Workplace violence experienced by Nursing professionals in the Health Care Network: a cross-sectional studyABSTRACT
Objective: To analyze workplace violence against Nursing professionals in the Health Care Network.
Method: Cross-sectional study with 179 Nursing professionals, using a questionnaire to assess workplace violence. Data were analyzed using descriptive and inferential statistics.
Results: Among the participants, 88 (49.1%) reported having suffered some type of violence in the workplace, with verbal aggression being the most common, perpetrated by patients, family members, and healthcare professionals (48.0%). The main consequences reported were: stress associated with physical violence (66.7%), loss of job satisfaction related to verbal violence (33.7%), ana irritation in cases of sexual violence (4.5%).
Conclusion: Workplace violence was frequent among Nursing professionals, with verbal aggression predominating. This reality generates emotional repercussions and job dissatisfaction, compromising care. Furthermore, violence is a worrying reality in the daily lives of nursing professionals throughout the healthcare network.
DESCRIPTORS:
Workplace Violence; Aggression; Nursing, Team; Health Services; Mental Health
HIGHLIGHTS
1. High prevalence of verbal violence among Nursing professionals.
2. Physical and sexual violence occur less frequently.
3. Women with low incomes suffer more sexual violence.
4. Violence affects mental health and reduces job satisfaction.
RESUMO
Objetivo: Analisar a violência no local de trabalho contra os profissionais de Enfermagem da Rede de Atenção à Saúde.
Método: Estudo transversal, com 179 profissionais de Enfermagem, utilizando questionário para a avaliação da violência no trabalho. Os dados foram analisados com estatística descritiva e inferencial.
Resultados: Dos participantes, 88 (49,1%) relataram ter sofrido algum tipo de violência no ambiente laboral, sendo a agressão verbal a forma mais comum, praticada por pacientes, familiares e profissionais de saúde (48,0%). As principais consequências relatadas foram: estresse associado à violência física (66,/%), perda de satisfação no trabalho relacionada à violência verbal (33,7%) e irritação nos casos de violência sexual (4,5%).
Conclusão: A violência no trabalho mostrou-se frequente entre os profissionais de Enfermagem, predominando as agressões verbais. Essa realidade gera repercussões emocionais e insatisfação laboral, comprometendo o cuidado. Ademais, a violência é uma realidade preocupante no cotidiano dos profissionais de Enfermagem de toda a Rede de Atenção à Saúde.
DESCRITORES:
Violência no Trabalho; Agressão; Equipe de Enfermagem; Serviços de Saúde; Saúde Mental
HIGHLIGHTS
1. Alta prevalência de violência verbal entre os profissionais de Enfermagem.
2. Violência física e sexual ocorrem com menor frequência.
3. Mulheres com renda baixa sofrem mais violência sexual.
4. A violência afeta a saúde mental e reduz a satisfação laboral.
RESUMEN
Objetivo: Analizar la violencia laboral contra profesionales de enfermería en la Red de Atención Médica.
Método: Estudio transversal con 179 profesionales de enfermería, mediante un cuestionario para evaluar la violencia laboral. Los datos se analizaron mediante estadística descriptiva e inferencial.
Resultados: De los participantes, 88 (49,1%) reportaron haber sufrido algún tipo de violencia en el ámbito laboral, siendo la agresión verbal la más común, perpetrada por pacientes, familiares y profesionales de la salud (48,0%). Las principales consecuencias reportadas fueron: estrés asociado a la violencia física (66,7%), pérdida de satisfacción laboral relacionada con la violencia verbal (33,7%) e irritación en casos de violencia sexual (4,5%).
Conclusión: Se encontró que la violencia laboral es frecuente entre los profesionales de enfermería, con predominio del abuso verbal. Esta realidad genera repercusiones emocionales e insatisfacción laboral, lo que compromete la atención. Además, la violencia es una realidad preocupante en la vida cotidiana de los profesiona es de enfermería en toda la red de atención sanitaria.
DESCRIPTORES:
Violencia Laboral; Agresión; Grupo de Enfermería; Servicios de Salud; Salud Mental
HIGHLIGHTS
1. Alta prevalencia de violencia verbal entre profesionales de enfermería.
2. La violencia física y sexual es menos frecuente.
3. Las mujeres con bajos ingresos sufren más violencia sexual.
4. La violencia afecta la salud mental y reduce la satisfacción laboral.
INTRODUCTION
Workplace violence can take many forms and be defined in many ways1. It is considered aggression when workers are abused, intimidated, or attacked in circumstances related to the exercise of their profession, involving explicit or implicit challenges to the safety, well-being, or health of these individuals2. This violence can manifest itself through verbal and physical abuse, harassment, exclusion, or intimidation, and can be directed and perpetrated by different actors, such as patients, family members, caregivers, other professionals, or managers1.
The frequency of workplace violence has increased significantly in several countries3. Globally, Nursing professionals are among the most susceptible to this type of exposure4, due to their position on the front line of health services and the provision of direct care to patients, continuously5, 24 hours a day3. However, rates of violence against this category remain underreported, largely due to the widespread belief that these incidents are an unfortunate but inevitable part of the profession5,6.
According to the American Nurses Association, approximately 25% of these professionals reported having suffered physical aggression by patients or family members, while more than 50% were exposed to verbal abuse or bullying. In addition, about 9% expressed concern about their own physical safety in the workplace7. In Brazil, studies indicate similarly high prevalences of violence against Nursing professionals, reaching rates exceeding 60% among the workers evaluated8,9.
Regardless of its nature, workplace violence has long-term professional, physical, and psychological repercussionsl, compromising well-being, professional conduct, and family dynamics6. Among the observed consequences are job dissatisfaction, reduced productivity, substance abuse, excessive alcohol consumption, decreased satisfaction with health and life, as well as mental health problems such as emotional exhaustion, suicidal ideation, depression, and anxiety2. Cases of injuries and hospitalizations resulting from these episodes have also been recorded10.
Organizational implications are equally relevant, especially due to increased absenteeism related to injuries or illness and physical and emotional exhaustion, factors that compromise the quality of care, financial resources, and institutional efficiency2.
Despite the relevance of the topic, gaps persist in knowledge about workplace violence affecting the Nursing team. Thus, identifying the real prevalence and the most vulnerable subgroups is essential to strengthen the safety of these professionals11. The development of studies based on validated instruments represents a fundamental step in addressing occupational violence and measuring its magnitude, making it possible to provide occupational health services with accurate data to support effective preventive and corrective measures12. In view of this, the objective was to analyze workplace violence against Nursing professionals in the Health Care Network.
METHOD
This is an analytical, cross-sectional study conducted in public and private services that make up the Health Care Network of a municipality in the interior of Piauí, Brazil. The research sites were defined based on the National Registry of Health Establishments (CNES), an official system that gathers information on health services nationwide. Establishments with active Nursing professionals on teams and that institutionally authorized data collection were included. The guiding hypothesis of the study considered that workplace violence had a high prevalence among Nursing professionals, varying according to the level of care and the type of institution (public or private).
The sample encompassed different levels of care in the Network, including one public hospital; two private hospitals; 10 Basic Health Units (BHU)/Family Health Strategy (FHS); one private clinic; and one Municipal Health Department (MHD), to consider different organizational contexts and broaden the representativeness of the findings.
669 Nursing professionals were identified in the eligible locations. Based on the sample size calculation (5% error, 5% significance), 179 participants were selected. The inclusion criteria included professionals with active registration with the Regional Nursing Council of Piauí (COREN-PI) and a minimum of 12 months of experience at the institution. Those who were on medical leave, vacation, or any other reason at the time of data collection were excluded. Recruitment was carried out in person at the health services, through a direct invitation from the assistant researcher, who explained the objectives and procedures of the study before the signing of the Free and Informed Consent Term (FICT).
Data collection was carried out between October 2022 and March 2023, in a private setting, through semi-structured interviews, with an average duration of 30 minutes. A questionnaire developed by the researchers was used to record socioeconomic, demographic, and occupational information, complemented by a validated instrument for assessing workplace violence suffered or witnessed by Nursing professionals, previously adapted and validated for the Brazilian context13.
The questionnaire has apparent and content validity, resulting from a rigorous methodological process of construction and analysis by expert judges, which achieved a minimum consensus of 80% agreement among the evaluators, indicating excellent reproducibility and internal consistency. The instrument was designed to measure the occurrence, nature, frequency, and forms of violence in the workplace, consisting of five main domains: physical violence, verbal abuse, sexual harassment, other types of violence, and prevention strategies13.
In addition to identifying the frequency and severity of episodes, the instrument allows characterizing the location of occurrence and the profile of the aggressors, configuring itself as a robust tool, capable of being used in investigations on occupational violence in Nursing3,6. The data collection was conducted by a research assistant, duly trained in ethical, technical, and methodological aspects, ensuring the standardization of the interview process and the reliability of the data obtained.
The data were entered into an electronic spreadsheet (Excel), with double entry for validation, and subsequently analyzed using the Statistical Package for the Social Sciences (SPSS), version 19.0. Descriptive statistics and Fisher’s Exact test were applied for categorical variables, adopting a confidence level of 95% (p < 0.05).
The study fully complied with the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines, ensuring the transparency and completeness of the scientific writing. The project was approved by the Research Ethics Committee (REC) of the Universidade Federal do Piauí - opinion 4,737,766, and all participants signed the Free and Informed Consent Term (FICT).
RESULTS
The study analyzed the occurrence of violence against 179 Nursing professionals, revealing that 88 (49.1%) reported having been victims of some type of violence in the year before the data collection. The most common form was verbal violence, reported by 86 (48.0%) professionals, followed by sexual and physical violence, reported by 11 (6.1%) and 6 (3.4%) participants, respectively.
Although no statistically significant associations were observed, it was found that the main targets of verbal violence were Nursing professionals aged between 20 and 40 years, totaling 79 (50.6%) participants. The occurrence was relatively higher among male professionals, 24 (53.3%); single, 53 (50.5%); with a higher level of education, 55 (52.9%); self-declared white, 12 (54.5%); with a family income equal to or greater than three minimum wages, 53 (54.1%); and belonging to the professional category of nurses, 39 (53.4%) (Table 1).
Distribution of socioeconomic, demographic, and professional characteristics of participants, according to the occurrence or absence of verbal violence. Floriano, PI, Brazil, 2022
Regarding sexual violence among Nursing professionals, of the 179 participants, only 11 (6.1%) reported having suffered this type of aggression, the majority being women, who tota ed nine (81.8%) victims. The occurrence of sexual violence showed a statistically significant association only with the variable family income, showing that lower incomes (between one and two minimum wages) were associated with a higher incidence (n=11; 100%; p=0.009). It was observed that the 20 to 40 age group had the highest proportion of cases, corresponding to 7.1% of professionals within this age group, indicating greater vulnerability among younger professionals (Table 2).
Distribution of socioeconomic, demographic, and professional characteristics of participants, according to the occurrence or absence of sexual violence. Floriano, PI, Brazil, 2022
Regarding physical violence, it was found that only younger professionals, aged between 20 and 40 years, were victims, totaling 6 (3.8%) participants. The distribution among the variables sex (male: n=3; 2.2% / female: n=3; 6.7%), marital status (single: n=3; 2.9% / married or divorced: n=3; 4.1%) and education (High School: n=3; 4.0% / Higher Education: n=3; 2.9%) was equal in absolute numbers (Table 3).
Distribution of socioeconomic, demographic, and occupational characteristics of participants, according to the occurrence or absence of physical violence. Floriano, PI, Brazil, 2022
In relation to ethnicity, most cases of physical violence involved black and brown professionals, totaling five (3.2%). All cases occurred among professionals with family income between one and two minimum wages, corresponding to six (5.1%). Regarding occupational characteristics, only workers employed in hospitals, six (3.9%), and those with shifts exceeding eight hours a day, six (4.1%), reported having suffered physical violence. Moreover, no differences were observed in the professional category, with equal absolute numbers between nurses, three (4.1%), and Nursing technicians/ assistants, 3 (2.8%). Finally, it was found that physical violence did not show statistically significant associations with the study variables (Table 3).
The authorship of violent incidents against Nursing professionals was also evaluated, as shown in Table 4. The main perpetrators of verbal violence were patients’ family members, totaling 33 (18.4%). Concerning sexual violence, the main aggressors identified were colleagues from the same sector, with seven (3.9%) occurrences. In cases of physical violence, the main perpetrators were patients, with three (1.7%).
Distribution of perpetrators of physical violence, verbal violence, and sexual violence, according to the occurrence or absence of violence. Floriano, PI, Brazil, 2022
As a consequence of the violent situations they experienced, Nursing professionals reported manifestations of an emotional, physical, and psychosocial nature. Verbal violence, mainly, generated loss of job satisfaction, 29 (33.7%); and feelings of inferiority, 24 (27.9%); while sexual violence resulted, for most victims, in irritation, eight (4.5%). In contrast, physical violence was associated with stress, recorded in four (66.7%) cases.
Table 5 Distribution of the consequences of physical violence, verbal violence, and sexual violence, according to the occurrence or absence of verbal violence. Floriano, PI, Brazil, 2022| Verbal violence | Sexual violence | Physical violence | |||||
|---|---|---|---|---|---|---|---|
| Variables | Ν | % | Ν | % | Ν | % | |
| Absence from work | Yes | 3 | 3.5 | 2 | 1.1 | - | - |
| No | 83 | 96.5 | 177 | 98.9 | |||
| Anxiety | Yes | - | - | 5 | 2.8 | - | - |
| No | 174 | 97.2 | |||||
| Low self-esteem | Yes | 18 | 20.9 | 2 | 1.1 | - | - |
| No | 68 | 79.1 | 177 | 98.9 | |||
| Crying spells | Yes | 20 | 23.3 | 4 | 2.2 | 2 | 33.3 |
| No | 66 | 76.7 | 175 | 97.8 | 4 | 66.7 | |
| Difficulty sleeping | Yes | 21 | 24.4 | 4 | 2.2 | 1 | 16.7 |
| No | 65 | 75.6 | 175 | 97.8 | 5 | 83.3 | |
| Stress | Yes | 17 | 19.8 | 4 | 2.2 | 4 | 66.7 |
| No | 69 | 80.2 | 175 | 97.8 | 2 | 33.3 | |
| Bodily injury | Yes | 27 | 31.4 | 4 | 2.2 | 1 | 16.7 |
| No | 59 | 68.6 | 175 | 97.8 | 5 | 83.3 | |
| Loss of concentration | Yes | 17 | 19.8 | 4 | 2.2 | 2 | 33.3 |
| No | 69 | 80.2 | 175 | 97.8 | 4 | 66.7 | |
| Anger | Yes | 3 | 3.5 | 7 | 3.9 | 3 | 50.0 |
| No | 83 | 96.5 | 172 | 96.1 | 3 | 50.0 | |
| Sadness | Yes | 21 | 24.4 | 7 | 3.9 | 1 | 16.7 |
| No | 65 | 75.6 | 172 | 96.1 | 5 | 83.3 | |
| Fatigue | Yes | 11 | 12.8 | 4 | 2.2 | 1 | 16.7 |
| No | 75 | 87.2 | 175 | 97.8 | 5 | 83.3 | |
| Disappointment | Yes | 6 | 7.0 | 4 | 2.2 | - | - |
| Yes | 80 | 93.0 | 175 | 97.8 | |||
DISCUSSION
This study’s results highlighted the complexity and severity of the violence experienced by Nursing professionals in the workplace. The high prevalence of verbal violence and the occurrence, albeit on a smaller scale, of sexual and physical violence, revealed a scenario of occupational vulnerability. Thus, it corroborates the current literature that indicates that violence against Nursing professionals is frequent and constitutes a cause for concern in the health system2,5.
Almost half of the study participants reported having suffered some type of violence. The observed incidence was slightly lower than that of a meta-analysis that synthesized global epidemiological evidence on the prevalence rates of workplace violence, estimated at 59.2%. This difference may be attributed to different cultural and institutional contexts among the countries analyzed14.
In the health sector, Nursing professionals are subjected to prolonged pressure and have a high risk of experiencing violence at work1. Verbal violence is the most common type in this category15, characterized as an intentional imposition of one’s voice against another person, capable of causing mental, social, moral, or spiritual harm1. Another Brazilian study, which investigated the types of occupational violence experienced by Nursing professionals, obtained results similar to those of this research, with verbal abuse being the most frequent, reaching a prevalence of 38%3.
This type of violence was more common among professionals in the 20 to 40 age range, which is consistent with the literature, which indicates that younger and less experienced professionals are more exposed to verbal violence16,17. On the other hand, older age is a protective factor: professionals between 40 and 60 years of age tend to suffer less violence, possibly due to experience and the acquisition of skills in managing and communicating with patients and caregivers, which allows them to neutralize cases of verbal violence18.
Paradoxically, specific groups, historically considered vulnerable to violence in the workplace (such as younger professionals, females, those with lower education, those with family income below two minimum wages, and nursing technicians and assistants) did not, for the most part, report episodes of violence. It is assumed that this may be related to the normalization of these aggressions, often interpreted as an inherent part of the work routine, which motivates professionals to minimize the events and avoid reporting them5.
Related to sex, the results corroborate research conducted in Italy6, which indicated a higher frequency of verbal violence reports among male professionals when compared to female professionals. On the other hand, in Brazil, women have suffered the majority of workplace violence19. This shows that, while social stereotypes make it difficult for men to confront violent situations without resorting to alternative strategies20, the normalization of violence among women can hinder the recognition of aggressions, perpetuating silence in the face of these episodes.
A study conducted in the Philippines, to understand the experiences of nurses who witnessed verbal abuse in the workplace, revealed that, often, nurses who are victims of verbal aggression do not identify or deliberately ignore the aggressors during the attacks, maintaining a professional posture that reflects the belief that such situations are inevitable21. The female identity, socially constructed around ideas of submission and silence, is reinforced by the Nursing culture, motivating many women not to report this type of violence22.
In this study, nurses with higher education and with higher income reported, in greater proportion, episodes of verbal violence. This result was similar to that of another Brazilian study that related greater perception of violence to educational and professional level, suggesting that nurses may have greaterclarity about what constitutes aggression and greater willingness to recognize it8. This finding highlights the need for ethical and inclusive pedagogical approaches in training processes, promoting professional empowerment and the assertive confrontation of violence.
Sexual violence was the second most frequent type, reported by 6.1% of participants. Sexual violence or harassment was considered to be any unwanted behavior of a sexual connotation, with the potential for offense, humiliation, or threat to well-being13. This broader conception may explain the higher prevalence, compared to physical violence, contradicting other studies3,23,24.
The literature shows that sexual violence in the health sector more frequently affects women, due to the objectification of the female body and the social construction of the nurse image as a sexualized figure. In many cases, harassment is ignored or not reported, due to shame or fear of judgment, which can cause statistics to underestimate the reality3,25.
Low monthly income, widely cited as a risk factor for violence in Nursing26, is a determining factor in maintaining the cycle of aggression. Poorly paid professionals tend not to report for fear of losing their jobs, suffering retaliation, or being unable to take time off work11.
Although not very representative in the sample of this study, physical violence has shown significant growth, especially in the hospital environment. In this context, Nursing professionals, because they work on the front line, with continuous care and multiple responsibilities, become frequent targets of expressions of user dissatisfaction27.
The perpetrators of violence varied according to the type: patients were the main aggressors in cases of physical violence; family members and companions, in episodes of verbal violence; and work colleagues, in sexual violence, following a similar pattern to that found in other research19,24. The constant exposure of Nursing professionals to patients and family members may explain this vulnerability, particularly concerning verbal abuse20,21.
The negative consequences of violence against workers can emerge in the short and long term25 and reveal the significant impact that dealing with violence can have on the emotional and physical well-being of Nursing professionals. These effects are not always visible, manifesting themselves in painful memories and so-called “invisible wounds”28. Even in physical violence, where visible sequelae would be expected, stress stood out as the main consequence, a result also observed in another Brazilian study29.
It was identified that nursing professionals who experienced verbal violence presented a significant emotional response, especially related to reduced job satisfaction. A study conducted in China indicated a similar result18. This occurs because suffering violence diminishes the perception of effectiveness in stopping the aggression, motivating some professionals to accept or justify the behavior as an inevitable part of the profession. This perception reduces motivation and work commitment, especially when the victim does not receive institutional support, after the incident of aggression20.
Regarding sexual violence, it was found that professionals who experience it have suffer a wide variety of adverse repercussions on their mental, physical, and emotional health. These results converged with a systematic review that demonstrated that this type of violence results in fear, anxiety, depression, stress, disappointment, helplessness, and emotional disturbances such as anger, irritability, and nervousness30. These multiple implications demonstrate the complexity of the phenomenon of sexual violence in the workplace.
The study’s limitations included the fact that the research was conducted in public and private institutions in a specific region, which may limit the generalization of the results to other realities, cultural, and organizational contexts. Furthermore, the use of interviews and questionnaires may be subject to memory bias and participants’ subjectivity, especially in relation to traumatic events, which may have led to violence being underestimated.
This study’s implications for Nursing are significant, as the findings reinforce the urgency of institutional policies aimed at preventing and addressing workplace violence, with an emphasis on creating safe environments, providing psychological support, and offering continuous training for teams. It also highlighted the importance of including the topic of occupational violence in Nursing education and continuing education to promote assertive communication, conflict management, and professional empowerment. Furthermore, the results provide insights for improving management practices and developing protocols and public policies that value and protect Nursing professionals.
CONCLUSION
Based on the data analyzed, it was concluded that violence against Nursing professionals is a present and worrying reality, with a higher prevalence of verbal violence, affecting almost half of the participants. Although no statistically significant associations were identified with sociodemographic and occupational variables, some groups - such as young professionals, men, single individuals, those with higher education, and higher income - showed a higher frequency of exposure to verbal violence. Women with low incomes were at greater risk of experiencing sexual violence, and physical violence, although less prevalent, was concentrated among younger professionals, aged between 20 and 40 years, who worked in hospital services, with working hours exceeding eight hours per day, possibly due to direct contact with patients.
The diversity of aggressors, involving family members, patients, and colleagues, increases the team’s vulnerability. The consequences include stress, loss of job satisfaction, and irritation, affecting the physical and mental health of professionals. Thus, it is expected that the study will help to raise awareness among health services to adopt effective prevention policies more consistently, safe reporting channels, training to address violence, and ongoing psychological support, prioritizing the most vulnerable groups identified.
-
HOW TO REFERENCE THIS ARTICLE:
Pimenta MCR, Miranda ES, Rocha RC, Carneiro CT, Brito MA, Bezerra MAR. Workplace violence experienced by Nursing professionals in the Health Care Network: a cross-sectional study. Cogitare Enferm [Internet]. 2026 [cited “insert year, month and day”];31:e100850en. Available from: https://doi.org/10.1590/ce.v31i0.100850en
Data availability:
The authors declare that all data are fully available within the article.
References
-
1 Pariona-Cabrera P, Cavanagh J, Bartram T. Workplace violence against nurses in health care and the role of human resource management: a systematic review of the literature. J Adv Nurs [Internet]. 2020 [cited 2024 May 10];76(7):1581-93. Available from: https://doi.org/10.1111/jan.14352
» https://doi.org/10.1111/jan.14352 -
2 Mento C, Silvestri MC, Bruno A, Muscatello MRA, Cedro C, Pandolfo G, et al. Workplace violence against healthcare professionals: A systematic review. Aggress Violent Behav [Internet]. 2020 [cited 2024 May 151:51:101381. Available from: https://doi.org/10.1016/j.avb.2020.101381
» https://doi.org/10.1016/j.avb.2020.101381 -
3 Bernardes MLG, Karino ME, Martins JT, Okubo CVC, Galdino MJQ, Moreira AAO. Workplace violence among nursing professionals. Rev Bras Med Trab [Internet]. 2021 [cited 2024 Jun 13];18(3):250-7. Available from: https://doi.org/10.47626/1679-4435-2020-531
» https://doi.org/10.47626/1679-4435-2020-531 -
4 Karatuna I, Jönsson S, Muhonen T. Workplace bullying in the nursing profession: a cross-cultural scoping review. Int J Nurs Stud [Internet]. 2020 [cited 2024 Jun 15];111:103628. Available from: https://doi.org/10.1016/j.ijnurstu.2020.103628
» https://doi.org/10.1016/j.ijnurstu.2020.103628 -
5 Somani R, Muntaner C, Hillan E, Velonis AJ, Smith P. A systematic review: effectiveness of interventions to de-escalate workplace violence against nurses in healthcare settings. Saf Health Work [Internet]. 2021 [cited 2024 Jun 10];12(3):289-95. Available from: https://doi.org/10.1016/j.shaw.2021.04.004
» https://doi.org/10.1016/j.shaw.2021.04.004 -
6 Ferri P, Stifani S, Accoto A, Bonetti L, Rubbi I, Di Lorenzo R. Violence against nurses in the triage area: A mixed-methods study. J Emerg Nurs [Internet]. 2020 May [cited 2024 May 15];46(3):384-97. Available from: https://doi.org/10.1016/j.jen.2020.02.013
» https://doi.org/10.1016/j.jen.2020.02.013 -
7 American Nurses Association (ANA). Executive summary: American Nurses Association Health Risk Appraisal [Internet]. ©2017 [cited 2019 Dec 1];1-6 Available from: https://www.nursingworld.org/globalassets/practiceandpolicy/work-environment/health--safety/ana-healthriskappraisalsummary_2013-2016.pdf
» https://www.nursingworld.org/globalassets/practiceandpolicy/work-environment/health--safety/ana-healthriskappraisalsummary_2013-2016.pdf -
8 Bordignon M, Monteiro Ml. Analysis of workplace violence against nursing professionals and possibilities for prevention. Rev Gaúcha Enferm [Internet]. 2021 [cited 2025 Feb 1];42:e20190406. Available from: https://doi.org/10.1590/1983-1447.2021.20190406
» https://doi.org/10.1590/1983-1447.2021.20190406 -
9 dos Santos J, Meira KC, Coelho JC, Dantas ESO, e Oliveira LV, de Oliveira JSA, et al. Work-related violences and associated variables in oncology nursing professionals. Ciênc Saúde Colet [Internet]. 2021 [cited 2024 Dec 1];26(12):5955-66. Available from: https://doi.org/10.1590/1413-812320212612.14942021
» https://doi.org/10.1590/1413-812320212612.14942021 -
10 Njaka S, Edeogu OC, Oko CC, Goni MD, Nkadi N. Work place violence (WPV) against healthcare workers in Africa: a systematic review. Heliyon [Internet]. 2020 [cited 2025 May 19];6(9):e04800. Available from: https://doi.org/10.1016/j.heliyon.2020.e04800
» https://doi.org/10.1016/j.heliyon.2020.e04800 -
11 Byon H, Lee M, Choi M, Sagherian Κ, Crandall M, Lipscomb J. Prevalence of type II workplace violence among home healthcare workers: A meta-analysis. Am J Ind Med [Internet]. 2020 [cited 2025 Jun 4];63(5):442-55. Available from: https://doi.org/10.1002/ajim.23095
» https://doi.org/10.1002/ajim.23095 -
12 García-Pérez MD, Rivera-Sequeiros A, Sánchez-Elias TM, Lima-Serrano M. Workplace violence on healthcare professionals and underreporting: characterization and knowledge gaps for prevention. Enferm Clin [Internet]. 2021 [cited 2024 Aug 8];31(6):390-5. Available from: https://doi.org/10.1016/j.enfcle.2021.05.001
» https://doi.org/10.1016/j.enfcle.2021.05.001 -
13 Bordignon M, Monteiro Ml. Apparent validity of a questionnaire to assess workplace violence. Acta Paul Enferm [Internet]. 2015 Nov-Dec [cited 2024 Jun 11];28(6):601-8. Available from: https://doi.org/10.1590/1982-0194201500098
» https://doi.org/10.1590/1982-0194201500098 -
14 Liu J, Gan Y, Jiang H, Li L, Dwyer R, Lu Κ, et al. Prevalence of workplace violence against healthcare workers: a systematic review and meta-analysis. Occup Environ Med [Internet]. 2019 Dec [cited 2025 Mar 10];76(12):927-37. Available from: https://doi.org/10.1136/oemed-2019-105849
» https://doi.org/10.1136/oemed-2019-105849 -
15 Schlup N, Gehri B, Simon M. Prevalence and severity of verbal, physical, and sexual inpatient violence against nurses in Swiss psychiatric hospitals and associated nurse-related characteristics: Cross-sectional multicentre study. Int J Ment Health Nurs [Internet]. 2021 Dec [cited 2025 Jun 30];30(6): 1550-63. Available from: https://doi.org/10.1111/inm.12905
» https://doi.org/10.1111/inm.12905 -
16 Hunter EJ, Eades CE, Evans JMM. Violence experienced by undergraduate nursing students during clinical placements: an online survey at a Scottish University. Nurse Educ Pract [Internet]. 2022 May [cited 2025 Jun 4];61:103323. Available from: https://doi.org/10.1016/j.nepr.2022.103323
» https://doi.org/10.1016/j.nepr.2022.103323 -
17 Al Muharraq EH, Baker OG, Alallah SM. The Prevalence and the relationship of workplace bullying and nurses turnover intentions: a cross sectional study. SAGE Open Nurs [Internet]. 2022 Jan 24 [cited 2024 Mar 131:8:1-10. Available from: https://doi.org/10.1177/23779608221074655
» https://doi.org/10.1177/23779608221074655 -
18 Cao Y, Gao L, Fan L, Zhang Z, Liu X, Jiao M, et al. Effects of verbal violence on job satisfaction, work engagement and the mediating role of emotional exhaustion among healthcare workers: a cross-sectional survey conducted in Chinese tertiary public hospitals. BMJ Open [Internet]. 2023 [cited 2025 Mar 13];13(3):e065918. Available from: https://doi.org/10.1136/bmjopen-2022-065918
» https://doi.org/10.1136/bmjopen-2022-065918 -
19 Silveira FBCA, Lira Neto JCG, Weiss C, de Araújo MFM. Association between community-based and workplace violence and the sleep quality of health professionals: a cross-sectional study. Ciênc Saúde Coletiva [Internet]. 2021 May [cited 2025 Sep 05];26(5):1647-56. Available from: https://doi.org/10.1590/1413-81232021265.04522021
» https://doi.org/10.1590/1413-81232021265.04522021 -
20 Pérez-Fuentes MDC, Gázquez JJ, Molero MDM, Oropesa NF, Martos A. Violence and job satisfaction of nurses: importance of a support network in healthcare. The European Journal of Psychology Applied to Legal Context [Internet]. 2021 [cited 2025 Jul 23];13(1):21-8. Available from: https://doi.org/10.5093/ejpalc2021a3
» https://doi.org/10.5093/ejpalc2021a3 -
21 Cabilo JAE, Daño JC. Verbal abuse in the workplace: the unfolding phenomenon. The Malaysian Journal of Nursing (MJN) [Internet]. 2020 [cited 2025 Jul 30]; 11 (4):68-77. Available from: https://ejournal.Iucp.net/index.php/mjn/article/view/1004
» https://ejournal.Iucp.net/index.php/mjn/article/view/1004 -
22 Abbas S, Zakar R, Fischer F, Gilani A. Challenges perceived by nursing professionals in physician-centred organizations: An exploratory qualitative study. Int Nurs Rev [Internet]. 2022 [cited 2025 Jul 23];69(3):384-91. Available from: https://doi.org/10.1111/inr.12741
» https://doi.org/10.1111/inr.12741 -
23 Özkan Şat S, Akbaş P, Yaman Sözbir Ş. Nurses’ exposure to violence and their professional commitment during the COVID-19 pandemic. J Clin Nurs [Internet]. 2021 Jul [cited 2025 Jul 23];30(13-14):2036-47. Available from: https://doi.org/10.1111/jocn.15760
» https://doi.org/10.1111/jocn.15760 -
24 Amaral ES, Arruda G, Perondi AR, Cavalheiri JC, Vieira AP, Follador FAC. Violence at work experienced by nursing professionals working in hospital units: an exploratory and correlational study. Rev Latino-Am Enfermagem [Internet]. 2025 [cited 2025 Jul 23];33:e4527. Available from: https://doi.org/10.1590/1518-8345.7451.4527
» https://doi.org/10.1590/1518-8345.7451.4527 -
25 Trindade LL, Ribeiro ST, Zanatta EA, Vendruscolo C, Dal Pai D. Verbal aggression in nursing work at the hospital. Rev Eletr Enferm [Internet]. 2019 [cited 2025 Jul 23];21:54333. Available from: https://doi.org/10.5216/ree.v21.54333
» https://doi.org/10.5216/ree.v21.54333 -
26 Silva FB, Silveira EF, Gedrat DC. Violência sofrida no trabalho: um estudo com profissionais do setor de urgência e emergência de um hospital do norte do Brasil. Aletheia [Internet]. 2021 [cited 2025 Jul 23];54(2):67-81. Portuguese. Available from: https://pepsic.bvsalud.org/scielo.php?pid=S141303942021000200008&script=sci_abstract&tlng=pt
» https://pepsic.bvsalud.org/scielo.php?pid=S141303942021000200008&script=sci_abstract&tlng=pt -
27 Scaramal DA, Haddad MCFL, Garanhani ML, Nunes EFPA, Galdino MJQ, Pissinati PSC. Occupational physical violence in urgency and emergency hospital services: perceptions of nursing workers. REME Rev Min Enferm [Internet]. 2017 Nov. 9 [cited 2025 Aug 5];21 (1):e-1024 Available from: https://www.researchgate.net/publication/319886964
» https://www.researchgate.net/publication/319886964 -
28 Al-Qadi MM. Nurses’ perspectives of violence in emergency departments: a metasynthesis. Int Emerg Nurs [Internet]. 2020 [cited 2025 Aug 5];52:100905. Available from: https://doi.org/10.1016/j.ienj.2020.100905
» https://doi.org/10.1016/j.ienj.2020.100905 -
29 Ceballos JB, Frota OP, Nunes HFSS, Ávalos PL, Krügel CC, Ferreira Júnior MA, et al. Physical violence and verbal abuse against nurses working with risk stratification: characteristics, related factors, and consequences. Rev Bras Enferm [Internet]. 2020 Dec 21 [cited 2025 Aug 5];73(suppl 5):e20190882. Available from: https://doi.org/10.1590/0034-7167-2019-0882
» https://doi.org/10.1590/0034-7167-2019-0882 -
30 Kahsay WG, Negarandeh R, Dehghan Nayeri N, Hasanpour M. Sexual harassment against female nurses: a systematic review. BMC Nurs [Internet]. 2020 Jun 29 [cited 2024 Mar 5];19:(58):1-12. Available from: https://doi.org/10.1186/s12912-020-00450-w
» https://doi.org/10.1186/s12912-020-00450-w
-
Associate editor:
Dr. Gilberto Tadeu Reis da Silva
