Nursing and aggression in the workplace: a systematic review

Abstract

Personal experiences of aggression or violence in the workplace leads to serious consequences for nurses, the patient, patient care and the organisation. While there is a plethora of research on this topic no review is available that identifies types of aggression encountered, individuals perceived to be most at risk and coping strategies for victims. The aim of this systematic review was to examine occupational anxiety related to actual aggression in the workplace for nurses. Databases (Medline, CINAHL and Psyinfo) were searched resulting 1543 titles and abstracts. After removal of duplicates and non-relevant titles, 137 papers were read in full. The major findings of the review were that physical aggression was most frequent in mental health, nursing homes and emergency departments while verbal aggression was more commonly experienced by general nurses. Nurses exposed to verbal or physical abuse often experienced a negative psychological impact post incident.

Violence, Burnout and Minor Psychiatric Disorders in Hospital Work

“…Some authors state that nursing is more exposed to violence from both the profile of their direct care activities to the patient (5)(6)11) and the predominance of female workers (5) , placing particular emphasis on the implications of gender being aggravating. A longitudinal study pointed to the exposure of nurses to gender violence, finding that in this class there was an increased risk of violence due to the overlap of labor abuse to domestic violence, and an increase in the chances of stress and depression (19) .…”

“…The implication of gender on the understanding of violence should consider the historical cultural and economic inequality between genders, for which women have been in unfavorable ...continuation conditions. Females having the largest distribution in the group of workers exposed to occupational violence has been recurrent in the health sector (5,9,12) .…”

“…Therefore, violence at work has gained international prominence in discussions on the challenges related to human resources for health (3)(4)(5) . Prevalence rates show that the problem of violence in health services range from 17 to 94%, and frequently exceeds 50% of workers (2)(3)(4)(5)(6) .…”

“…In the international scenario, studies have revealed concern about violence in health services (2,(5)(6) . However, in Brazil the problem still needs to be studied further (8)(9)(10) , since the invisibility of its occurrence and consequences contributing to the attacks are treated as "natural" in many work environments and the magnitude of the problem is underestimated.…”

“…The negative consequences of violence on the health of workers and the assistance provided have been evidenced by symptoms of stress, low self-esteem and the demotivation of the victims (5,(10)(11)(12) . These symptoms, which have been linked to the exposure of workers to violence and are characteristic of Burnout, a prevalent syndrome in health workers and characterized by high levels of emotional exhaustion, depersonalization, and low job satisfaction (13) .…”