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.

Workplace Violence Against Doctors in Bangladesh: A Content Analysis

Workplace violence in healthcare settings is a common global problem, including in Bangladesh. Despite the known presence of workplace violence in healthcare environments of developing countries, there is limited understanding of factors that lead to hospital violence in Bangladesh. This study aims to explore factors that influence incidents of violence against healthcare professionals in Bangladesh, as reported by doctors via social media forum. Content analysis was conducted on 157 reported incidents documented on “Platform,” the online social media most used by medical students and doctors in Bangladesh. Posts by doctors detailing experiences of physical or verbal violence at their workplace between July 2012 and December 2017 were included in this study. The majority of reported incidents were reported by male doctors (86%) and from government hospitals (63.7%). Findings showed that primary healthcare centers experienced more violence than secondary and tertiary facilities. This may largely be due to insufficient human and other resources in primary care settings to meet patient demand and expectations. Most of the events happened at night (61%), and as a result, entry-level doctors such as emergency duty doctors and intern doctors were commonly affected. Six themes were identified as vital factors in workplace violence against doctors: patients’ perspectives, delayed treatment, power practice, death declarations, extreme violence, and care-seeking behaviors. Most incidents fell under the categories of delayed treatment and power practice at 26.8 and 26.1%, respectively. This study identified possible factors for reported violence in hospital settings. To address and reduce these incidents, hospital administrators should be aware of risk factors for violent behavior and design appropriate measures to prevent workplace violence. Further qualitative and quantitative research is needed to appropriately address the consequences of violence on healthcare workers and implement measures to mitigate these events.

Violence against doctors in Iraq during the time of COVID-19

Objectives This study assessed patterns in reported violence against doctors working in 11 Baghdad hospitals providing care for patients with COVID-19 and explored characteristics of hospital violence and its impact on health workers. Methods Questionnaires were completed by 505 hospital doctors (38.6% male, 64.4% female) working in 11 Baghdad hospitals. No personal or identifying information was obtained. Findings Of 505 doctors, 446 (87.3%) had experienced hospital violence in the previous 6 months. Doctors reported that patients were responsible for 95 (21.3%) instances of violence, patient family or relatives for 322 (72.4%), police or military personnel for 19 (4.3%), and other sources for 9 (2%). The proportion of violent events reported did not differ between male and female doctors, although characteristics varied. There were 415 of the 505 doctors who reported that violence had increased since the beginning of the pandemic, and many felt the situation would only get worse. COVID-19 has heightened tensions in an already violent health workplace, further increasing risks to patients and health providers. Interpretation During the COVID-19 epidemic in Iraq an already violent hospital environment in Baghdad has only worsened. The physical and emotional toll on health workers is high which further threatens patient care and hospital productivity. While more security measures can be taken, reducing health workplace violence requires other measures such as improved communication, and addressing issues of patient care.

Mediating role of coping styles on anxiety in healthcare workers victim of violence: a cross-sectional survey in China hospitals

ObjectiveThe purposes of this study were to evaluate the rate of workplace violence in county hospitals in China and its impact on healthcare workers and to explore the relationship between hospital violence, coping styles and anxiety to provide effective procedures for reducing anxiety among healthcare workers.MethodsThe study used stratified sampling to select 1200 healthcare workers from 30 county hospitals in China to conduct a questionnaire survey. Of these, 1030 were valid questionnaires, and the effective response rate was 85.83%. We collected demographic characteristics of our participants and administered the following scales to them: Workplace Violence, Trait Coping Style, Self-rating Anxiety. Data were statistically analysed.ResultsThe results showed that 67.28% of healthcare workers in county hospitals in China had experienced workplace violence in the previous 12 months, with prevalent verbal violence (66.12%) followed by physical violence (15.24%). Workplace violence in hospitals was negatively related to positive coping (r=−0.091, p<0.01) but positively related to negative coping (r=0.114, p<0.001) and anxiety (r=0.298, p<0.001). Positive and negative coping was negatively (r=−0.085, p<0.01) and positively (r=0.254, p<0.001) associated with anxiety respectively. Positive and negative coping influenced both hospital workplace violence and anxiety in healthcare workers who were victims of violence. Compared with positive coping, the mediating effect of negative coping was stronger (95% CI −0.177 to –0.006).ConclusionsThe incidence of workplace violence among healthcare workers in county-level hospitals in China is relatively high, and there is a correlation between hospital violence, coping styles and anxiety. Positive and negative coping play a mediating role in the impact of hospital violence on healthcare workers’ anxiety. Therefore, hospital administrators should actively promote healthcare workers’ transition to positive coping strategies and minimise the negative impact of anxiety on them.