A Systematic Literature Review: Workplace Violence Against Emergency Medical Services Personnel

Abstract

ContextIn spite of the high prevalence and consequences of much workplace violence against emergency medical services personnel, this phenomenon has been given insufficient attention. A systematic review can aid the development of guidelines to reduce violence.ObjectivesThe research question addressed by this paper is, “What are the characteristics and findings of studies on workplace violence against emergency medical services personnel”?Data SourcesA systematic literature review was conducted using online databases (PubMed, Scopus, Google Scholar, and Magiran) with the help of experienced librarians.Study SelectionInclusion criteria comprised studies in the English or Persian language and researcher’s access to the full text. There was no limit to the entry of the study design. Exclusion criteria included lack of access to the full text of the article, studies published in unreliable journals or conferences, and studies in which the results were shared with other medical or relief groups and there was no possibility of breaking down the results.Data ExtractionA “Data extraction form” was designed by the researchers based on the goals of the study that included the title and author(s), study method (type, place of study, sample size, sampling method, and data collection/analysis tool), printing location, information related to the frequency of types of violence, characteristics of victims /perpetrators, and related factors.ResultsThe papers reviewed utilized a variety of locations and environments, methods, and instrument samplings. The majority of the studies were performed using the quantitative method. No intervention study was found. Most studies focused on the prevalence of violence, and their results indicated that exposure to violence was high. The results are presented in six major themes.ConclusionsWorkplace violence and injuries incurred from it are extensive throughout the world. The important causes of violence include the shortage of training programs dealing with violence, lack of violence management protocols, and delays in response times. Therefore, afterthought and resolve are more crucial than ever. Workplace violence reduction strategies and suggestions for future studies are also discussed.

Workplace Violence Process against Emergency Medical Services Staffs: A Grounded Theory

“…On the other hand, EMS staffs, as a state organization, are subject to retaliation from the government and are the victims of WPV. The role of high-risk group (Grange, 2002;Petzäll, 2011;Piquero et al, 2013;Pourshaikhian, 2016;Shahzad, 2014;Steffgen, 2008;Suserud, 2002) in strengthening violence was emphasized in similar studies. It is expected that people/spectators of the emergency scene should provide conditions for seeking help from EMS, and service delivery to clients should be done with logic and patience.…”

“…Also, job dissatisfaction and/or lack of adequate job security and inadequate support of EMS organization from the staff; affect the motivation of providing optimal emergency services. In other studies, the use of a protector uniform (Pourshaikhian, 2016), self-defense by dodging and pepper spray (Mechem, 2002;Pourshaikhian, 2016), keeping distance (Suserud, 2002), transferring the aggressive person, use of restrictive agents (Franz, 2010) and need for the police involvement in case of violence were emphasized to establish security (Grange, 2002;Mechem, 2002;Shahzad, 2014). Several qualitative and quantitative studies have confirmed the relationship between job dissatisfaction and violence (Brough, 2005), the effectiveness of violent adjustment policies of the organization's manager to promote safety and prevent injury (Florence, 2009) and enhance the motivation and performance of staff to use copings strategies helped in preventing the outcomes of health injury (Carroll-Garrison, 2012).…”

“…In various studies, educational level, eligibility and how to assist the clients (Koritsas, 2010), shortage of specialized staff (Sheikh-Bardsiri, 2012), low experience (Bernaldo, 2015;Koritsas, 2010), insufficient professional training (Baydin, 2014) and low self-esteem (Steffgen, 2008), were reported as the underlying causes of WPV. Also, lack of training program on how to deal with WPV (Baydin, 2014;Pourshaikhian, 2016) and control of violence (Bernaldo, 2015;Brough, 2005;Duchateau, 2002;Petzäll, 2011) have been emphasized. Therefore, EMS managers must provide adequate and appropriate equipment/staff, create and maintain job satisfaction, and organize training on violence control as strategies to reduce WPV.…”

“…In related studies, insufficient skills and eligibility (Pourshaikhian, 2016), negligence (Sheikh-Bardsiri, 2012) and how to respond to client (Koritsas, 2010) were pointed out as stimulus of WPV Therefore, dispatch and ambulance staff should prevent the development of violence by being respectful to clients, provide appropriate services and should be questioned in case of negligence. On the other hand, conditions should be provided stating that the number of missions/day is appropriate in order to prevent the over use of staffs.…”

“…This issue is consistent with the basic theories of violence such as frustration theory, failure-aggression, social learning (Atkinson, 2008), the theory of social inequality and ecologic model (DeKeseredy, 2006). In a related quantitative study, the event of illness or trauma (Piquero, Piquero, Craig, & Clipper, 2013), despair of treatment (Petzäll, 2011), death of the patient (Bernaldo, 2015;Pourshaikhian, 2016;Rahmani, 2012;Sheikh-Bardsiri, 2012), fear and anxiety (Pourshaikhian, 2016;Sheikh-Bardsiri, 2012), low self-esteem, fast irritability, inadequate control of stimulations, lack of self-control (Bernaldo, 2015;Steffgen, 2008) and coping skills (Shahzad, 2014), the crime-susceptible environment (Esmaeilpour M, 2011;Shahzad, 2014;Steffgen, 2008), and unemployment (Salarifar, 2010) were singled out as the causes of violence. Thus, the use of the capacities of education and media for teaching culture, self-control, keeping calm and increasing tolerance in stressful events is effective for the prevention or control of WPV.…”