Workplace Violence in Psychiatric Hospitals
Date Issued
2008
Date
2008
Author(s)
Chen, Wen-Ching
Abstract
Workplace violence has become a global problem, crossing national border, work settings and occupational groups, and has received increasing attention as a substantial contributor to occupational injury. The role of health sector in workplace violence is uniquely placed to draw the public attention. One is because its closeness to and familiar with the problem, health sector has the potential to take a much more proactive role in violence prevention. The other one is because frustration and anger arising out of life difficulties such as poverty, illness, alcohol and substance abuse can make people violent, health care personnel is actually at the high risk situation of violence to deal with these people when they come to hospitals to seek for help. Therefore, it was realized that health sector, especially psychiatric department, was most serious in workplace violence among all working sites. To prevent violence, it is necessary to understand the causes and identify the factors that increase the likelihood of people becoming victims or perpetrators. But because there is no single factor can explain why a person is more or less likely to experience violence, the strategy to prevent violence should consider all the four levels of risk including individual, relationship, community and societal factors, the so called ecological model proposed by World Health Organization. In chapter I, in order to understanding the context of workplace violence, we conducted a face-to-face, in-depth, and semi-structured interview with 13 health care workers suffering from physical violence by patients in 2002. We found that all of the victims alleged they did not receive enough post-incident support, and more than a half of victims could not call others for help during the violence. The psychological harm include post-traumatic stress disorder and general anxiety disorder, and other feelings include shock, astonishment, anger, fear, and sadness, but some victims reported minimal or no psychological injury. In chapter II, we translated the questionnaire which was developed by ILO/ICN/WHO/PSI joint program on workplace in the health sector into the Traditional Chinese version and used this questionnaire to survey the workplace violence prevalence and its risk factors among all nursing assistants and nurses in the same hospital as aforementioned one. A total of 222 valid questionnaires, male 105 and female 117, response rate was about 90%. The prevalence of physical violence (PV), verbal abuse (VA), bully / mobbing (BM), sexual harassment (SH), and racial harassment (RH) were 35.1%, 50.9%, 15.8%, 9.5%, and 4.5% respectively. The prevalence of PV at this hospital was higher than that reported by other countries for the health sector. A high anxiety level was associated with the occurrence of PV. In chapter III, We recruited 80 volunteer nurses into this 6-month follow-up study to investigate the incidence and risk factors of workplace violence in another psychiatric hospital. The results of this study showed that the incidence rates of PV, VA, BM, SH, and RH were 2.4, 7.9, 0.3, 1.0, and 0 per staff-year respectively. A high level of anxiety, a shorter duration of employment, and married status were the risk factors for PV and VA. Young age was the only risk factor for SH. In conclusion, workplace violence is an occupational hazard, and we need zero injury in workplace, zero contamination in environment, and zero tolerance to violence. Therefore, re-engineering the organization to a supportive and safe working environment and providing training program for high risk groups are required for prevention of the workplace violence and the employer is obliged to do these jobs.
Subjects
Depth interview
Incidence
Prevalence
Psychiatric hospital
Risk factor
Workplace violence
Type
thesis
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