Assessment of Non-physical User Violence and Burnout in Primary Health Care Professionals. The Modulating Role of Job Satisfaction

Abstract

IntroductionGrowing concern about workplace violence shows the need for an evaluation in specific contexts in order to identify the particularities of each professional group. The health sector consists of a group of professionals with high exposure to violence, specially from users. There are differences depending on the professional category or unit in which the professional works. In this regard, Primary Health Care (PHC) is characterized by a personalized and continuous patient treatment over time, which is not exempt from cases of violence. Among the commonly studied consequences of these situations are decreases in job satisfaction and burnout.ObjectiveThe main objective of this study is to analyze the modulating role of job satisfaction in the relationship between non-physical user violence and the onset of burnout.MethodsCross-sectional comparative descriptive design. The sample consisted of 574 professionals from 39 PHC centers of the Murcian Health Service. Data were collected using two-stage cluster sampling. For data analysis, descriptive analysis, correlations and stepwise hierarchical regression were used to analyze the interaction between the variables.ResultsRegression analysis draws a model where non-physical violence and low intrinsic and extrinsic job satisfaction act as modulators of non-physical violence, cynicism and emotional exhaustion.ConclusionsThis study provides evidence of the psychological consequences of the perception of user violence in the PHC staff. Furthermore, it is evident that the emergence of burnout syndrome in these professionals is related to exposure to verbal or non-physical violence together with low job satisfaction. In this sense, a circular and bidirectional relationship between the variables studied is proposed as a possible explanatory model.

(Un)Broken: Lateral violence among hospital nurses, user violence, burnout, and general health: A structural equation modeling analysis

“…Using Depersonalization and Emotional Exhaustion as mediators, our SEM gives a rough indication of the indirect effect of verbal (non-physical) UV and poorer general health outcomes through burnout, as a cumulative effect of stress. Our results add evidence to those of other authors on the widespread exposure of nurses to user hostility in specific healthcare services ( 14 , 16 , 32 , 39 ) and the role of Emotional Exhaustion, either as a burden to the professionals’ wellbeing ( 21 ) or as an obstacle to professional efficacy ( 32 ). From jocular comments to life threats, nurses face daily non-physical aggressions that concur with somatic symptoms, anxiety, social dysfunction, and depression ( 32 ), which may be more impactful if nurses are not supported or motivated ( 39 ).…”

“…This is a dangerous aspect of WPVH, since, as it is not easily identified, it allows the problem to persist and insidiously destroy the victim’s ability to function in a medium and long-term ( 12 , 21 , 55 ). Verbal and psychological abuse is actually the most frequently observed in health institutions ( 13 ).…”

“…The way this violence is perceived has much to do with its consequences ( 20 ). Its impact on professionals ranges from low job satisfaction to somatization, with increased burnout symptoms in the long-term, particularly if it is not physical ( 21 ). The somatic alterations observed also act as mediators of anxiety symptomatology in nurses ( 22 ).…”

Burnout among nurses: Examining psychosocial work environment causes

“…This exposure may have a negative impact on their health, job satisfaction or emotional exhaustion and stress at work. 24 , 25 Recently, it has been observed that at least 5 out of 10 professionals show a high degree of emotional exhaustion, 6 out of 10 show a high degree of depersonalization and 6 out of 10 show a low degree of self-fulfillment. 25 Other studies found that 26.7% of participants had high emotional exhaustion, 38.1% had high cynicism and 35.6% had low self-fulfillment.…”

“…Specifically, in Spain, where the present study was carried out, 23% emotional exhaustion, 11.4% cynicism, and 12.8% reduced self-fulfillment were observed in health professionals. 24 …”