obtained from the WHO prior to data collection. The personal and workplace data section of the questionnaire is a descriptive section inquiring about the participants’ demographic background; hence, the demographic variables of this study: age, marital status, years of experience, level of education, etc. The items with yes/no forms inquire about workplace information. For example, participants were asked if there were procedures for reporting violence at their workplace, and if they had been encouraged to report workplace violence. A five-point Likert-type question was also used to assess how worried the nurses were about violence in their current workplace (from 1 = not worried at all to 5 = very worried). The physical workplace violence section focuses on the use of physical force against another person or group, which may include beating, kicking, slapping, stabbing, shooting, pushing, biting and/or pinching, resulting in physical, sexual or psychological harm. It consists of a descriptive questionnaire with a yes/no form inquiring about the participant’s experience of a physical attack; and a five-point Likert-type subscale (four questions) to assess how bothered with such an experience the nurse was (from 1 = not bothered at all to 5 = extremely bothered). In this study, the Cronbach’s alpha for this subscale was 0.75. Similarly, the verbal abuse section is a descriptive questionnaire with a yes/no form inquiring about the verbal abuse experience, and a fivepoint Likert-type subscale (four questions) to assess how bothered with the incident of verbal abuse the nurse was (from 1 = not bothered at all to 5 = extremely bothered). The Cronbach’s alpha for this subscale, in this study, was 0.79. Reliability was not determined in other sections of the questionnaire in this study.
Findings Of the 500 nurses who participated in the study, a total of 468 completed the WVQ. Most of the participants are male (52.9%),
4
H. Al-Omari
aged 30 years or younger (55.5%), married (60%), had a bachelor’s degree (69%) and had a work experience of less than 10 years (73.5%). The majority of the participants in this study worked as full time (78.1%), in public hospitals (81.2%) and worked in different shifts (88.6%). The sample consisted of predominately registered nurses (57.1%) who worked with both male and female patients (67.4%), and interacted with patients during their work (84.2%). The participants worked at different units, including general medicine (17.7%), general surgery (17.1%), emergency (16.7%), intensive care unit (14.7%), as well as other units, such as maternal/child, coronary care unit, specialized units, operation rooms, technical services and management, among others. The majority of the sample (95.9%) reported that they worked with other nurses and co-workers and did not work alone. Although the majority of the participants in this sample (63.2%) stated that there were procedures to report violence in their workplace, only 52% claimed that they were encouraged to report it. Many of the participants reported that they were moderately worried to very worried (17.9% and 11.7%, respectively) about violence in their workplace. Table 1 provides more information about the sample characteristics.
Physical workplace violence
Surprisingly, 52.8% of the sample stated that they were physically attacked at their workplace during the past 12 months. Although 26.5% of those who were physically attacked described it as ‘physical violence with a weapon’, 58.3% never took time off from work after the attack. The majority of the perpetrators were patients (84.5%); the attacks occurred inside the healthcare facility (53.6%) between afternoon time and early evening time (45%). The participants reported that the most common response to physical violence was to tell the person to stop it (40.6%), to report the incidence to the supervisor (29.7%) and/or to try a physical self-defense (28.5%). Very few of the respondents filled in an incident report and/or sought help from the Nursing Union (9.2% and 5.9%, respectively). The participants who reported being physically attacked during the previous year were asked to describe how bothered they have been since the time of the attack using a list of common problems and complaints people sometimes have in response to stressful life experiences. Most of them (33.2%) were a little bit bothered by repeated disturbing memories, thoughts or images of the attack, while 32.7% were moderately bothered by avoiding thinking or talking about the attack or avoiding the related feelings. Furthermore, 42.5% were moderately bothered by being super-alert or watchful and on guard,
© 2015 International Council of Nurses
Table 1 Demographic characteristics of the sample (n = 468)
Age (n = 467)* 19 years or under 20–29 years 30–39 years 40–49 years 50 years or over Gender (n = 465)* Male Female Marital status (n = 468)* Single Married Divorced Widow Living with partner Place of work (n = 467)* Public hospital University hospital Other Educational level (n = 468)* High school Diploma BSN degree MSN or higher Years of experience (n = 126)*
