Patient aggression towards different professional groups of healthcare workers
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Department of Integrated Medical Care, Medical University of Bialystok, Poland
Corresponding author
Krystyna Kowalczuk   

Department of Integrated Medical Care, Medical University of Bialystok, Poland
Ann Agric Environ Med. 2017;24(1):113-116
Patient aggression affects healthcare quality and, in extreme situations, may even lead to medical malpractice. Little is known, however, about the specific distribution of health care professionals’ exposure to patient aggression in various countries.

The aim of this study was to assess the exposure of various professional groups of healthcare personnel to patient aggression, and to identify potential determinants (medical profession, age, gender, professional experience and employment at outpatient/inpatient healthcare units) of this exposure.

Material and Methods:
The study was performed between January 2008 – December 2009 in northeastern Poland, and included 1,624 healthcare workers (493 nurses, 504 midwives, 501 physicians and 126 medical rescue workers). Exposure to eight forms of patient aggression was assessed using the MDM Mobbing Questionnaire.

Using a raised voice was the most frequently observed form of aggression in all groups, whereas the least frequent form of aggression encountered was the use of direct physical violence. In inpatient healthcare units, the intensity of patient aggression was encountered most by nurses and medical rescue workers, followed by physicians and midwives. In outpatient healthcare units, medical rescue workers experienced significantly higher levels of aggression when compared to other professional groups. Significant differences in mean aggression intensity experienced in inpatient and outpatient healthcare units were observed only in nurses and physicians. Furthermore, no significant effects of gender were observed on the intensity of patient aggression.

Nurses are most exposed to different forms of patient aggression, with verbal attacks being most prevalent. Nurses employed at inpatient healthcare units experienced aggression more frequently than those working in outpatient healthcare units.

European Commission. Opinion of the Advisory Committee on Safety, Hygiene and Health Protection at Work on Violence at the workplace DOC 1564/2/2001 EN. 2001.
Kowalczuk K, Krajewska-Kułak E, Kułak W, Ostapowicz-Van Damme K, Klimaszewska K, Rolka H. Influence of aggression on stress development in the population of nurses and midwives in the Podlaskie Province. Probl Hig Epidemiol 2010; 91(3): 444–450.
Merecz D, Drabek M, Moscicka A. Aggression at the workplace-psychological consequences of abusive encounter with coworkers and clients. Int J Occup Med Environ Health. 2009; 22(3): 243–260.
Hoel H, Sparks K, Cooper CL. The cost of violence/stress at work and the benefits of a violence/stress-free working environment. Geneva, Report commissioned by the International Labour Organization, 2001.
Fernandes CM, Bouthillette F, Raboud JM, Bullock L, Moore CF, Christenson JM, et al. Violence in the emergency department: a survey of health care workers. CMAJ. 1999; 161(10): 1245–1248.
Franz S, Zeh A, Schablon A, Kuhnert S, Nienhaus A. Aggression and violence against health care workers in Germany--a cross sectional retrospective survey. BMC Health Serv Res. 2010; 10: 51.
Bonner G, McLaughlin S. The psychological impact of aggression on nursing staff. Br J Nurs. 2007; 16(13): 810–814.
Dudek B, Waszkowska M, Merecz D, Hanke W. Worker’s health protection against the consequences of occupational stress. Łódź, Instytut Medycyny Pracy, 2004.
Dean AJ, Gibbon P, McDermott BM, Davidson T, Scott J. Exposure to aggression and the impact on staff in a child and adolescent inpatient unit. Arch Psychiatr Nurs. 2010; 24(1): 15–26.
Winstanley S, Whittington R. Aggression towards health care staff in a UK general hospital: variation among professions and departments. J Clin Nurs. 2004; 13(1): 3–10.
Zampieron A, Galeazzo M, Turra S, Buja A. Perceived aggression towards nurses: study in two Italian health institutions. J Clin Nurs. 2010; 19(15–16): 2329–2341.
Josefsson K, Ryhammar L. Threats and violence in Swedish community elderly care. Arch Gerontol Geriatr. 2010; 50(1): 110–113.
Yarovitsky Y, Tabak N. Patient violence towards nursing staff in closed psychiatric wards: it’s long-term effects on staff’s mental state and behaviour. Med Law. 2009; 28(4): 705–724.
Garcia-Calvo T, Guijarro R, Osun E. The phenomenon of physical aggression against health service personnel: different perspectives. Med Law. 2009; 28(3): 451–459.
Chapman R, Perry L, Styles I, Combs S. Predicting patient aggression against nurses in all hospital areas. Br J Nurs. 2009; 18(8): 476, 478–483.
Deans C. The effectiveness of a training program for emergency department nurses in managing violent situations. Aust J Adv Nurs. 2004; 21(4): 17–22.
Finfgeld-Connett D. Model of therapeutic and non-therapeutic responses to patient aggression. Issues Ment Health Nurs. 2009; 30(9): 530–537.
McLaughlin S, Bonner G, Mboche C, Fairlie T. A pilot study to test an intervention for dealing with verbal aggression. Br J Nurs. 2010; 19(8): 489–494.
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