Patient violence and health professionals’ occupational outcomes in China: A time-lagged survey study

Zhan, Yujie; Kim, Su Kyung; Zhou, Le; Xie, Bo; Li, Yuntao; Wen, Bixiu; Nie, Lisa

doi:10.1016/j.ijnurstu.2018.11.010

Cited by 32 publications

(39 citation statements)

References 66 publications

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“…These patterns are consistent with defensive medicine, which suggests that physicians increase unnecessary treatment provision as a form of defensive behavior. 6 Moreover, the worsened patient outcome is consistent with findings in the existing literature that patient violence has negative psychological impacts on physicians and thus decreases the quality of care (Beckman et al, 1994;He, 2014;He & Qian, 2016;Levinson et al, 1997;Roche et al, 2010;Wu et al, 2013;Zhan et al, 2019). In addition, we found that such changes in treatment intensity were only temporary, which is consistent with the notion that these changes reflect short-term responses driven by psychological factors such as salience effects.…”

Section: How Long Do the Effects Last?supporting

confidence: 90%

Patient violence, physicians treatment decisions, and patient welfare: Evidence from China

Zhao

Torgler

et al. 2021

Health Economics

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Although violence in healthcare settings has become a common occurrence worldwide, there is limited evidence on the spillover effects of patient violence on physicians' medical decisions. Utilizing microdata on inpatients from a major public hospital, we investigated how extreme patient violence-the murder of a physician in China-affected physicians' treatment decisions and patient welfare in a hospital geographically distant from the murder site. By matching this patient dataset to physician profiles, we performed a difference-in-differences analysis in which the treatment group comprised patients admitted shortly before and after the murder shock, and the control group consisted of patients admitted during the same months in the previous year. Immediately after the shock, the provision of medical treatment was notably higher, with a 16.9% increase in the number of surgeries and a 9.5% increase in the treatment expenditures. However, patient health outcomes were worse, with an increased mortality rate of 0.9% points. Findings suggest that patient violence dramatically changed physician behavior, causing negative consequences on patients even when the healthcare workers were not direct victims of patient violence.

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Section: How Long Do the Effects Last?supporting

confidence: 90%

Patient violence, physicians treatment decisions, and patient welfare: Evidence from China

Zhao

Torgler

et al. 2021

Health Economics

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“…9 10 Previous studies had shown that violence towards HWs has extremely negative impacts, such as HWs' impaired physical and mental health, decreased job satisfaction, increased mental stress and job burnout, and deterioration of the relationship between HWs and patients. [11][12][13][14] Even worse, such incidents ultimately further impact the overall quality of medical and health services. 1 There has been an abundance of literature on the prevalence, risk factors and mechanism of workplace violence towards HWs outside of China, particularly research conducted by international organisations and developed countries, such as studies on patterns and trends of workplace violence and its influencing factors, [14][15][16][17] the complex causal factors of violence, and tailored approaches to prevent and eliminate workplace violence.…”

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confidence: 99%

Risk assessment of workplace violence towards health workers in a Chinese hospital: a cross-sectional study

Liu

Zhang

et al. 2020

BMJ Open

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ObjectiveThis study aimed to assess the risk factors associated with workplace violence towards health workers (HWs) in a Chinese hospital.MethodsWe conducted a cross-sectional survey in a Chinese secondary hospital in 2019 using an international survey questionnaire, and collected valid data from 1028 HW respondents via mobile phone. Alongside analysing the potential association between exposure to violence and respondents’ characteristics, we compared the workplace violence between this survey and a baseline survey in the same hospital using the same questionnaire in 2018, and investigated the existing measures.ResultsA total of 5.45% of respondents had encountered physical violence while 41.63% had experienced psychological violence. Women (OR=3.45, 95% CI 1.87 to 6.38), those working in outpatient and emergency departments (OR=7.96, 95% CI 2.27 to 27.95), and those with extremely high concern about workplace violence (OR=7.94, 95% CI 1.04 to 60.85) were significantly more likely to suffer physical violence. Working in the outpatient and emergency department (OR=2.03, 95% CI 1.23 to 3.34), having direct physical contact/interaction with patients (OR=2.98, 95% CI 1.62 to 5.49), and extremely high worry about workplace violence (OR=6.47 95% CI 3.38 to 12.40) significantly increased the risk of psychological violence. When the results of the baseline survey were compared with those in this survey, it was shown that physical violence declined significantly from 8.79% in 2018 to 5.45% in 2019, while psychological violence declined significantly from 47.14% in 2018 to 41.63% in 2019. The most recognised measures were security measures (81.03%) while the least recognised measures were check-in procedures for staff (11.19%).ConclusionWorkplace violence towards HWs is a global problem with country-specific features. In our study, workplace violence in the hospital is of great concern. While demonstrating the effectiveness of measures in some degree, there is significant room for improvement. To achieve the vision of ‘zero violence’ in the health sector, aligned comprehensive measures should be systematically adopted.

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“…On December 24, 2019, Wen Yang, an emergency physician at the Beijing Civil Aviation General Hospital, was brutally killed by a patient's son who was dissatisfied with what he thought was the inadequate treatment of his 95-year-old mother (26). Workplace violence has strongly influenced physicians' regret of their career choice, professional turnover, and word-of-mouth communication (27).…”

Section: Physician-patient Relationshipmentioning

confidence: 99%

Health care reform in China from the perspective of physicians

Lin

Zhou

Wang

2020

BST

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Patient violence and health professionals’ occupational outcomes in China: A time-lagged survey study

Cited by 32 publications

References 66 publications

Patient violence, physicians treatment decisions, and patient welfare: Evidence from China

Patient violence, physicians treatment decisions, and patient welfare: Evidence from China

Risk assessment of workplace violence towards health workers in a Chinese hospital: a cross-sectional study

Health care reform in China from the perspective of physicians

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