This study analyzes violence against personnel in the emergency wards of all 25 general hospitals in Israel using a self-report questionnaire (N=2,356). Informed by the routine activity theory, the hypotheses related to the major concepts of this approach: exposure, target suitability, guarding and proximity to offenders. A General Exposure to Violence Index (GEVI) was constructed, based on the participants' reports about type and frequency of their victimization to violence during the preceding year. The multiple regression analysis for explaining the GEVI was composed of 15 independent variables relating to participants' professional and personal characteristics as well as to structural features of hospitals. As predicted, higher exposure to violence was related to security or nursing staff and positions of authority; high weekly workload; working in a profession other than that of training; inability of coping with verbal violence; having no access to an emergency button, and working in settings restricting the number of accompanying persons to one only. Unexpectedly, previous training in coping with violence was related to higher victimization. Younger age, male gender and being of European/American origin (mainly from the former Soviet Union) was also related to higher risk of victimization. The results support the utility of the routine activities approach in explaining differences in emergency ward personnel victimization. The findings also indicate, however, the need to add domain-specific contextual analyses to this approach to reach a fuller understanding of the behaviors under discussion. Implications of the finding to coping with violence against emergency ward personnel are discussed, and suggestions are put forward for further study in this field.

Victimization through violence against personnel in the emergency ward (EW) was studied in all 25 general hospitals in Israel, using a self-report questionnaire (N = 1,484). Informed by routine activity theory as well as stress (negative affect) theories, the study analyzed victim and offender related variables, as well as structural, situational and interactional variables. A Victimization Seriousness Score (VSS) was constructed, based on participants' reports about the most serious type of violence they had experienced from patients and/or their relatives during the preceding year. The multiple regression analysis to explain the VSS was comprised of 35 independent variables relating to the victim's professional and personal characteristics, the hospital's structural features, and the offenders' personal characteristics, as well as situational and interactional factors, jointly explaining 47.4% of the variance (R2 = 0.474). As predicted, victimization by more serious violence was related to being security or nursing staff, positions of authority, and having no access to an emergency button. Male gender and being of Israeli or European/American origin (mainly from the former Soviet Union) was also related to more severe victimization. Offenders behaving more violently were younger, of Asian/African origin, new immigrants, and initially unstable (alcoholics, drug addicts, homeless, or psychiatric disorders). More serious victimization took place during evening shifts, related to severe medical problems and was characterized by the victim's inability to verbally communicate with the offender, and by calling other staff for help. The study demonstrates the importance of situational and interactional variables, and that violence in the EW is best explained by a comprehensive theoretical model that combines a routine activity approach with stress (negative affect) models. Suggestions are put forward for further research in this area.

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