Workplace Violence Is Associated With Impaired Work Functioning in Nurses: An Italian Cross‐Sectional Study

Abstract

Objective: Workplace violence against nurses is a widespread phenomenon that has been associated with many unfavorable individual and organizational outcomes. The aim of this study was to analyze the relationship between violence and work functioning in a sample of Italian nurses. Design: Cross-sectional, with retrospective analysis of exposure. Methods: All nurses from a local hospital were invited to complete a questionnaire assessing violent experiences that occurred in the previous 12 months. The questionnaire also measured job strain (with the Demand-Control-Support questionnaire), organizational justice (with Colquitt's Questionnaire), and work impairment (with the Nurses Work Functioning Questionnaire). The associations were examined with logistic regression analyses. Findings: Of the 302 nurses who were invited, 275 (91.1%) agreed to participate. The total work impairment score was significantly higher among the nurses exposed to violence compared with the nonexposed nurses (42.2 ± 27.8 vs. 31.9 ± 31.6, respectively; p < .001). Exposed nurses also reported significantly higher levels of job strain (0.96 ± 0.25 vs. 0.8 ± 0.21; p = .003) and lower levels of perceived organizational justice (56.6 ± 12.6 vs. 62.5 ± 14.8; p = .001) than nonexposed nurses. Nurses who had experienced violence had a significantly higher risk for impairment of work functioning than their colleagues (crude odds ratio [OR] = 2.33; 95% confidence interval [CI 95%] = 1.42-3.83). The association between violence and impairment remained significant after adjusting for demographic variables, occupational stress, and perceived organizational justice (OR = 1.83; 95% CI 95% = 1.06-3.17). Conclusions: Workplace violence is associated with impaired work function in nurses. Job strain and perceived organizational injustice are associated with impairment. Clinical Relevance: Violence prevention programs in healthcare activities should include training for violent behavior identification and de-escalation techniques, structural and administrative measures for violence control (such as alarms, surveillance, staff increase), and measures to reduce occupational stress, which can include wellness courses, spirituality, organizational improvements, and staffing methodologies.

Violence Against Healthcare Workers: A Worldwide Phenomenon With Serious Consequences

“…The consequences of violence against HCWs can be very serious: deaths or life-threatening injuries ( 15 ), reduced work interest, job dissatisfaction, decreased retention, more leave days, impaired work functioning ( 22 ), depression, post-traumatic stress disorder ( 23 ), decline of ethical values, increased practice of defensive medicine ( 24 ). Workplace violence is associated directly with higher incidence of burnout, lower patient safety, and more adverse events ( 25 ).…”

Workplace verbal abuse, nurse‐reported quality of care and patient safety outcomes among early‐career hospital nurses

“…However, verbal abuse among health care providers can have an adverse effect on forming collaborative relationships, which may not only deteriorate the quality of patient care but also lead to patient safety issues. Nurses' negative feelings such as fear, anger, humiliation or anxiety caused by verbal abuse experiences from patients or their families can make it difficult for nurses to develop and maintain therapeutic relationships with patients and reduce nurses' desire and motivation to provide safe high-quality care (Magnavita, Heponiemi, & Chirico, 2020;Najafi, Fallahi-Khoshknab, Ahmadi, Dalvandi, & Rahgozar., 2018). This impact may be more significant for ear- (Hong & Li, 2017).…”

Hospital-Based Healthcare Workers Victims of Workplace Violence in Italy: A Scoping Review

“…The other publications employed various terms to describe violence or aggressive behavior. These descriptions can be categorized as verbal or physical violence [ 41 , 49 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 ]. In five papers, the definitions used distinguish between verbal aggression (shouting, offenses and threats), physical assault and harassment by describing each behavior in detail [ 50 , 63 , 64 , 65 , 66 ].…”

“…Sixteen studies [ 32 , 41 , 44 , 45 , 48 , 49 , 52 , 55 , 56 , 59 , 60 , 62 , 63 , 65 , 66 , 68 ] focused on prevalence of violence experienced by all the categories of healthcare workers working in general hospitals or healthcare institutions. Across occupations and professional roles, nurses and physicians were the professional groups most exposed to verbal violence (48%).…”