How do aggression source, employee characteristics and organisational response impact the relationship between workplace aggression and work and health outcomes in healthcare employees? A cross-sectional analysis of the National Health Service staff survey in England

Abstract

ObjectivesTo examine the prevalence of aggression in healthcare and its association with employees’ turnover intentions, health and engagement, as well as how these effects differ based on aggression source (patients vs colleagues), employee characteristics (race, gender and occupation) and organisational response to the aggression.DesignMultilevel moderated regression analysis of 2010 National Health Service (NHS) survey.Setting147 acute NHS trusts in England.Participants36 850 participants across three occupational groups (14% medical/dental, 61% nursing/midwifery, 25% allied health professionals or scientific and technical staff).Main outcome measuresEmployee turnover intentions, health and work engagement.ResultsBoth forms of aggression (from patients and colleagues) have significant and substantial effects on turnover intentions, health and work engagement; however, for all three outcome variables, the effect of aggression from colleagues is more than twice the size of the effect of aggression from patients. Organisational response was found to buffer the negative effects of aggression from patients for turnover intentions and the negative effects of aggression from patients and colleagues for employee health. The results also demonstrated that nurses/midwives, women and Black employees are more likely to experience aggression; however, no clear patterns emerged on how aggression differentially impacts employees of different races, genders and occupations with respect to the outcome variables.ConclusionsAlthough aggression from patients and colleagues both have negative effects on healthcare employees’ turnover intentions, health and work engagement, these negative effects are worse when it is aggression from colleagues. Having an effective organisational response can help ameliorate the negative effects of aggression on employees’ health; however, it may not always buffer negative effects on turnover intentions and work engagement. Future research should examine other approaches, as well as how organisational responses and resources may need to differ based on aggression source.

Aggressive Behavior and Psychiatric Inpatients: a Narrative Review of the Literature with a Focus on the European Experience

“…These findings suggest that in UK, aggression episodes might occur (or are reported) more frequently than in other European countries [22]. In general, however, in European hospital psychiatric settings, preoccupying rates of both verbal and physical violence are enacted by patients, and this condition has remained unvaried over the last two decades, according to recent studies based on specifically developed questionnaires and interviews carried out in Norway [23], England [24], and Italy [25].…”

“…A UK-based investigation among 194 subjects with a first episode psychosis using the Psychiatric and Personal History Schedule (PPHS) [26] showed that almost 40% of cases enacted an aggressive behavior and that approximately half of these were physically violent [27]. A very recent survey promoted by the UK National Health System [24] using ad hoc developed measures and existing instruments altered to fit the research intents found that the average number of aggressive incidents in mental health/learning disability trusts was over three times the average for all trusts.…”

The Relationship between Emotional labor, Workplace Aggression and Organizational Role Stress among Nursing Staff

“…Reported that workplace aggression among workers was low because organization designed intervention to prevent workplace aggression and reduce burnout, supervisor have good communication with staff and the organization takes into account the workers' complaints. Furthermore, result Cheng, Dawson, Thamby, Liaw & King, (2020) (32) . Revealed that aggression related workplace was the phenomenon is difficult to occur among nursing staff because have the responsibility to provide safe and healthy working environment and to protect other people in the workplace from conflicts or situations that may cause physical and psychological injury or harm.…”

Satisfaction and attrition in the UK healthcare sector over the past decade

“…High quality quantitative studies on NHS job attrition are less common. Many of them suffer from small samples or lack adequate regression modelling to robustly estimate relationships [14,[27][28][29][30][31], though some larger sample regression-based studies do exist [32][33][34][35][36]. For registered nurses, work pressure and work-related stress emerged from structural equation modelling (n = 16,707) as the strongest positive correlates with intent to leave the NHS (other than organisation type) [32].…”

“…For registered nurses, work pressure and work-related stress emerged from structural equation modelling (n = 16,707) as the strongest positive correlates with intent to leave the NHS (other than organisation type) [ 32 ]. Aggression from both colleagues and patients is significantly related to the intent to leave [ 33 ], though it is not clear from the study how important this reason is relative to others. Hann et al [ 36 ] and Fletcher et al [ 34 ] both study GP survey data in samples >1000.…”