Analysis of workplace violence against nursing professionals and possibilities for prevention

Bordignon, Maiara; Monteiro, Maria Inês

doi:10.1590/1983-1447.2021.20190406

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Revista Gaúcha de Enfermagem

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Sumário

Original Article • Rev. Gaúcha Enferm. 42 • 2021 • https://doi.org/10.1590/1983-1447.2021.20190406 copy

Analysis of workplace violence against nursing professionals and possibilities for prevention

Análisis de la violencia laboral contra profesionales de enfermería y posibilidades de prevención

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objective

To investigate workplace violence against nursing professionals, its relationship with personal, health and work variables, and to know possibilities for prevention.

Method

Descriptive and cross-sectional study, with quantitative approach, conducted with 267 nursing professionals from urgency and emergency units between 2015 and 2017. The Questionnaire of socio-demographic, life style and work and health aspects and Questionnaire on Workplace violence collected data, after submitted to statistical analysis.

Results

61.6% reported having been victims of verbal abuse, sexual harassment, or physical violence at work in the last 12 months. Statistically significant relationships were identified between suffering or not violence and personal, health and work variables. Possibilities for prevention were revealed and constituted a multidimensional model.

Conclusion

More than half of the sample reported having suffered workplace violence in the previous year, and possibilities of how to avoid it were revealed to support prevention protocols.

Keywords
Violence; Workplace violence; Work; Health personnel; Nursing

Variable		Verbal abuse (n=159)		Sexual harassment (n=16)		Physical violence (n=41)
		n	%	n	%	n	%
		Occurred in the studied unit no inf. 1^*	No	7	4.4	2	12.5	2	4.9
Yes	151	Occurred in the studied unit no inf. 1^*	95.6	14	87.5	39	95.1
Use of object no inf. 1^**	With weapon	-	-	-	-	1	2.5
Use of object no inf. 1^**	Without weapon	-	-	-	-	39	97.5
Aggressor - chief^† no inf. 2^*	No	141	89.8	11	68.8	41	100.0
Aggressor - chief^† no inf. 2^*	Yes	16	10.2	5	31.3	0	0.0
Aggressor - co-worker (internal or external to the unit)^† no inf. 2^*	No	128	81.5	10	62.5	39	95.1
	Yes	29	18.5	6	37.5	2	4.9
Aggressor - patient relatives^† no inf. 2^*	No	82	52.2	16	100.0	36	87.8
Aggressor - patient relatives^† no inf. 2^*	Yes	75	47.8	0	0.0	5	12.2
Aggressor - patient^† no inf. 2^*	No	58	36.9	9	56.3	3	7.3
Aggressor - patient^† no inf. 2^*	Yes	99	63.1	7	43.8	38	92.7
Aggressor - general public^† no inf. 2^*	No	111	70.7	15	93.8	35	85.4
Aggressor - general public^† no inf. 2^*	Yes	46	29.3	1	6.3	6	14.6
Shift of occurrence no inf. 3^*	Morning	36	23.1	7	43.8	14	34.1
	Afternoon	45	28.8	2	12.5	12	29.3
	Night	70	44.9	7	43.8	15	36.6
	2 shifts or more	5	3.2	-	-	-	-
Received assistance no inf. 4^, 2^*	No	122	78.7	13	81.3	34	87.2
Received assistance no inf. 4^, 2^*	Yes	33	21.3	3	18.8	5	12.8
Recorded the incident no inf. 2^*	No	128	81.5	15	93.8	35	85.4
Recorded the incident no inf. 2^*	Yes	29	18.5	1	6.3	6	14.6

Variable		Has suffered Workplace violence				p-value
		No		Yes
		n	%	n	%
Gender (no inf. 4)	Female	74	35.4	135	64.6	0.0494*
Gender (no inf. 4)	Male	27	50.0	27	50.0
Age group (in years) (no inf. 9)	<30	9	21.4	33	78.6	0.0448*
	30 to 39	37	37.0	63	63.0
	40 to 49	33	44.0	42	56.0
	50 or more	20	48.8	21	51.2
Generations (no inf. 19)	Baby boomers	19	50.0	19	50.0	0.0431*
	Generation X	48	42.1	66	57.9
	Millennials	28	29.2	68	70.8
Health problem last 15 days (no inf. 6)	No	85	41.7	119	58.3	0.0186*
Health problem last 15 days (no inf. 6)	Yes	14	24.6	43	75.4
Sleep well after work (no inf. 5)	No	15	26.8	41	73.2	0.0414*
Sleep well after work (no inf. 5)	Yes	86	41.7	120	58.3
	Has suffered verbal abuse at work
Gender (no inf. 2)	Female	78	37.0	133	63.0	0.0463*
Gender (no inf. 2)	Male	28	51.9	26	48.1
Schooling (no inf. 4)	Up to complete technician	46	52.3	42	47.7	0.0362*
	Incomplete higher education	16	33.3	32	66.7
	Complete higher education	25	35.2	46	64.8
	Postgraduate	18	32.1	38	67.9
Health problem last 15 days (no inf. 4)	No	89	43.2	117	56.8	0.0210*
Health problem last 15 days (no inf. 4)	Yes	15	26.3	42	73.7
Tired and/or discouraged after work (no inf. 15)	No	47	47.5	52	52.5	0.0420*
Tired and/or discouraged after work (no inf. 15)	Yes	53	34.6	100	65.4
Sleep well after work (no inf. 3)	No	15	26.8	41	73.2	0.0215*
Sleep well after work (no inf. 3)	Yes	91	43.8	117	56.2
	Has suffered sexual harassment at work
Gender (no inf. 4)	Female	193	92.3	16	7.7	0.0487**
Gender (no inf. 4)	Male	54	100.0	0	0.0
Schooling (no inf. 6)	Up to complete technician	87	98.9	1	1.1	0.0254**
	Incomplete higher education	41	87.2	6	12.8
	Complete higher education	64	91.4	6	8.6
	Postgraduate	53	94.6	3	5.4
Generations (no inf. 19)	Baby boomers	37	97.4	1	2.6	0.0152**
	Generation X	110	97.3	3	2.7
	Millennials	85	87.6	12	12.4
Satisfaction with current life (no inf. 5)	Little satisfied /neither satisfied, nor dissatisfied	20	80.0	5	20.0	0.0052**
	Satisfied	148	93.7	10	6.3
	Very satisfied	78	98.7	1	1.3
	Has suffered physical violence at work
Age group (in years) (no inf. 13)	< 30	30	71.4	12	28.6	0.0013**
	30 to 39	83	84.7	15	15.3
	40 to 49	61	81.3	14	18.7
	50 or more	39	100.0	0	0.0
Generations (no inf. 23)	Baby boomers	37	100.0	0	0.0	0.0013**
	Generation X	92	82.9	19	17.1
	Millennials	74	77.1	22	22.9

Dimension	Strategies
Workplace Safety	Promoting workplace safety: installing video cameras; identify people (identification badges); presence of trained security professionals and in an adequate number to regulate entry and exit and the flow of people for 24 hours, preferably armed, committed to their duties and who are not limited to the function of patrimonial guards; presence of police security, municipal guard or policing; restrict the entry of people to the unit's internal environment; adapt the facilities so that there are environments with greater privacy, in terms of contact with the public; implement safety measures at the service location and protection to professionals.
Work Team	Team composition: adjust the number of workers to have a complete team, with emotionally qualified people and with defined duties; improve the distribution of personnel and resize the multidisciplinary team. Interpersonal relationships: resolving disagreements and improving the interprofessional relationship, including between headship and professionals. Professional training: training professionals to exercise their functions; train with respect to workers' rights, improved public service, adequate ways to face or overcome insults and to handle conflicting situations. Work performance: directing the team to promote teamwork, commitment to work, responsibility and respect, and compliance with institutional duties and standards in accordance with ethical and moral principles. Worker's health: improve the reception in relation to the worker's health (support groups, therapeutic listening, psychological assistance and others), decrease the level of stress and promote the professionals' self-esteem.
Service to the population	Quality of care services: reduce waiting times and streamline care, reducing overcrowding of the service; keep patients and family members informed about the care and situation of services in the unit; provide humanized, welcoming, responsible, dialogic care and with respect to the patient and family; improve the facilities and the process so that the service is able to provide service to people who use it, without overcrowding.
Process and organization of work or service	Working conditions: improving working conditions. Service organization: organize the service and its routines; systematize work; reduce the workload; make the service more resolute, agile and efficient in solving problems; improve the flow care, inserting a flow aimed at patients; improve the quality of the workplace environment and the work process, with definition of guidelines or standards for patients and professionals; recognize the reality of the workplace to provide targeted actions and plan in order to achieve effective service; organize the scale of professionals according to the unit's demands; work together with other sectors, such as social assistance; sensitize service teams that communicate with each other so that violence is not practiced.
Education/population awareness	Guide people regarding the flow care in public health, the functioning of the health system and the unit (institutional regulation), the attributions of each service at different levels of care, the rights of the population, the responsibilities of health services and their professionals and about the existence of punishment for contempt and workplace violence (publicize laws and the topic) through letters, radio, television and others; sensitize the public that the provision of care with excellence does not depend only on the professional team; promote the valorization of Primary Health Care and health professionals.
Physical structure	Improve the physical structure of the unit, with airy rooms, a cozy waiting room, more space and better accommodation for patients.
Rescue of values	Promote the professional recognition of health teams; rescue education and respect between individuals, specifically in contact with health professionals.
Leadership/government/health management	Expansion of health services: have sufficient units and hospital beds to provide the population with the necessary care. Investment in services and public policies: promote the quality of health services that integrate the primary and secondary levels of health care, as well as the excellence of the assistance provided by public services; invest in public health policies.
Support, denunciation and punishment to aggressor	Support: support from managers in relation to workers. Denunciation: encourage the reporting of cases of workplace violence, providing security for its realization or communication of the fact. Punishment: to exist punishments for the aggressor and they are applied, regardless of their hierarchical position.
Equipment	Availability and quality of equipment and materials: provide equipment and materials of quality and in sufficient quantity, and perform maintenance of equipment.

Universidade Federal do Rio Grande do Sul. Escola de Enfermagem Rua São Manoel, 963 -Campus da Saúde , 90.620-110 - Porto Alegre - RS - Brasil, Fone: (55 51) 3308-5242 / Fax: (55 51) 3308-5436 - Porto Alegre - RS - Brazil
E-mail: revista@enf.ufrgs.br

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[1] Corresponding author
Maiara Bordignon bordignonmaiara@gmail.com