Causes of Hospital Violence, Characteristics of Perpetrators, and Prevention and Control Measures: A Case Analysis of 341 Serious Hospital Violence Incidents in China

Objective: Hospital violence remains a global public health problem. This study aims to analyze serious hospital violence causes in China and the characteristics of perpetrators. It likewise seeks to understand frontline personnel's needs and put forward targeted suggestions.Methods: Serious hospital violence cases from 2011 to 2020 in the China Judgment Online System (CJOS) were selected for descriptive statistical analysis. A total of 72 doctors, nurses, hospital managers, and security personnel from 20 secondary and tertiary hospitals in China were selected for semi-structured interviews.Results: Of the incidents, 62.17% were caused by patients' deaths and dissatisfaction with their treatment results. Moreover, it was found that out-of-hospital disputes (11.14%) were also one of the main reasons for serious hospital violence. The perpetrators were mainly males (80.3%), and had attained junior high school education or lower (86.5%). Furthermore, most of them were family members of the patients (76.1%). Healthcare workers urgently hope that relevant parties will take new measures in terms of legislation, security, and dispute handling capacity.Conclusion: In the past 10 years, serious hospital violence's frequency in China has remained high. Furthermore, their harmful consequences are more serious. The causes of hospital violence are diverse, and the characteristics of perpetrators are obvious. Frontline healthcare workers urgently need relevant parties to take effective measures in terms of legislation, security, and dispute handling capacity, to prevent the occurrence of violence and protect medical personnel's safety.

Managerial Challenges of Emotional Labor Disruption: The COVID-19 Crisis in Mexico

The purpose of this article is to contribute to the knowledge of managing emotional labor during a crisis. The COVID-19 pandemic has been a disrupting event, particularly affecting frontline healthcare workers and their supervisors who faced pressures to manage emotions during their interactions with patients. Emotional labor has been studied in emergencies; however, the case of Mexico offers insights into an understudied context and a long and singular crisis. Drawing from multi-level storytelling interviews with medical managers, physicians, and nurses in hospitals in different states of Mexico, this article argues that COVID-19 blurred relationships between performance and outcomes of emotional labor. As the organizational goal focused mainly on saving lives, some workers intensified and performed emotional labor innovatively, but others deviated from feeling rules. Managers’ role became crucial for employees to abide by affective requirements facing disruption.

Mental Health Problems among COVID-19 Frontline Healthcare Workers and the Other Country-Level Epidemics: The Case of Mexico

COVID-19 frontline healthcare workers (FHCW) are struggling to cope with challenges that threaten their wellbeing. We examine the frequency and predictors of the most frequent mental health problems (MHP) among FHCW during the first COVID-19 peak in Mexico, one of the most severely affected countries in terms of FHCW’s COVID-19 mortality. A cross-sectional survey was conducted between May 8 and August 18, 2020. A total of 47.5% of the sample (n = 2218) were FHCW. The most frequent MHP were insomnia, depression, posttraumatic stress symptoms, and health anxiety/somatization (whole sample: 45.7, 37.4, 33.9, and 21.3%; FHCW: 52.4, 43.4, 40.3 and 26.1, respectively). As compared to during the initial COVID-19 phase, depression and health anxiety/somatization symptoms as well as experiences of grieving due to COVID-19, personal COVID-19 status, and having relatives and close friends with COVID-19 were more frequent during the COVID-19 peak. Obesity, domestic violence, personal COVID-19 status, and grieving because of COVID-19 were included in regression models for main FHCW’s MHP during the COVID-19 peak. In conclusion, measures to decrease other country-level epidemics contributing to the likelihood of COVID-19 complications (obesity) and MHP (domestic violence) as well as FHCW´s probability of COVID-19 infection could safeguard not only their physical but also mental health.

Listening and learning from the COVID-19 frontline in one US healthcare system

PurposeThe on-going COVID-19 pandemic has drastically impacted healthcare systems worldwide. Understanding the perspectives and insights of frontline healthcare workers caring for and interacting with patients with COVID-19 represents a timely, topical, and important area of research. The purpose of this qualitative action research study was to assist one US healthcare system that has an expansive footprint with the implementation of a needs assessment among its frontline healthcare workers. The leadership within this healthcare system wanted to obtain a deeper understanding of how the COVID-19 pandemic was impacting the personal and professional lives of its workers. Further, the organisation wanted to solicit employees’ feedback about what they needed, understand the issues they were facing, and solicit their ideas to help the organisation know where to take action.Design/methodology/approachThis qualitative research employed 45 focus groups, referred to as virtual listening calls (LCs) in this organisation, which were held over a four-week period. A total of 241 nursing staff, representing healthcare facilities across the country, attended 26 of the LCs. A total of 19 LCs were held with 116 healthcare workers who are employed in other clinical roles (e.g. therapists) or administrative functions.FindingsExtending beyond the available research at the time, this study was initiated from within a US healthcare system and informed by the frontline healthcare employees who participated in the LCs, the findings of this study include the perspectives of both nursing and other healthcare workers, the latter of which have not received considerable attention. The findings underscore that the COVID-19 pandemic has wreaked havoc on the personal and professional lives of all of these healthcare workers and has exacted an emotional toll as noted in other studies. However, this study also highlights the importance of listening to employees’ concerns, but more importantly, their recommendations for improving their experiences. Notably, the organisation is in the midst of making changes to address these frontline workers’ needs.Originality/valueThe study, inclusive of nursing and other healthcare staff, demonstrates how an organisation can adapt to a crisis by listening and learning from its frontline employees.

The Impact of Community Generated PPE During the SARS-COV-2 Pandemic in Southeast Alabama and Gulfport Mississippi

Background: The early stages of the SARS-COV-2 pandemic left many hospital systems devoid of personal protective equipment. Community-driven groups manufactured Personal Protective Equipment (PPE) as a form of temporary replacement until supply could increase to frontline healthcare workers. The purpose of this study was to survey hospital systems in Alabama and Mississippi who requested and received PPE to determine recipient opinions concerning community involvement.Methods: A 15-question Qualtrics survey was distributed to hospital systems who requested and received community-generated PPE (CGPPE) from the group known as Alabama Fighting COVID. 275 responses were gathered over a period of 6 months.Results: Survey data showed that most respondents from healthcare and healthcare-associated professions responded that wearing community generated personal protective equipment provided them with the perception of added protection (55.31% of participants selected either “Agree” or “Strongly Agree”), and that it improved their outlook and desire to work during the pandemic (51.77% of participants selected either “Agree” or “Strongly Agree”).Conclusions: Most respondents reported that wearing community generated personal protective equipment not only provided them with the perception of added protection, but that it improved their outlook and desire to work during the pandemic. With these responses in mind, our study raises questions concerning whether local CGPPE distribution could improve well-ness outcomes of healthcare workers (HCWs) not only in relation to decreased viral transmission, but also in favorable psychosocial health assessments. Further implications for research concerning community involvement during future medical crises are indicated, especially with the current rise of the delta variant strain.

Sources of Resilience in Frontline Health Professionals during COVID-19

Background: While the challenges for psychological well-being for Australian healthcare workers have been documented, there has been a dearth of qualitative research on the sources of resilience that sustained workers during the COVID-19 pandemic. This study identified sources of resilience that clinicians used to cope with frontline challenges during the COVID-19 pandemic. Methods: Semi-structured interviews were conducted with 20 frontline health professionals, across five Australian hospitals, between October 2020 and April 2021. The interviews were recorded and transcribed, and the results were analysed using thematic analysis based on a phenomenological approach. Results: Three sources of resilience were identified by respondents: personal, relational, and organisational. A positive mindset, sense of purpose, and self-care behaviours emerged as key sources of personal resilience. Teamwork, altruism, and social support from family and friends contributed to relational resilience. Leadership, effective communication, and effective implementation of COVID-19 policies were associated with resilience at the organisational level. Frontline healthcare workers also voiced the need for the implementation of further strategies to support personal resilience whilst nurturing resilience within clinical teams and across entire healthcare organisations. Conclusions: Trust in healthcare systems, organisation leaders, colleagues, and personal support teams was an overarching theme supporting resilience.

India and Pakistan: United by Covid-19

Madam, the number of new Covid-19 cases in India peaked at 362,902 on the 27th of April, 2021.1 This is the highest single day total for the world. India sold double the oxygen in 2020-21 than the previous year, now it faces a shortage of medical oxygen as it struggles with rising cases.2 Additionally, it struggles with the vaccine drive. In an article, Kamala Thiagarajan states that the initial block was mistrust of local vaccines, even among frontline healthcare workers. Other conspiracies followed, including fear of price hikes and reports about adverse effects, as approval for its own vaccines was rushed without proper evaluation to ensure safety.3 When adverse effects were observed in AstraZeneca and Johnson & Johnson trials, they were paused to conduct a safety review. However, no such thing occurred during the Covaxin trial.4 Continuous...