Prevalence and predictors of workplace violence against emergency physicians in China: a cross-sectional study

Abstract

Background Workplace violence (WPV) is considered a global problem, particularly in the health sector; however, no studies have assessed the national prevalence of WPV against emergency physicians and the associated factors in China. Methods A national cross-sectional survey was conducted in 31 provinces/autonomous regions/municipalities across China between July 2019 and September 2019. A total of 15 455 emergency physicians were selected using a multistage stratified random sampling method. A structured self-administered questionnaire was used to collect information on WPV and potential associated factors among emergency physicians. Descriptive and multivariable logistic regression analyses were used to identify the predictors of WPV. Results A total of 14 848 emergency physicians responded effectively (effective response rate: 96.07%). Of the respondents, 90.40%, 51.45%, and 90.00% reported exposure to any type of WPV, physical or nonphysical violence in the preceding year, respectively. Verbal aggression (87.25%) was the most common form of violence, followed by threat (71.09%), physical assault (48.24%), verbal sexual harassment (38.13%), and sexual assault (19.37%). Patients’ families were the main perpetrators of these incidents. Unmet patient needs, taking drugs or drinking, and long waiting times were the main contributors to WPV. Physicians who were from low-developed regions, female, and without shift work were less likely to have experienced any type of WPV. Chinese emergency physicians who were from medium-developed regions, had a bachelor’s degree, worked in a higher level hospital, had a higher professional title, with lower incomes, had a history of hypertension or coronary heart disease, were smokers or drinkers, and worked in hospitals without preventive measures or training for WPV and not encouraging to report WPV were more likely to have experienced any type of WPV. The predictors of WPV varied in different types of WPV. Conclusions This study shows that the prevalence of WPV against emergency physicians is high in China. Measures should be taken at the physicians, patients, hospital, and national levels to protect GPs from WPV; for example, improving physicians’ level of service and hospital’ reporting procedures. Creating a prevention strategy and providing a safer workplace environment for emergency physicians should be prioritized.

Prevalence and determinants of physical violence against doctors in Bangladeshi tertiary care hospitals

“…Therefore, the authors suggest that the authorities must introduce staff training in skills, cultural diversity, interpersonal communication, conflict management, and teamwork to prevent hospital violence in Bangladesh. It is pertinent to mention that the above recommendations have been encouraged in several studies to eliminate hospital violence or help doctors better manage in many countries [ 3 , 32 ]. Further, the Bangladesh Medical and Dental Council can integrate communication skills into medical education to ensure that future doctors develop essential knowledge on managing patients.…”

“…This may be due to a lack of empathy amongst relatives of patients for doctors. For example, when individuals are exposed to critical health conditions and wait for long times until seen by a doctor, and unmet needs or expectations such as high-level medical services even for minor, self-limiting conditions are not met; as a result, they and their relatives may experience high levels of stress, anger, and frustration, which may manifest as violence against physicians [ 32 ]. Consequently, their negative emotions are probably vented through extreme violence towards doctors as if they even resort to harming doctors violently.…”

“…Thus, doctor–patient contradictions are created and escalate, leading to further violence. On the other hand, a lack of humanity in treating patients and a lack of respect for patients’ dignity may account for the aggression perpetrated by patients and relatives [ 3 , 32 ]. Therefore, there is a need to determine the reason behind poor doctor–patient relations, particularly in hospital settings in Bangladesh.…”

Workplace violence against healthcare workers in the emergency department in Hong Kong

“…A systematic review reported the rates of violence from individual studies ranged from 1 incident to 172 incidents per 10,000 attendances 11 . Recently, a cross sectional study conducted in China targeting emergency physicians revealed a high workplace violence prevalence rate at 90.4% 14 …”

“…11 Recently, a cross sectional study conducted in China targeting emergency physicians revealed a high workplace violence prevalence rate at 90.4%. 14 The under-reporting of incidents of workplace violence is not uncommon in the healthcare profession. 13,15 Workplace violence is not only limited to physical injury but also affects the mental well-being of health care workers.…”