Prevalence of Type II and Type III Workplace Violence against Physicians: A Systematic Review and Meta-analysis

Abstract

Background: Workplace violence (WPV) in the health care sector remains a prominent, under-reported global occupational hazard and public health issue. Objective: To determine the types and prevalence of WPV among doctors. Methods: Primary papers on WPV in medicine were identified through a literature search in 4 health databases (Ovid Medline, EMBASE, PsychoINFO and CINAHL). The study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines for the mapping and identification of records. To assess the studies included in our review, we used the Critical Appraisal Skills Programme cohort review checklist and the Risk of Bias Assessment. Results: 13 out of 2154 articles retrieved were reviewed. Factors outlining physician WPV included (1) working in remote health care areas, (2) understaffing, (3) mental/emotional stress of patients/visitors, (4) insufficient security, and (5) lacking preventative measures. The results of 6 studies were combined in a meta-analysis. The overall prevalence of WPV was 69% (95% CI 58% to 78%). Conclusion: The impact of WPV on health care institutions is profound and far-reaching; it is quite common among physicians. Therefore, steps must be taken to promote an organizational culture where there are measures to protect and promote the well-being of doctors.

Violence Against Healthcare Workers: A Worldwide Phenomenon With Serious Consequences

“…Emergency Departments, Mental Health Units, Drug and Alcohol Clinics, Ambulance services and remote Health Posts with insufficient security and a single HCW are at higher risk. Working in remote health care areas, understaffing, emotional or mental stress of patients or visitors, insufficient security, and lack of preventative measures have been identified as underlying factors of violence against physicians in a 2019 systematic review and meta-analysis (26).…”

“…In public hospital/services, insufficient time devoted to patients and therefore insufficient communication between HCWs and patients, long waiting times, and overcrowding in waiting areas ( 27 ), lack of trust in HCWs or in the healthcare system, dissatisfaction with treatment or care provided ( 26 ), degree of staff professionalism, unacceptable comments of staff members, and unrealistic expectations of patients and families over treatment success ( 28 ) are thought to contribute. Indeed, in public hospitals worldwide, staff shortages prevent front-line HCWs from adequately coping with patients' demands.…”

Violence against healthcare workers and other serious responses to medical disputes in China: surveys of patients at 12 public hospitals

“…This no-referral-needed system further tilts the balance between supply and demand in the healthcare delivery system and worsens the issue of workforce shortages in China. The possible link between workplace violence, high demand, and understaffing in China could be impactful, as this association has already been demonstrated in some European studies [3,22]. Further-more, given legal channels for resolving confusion or anxiety are sometimes lacking and there is difficulty in implementing penalties for violence [17], verbally or physically attacking the healthcare worker becomes a way to release patients' anger [12,16].…”

“…The options are listed below, with assigned severity from lowest to highest: (1) complaining to friends and relatives, (2) negotiating with the doctor, (3) complaining to the hospital or the health department, (4) negotiating with a third party a , (5) seeking legal help, (6) exposing the issue to the news/media, and (7) resorting to violence. Given the nature of this question, if the patients chose option 7 (resorting to violence), we assume it stands for Type II workplace violence as defined by The National Institute for Occupational Safety and Health (NIOSH) [21,22], which is violence from customer or client.…”

Workplace violence against doctors

“…Globally, workplace violence against doctors is high, ranging from 54% (Thailand) to 70% (Morocco), regardless of work setting, access to resources, and organizational culture and support. [ 9 ] A rising trend is observed in Asian countries (19.6% to 25%) and a decline in North American countries (48.9% to 32.6%). [ 10 ] In developing countries, more than 50% of doctors have faced patient-led verbal and physical abuse.…”