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      WORKPLACE VIOLENCE AGAINST PHYSICIANS TREATING COVID-19 PATIENTS IN PERU: A CROSS-SECTIONAL STUDY

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          Abstract

          Background

          The COVID-19 pandemic is an unprecedented challenge to health systems that has revealed shortcomings and increased unmet demands. Such situations might exacerbate workplace violence (WPV) against doctors, as has been reported in several parts of the world.

          Methods

          To identify the frequency and characteristics of WPV suffered by physicians attending COVID-19 patients in Peru, a descriptive, cross-sectional study was conducted with an online survey of 200 physicians.

          Results

          Of the survey respondents, 84.5% had suffered some type of violence 97.5% of these suffered non-physical violence. Suffering more than one incidence of violence was reported by 75.7% of respondents. The primary aggressor was a patient's family member or caregiver. Violence occurred most frequently in critical areas inside the health service facility, such as COVID-19 triage, tents, and hospital units, although it also occurred during teleconsultations. Multiple shortcomings of the health services were perceived as the main trigger of violence. Being a female physician (odds ratio [OR] = 2.8 [1.06–5.83]) and working in a COVID-19 ICU (OR = 5.84 [1.60–21.28]) were the main factors associated with WPV.

          Conclusion

          Violence against physicians attending COVID-19 patients in Peru is common; the perceived factors that contribute most to violence are linked to deficiencies in health services.

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          Most cited references53

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          Clinical findings in a group of patients infected with the 2019 novel coronavirus (SARS-Cov-2) outside of Wuhan, China: retrospective case series

          Xiao-Wei Xu, Xiao-Xin Wu, Xian-Gao Jiang … (2020)
          Abstract Objective To study the clinical characteristics of patients in Zhejiang province, China, infected with the 2019 severe acute respiratory syndrome coronavirus 2 (SARS-Cov-2) responsible for coronavirus disease 2019 (covid-2019). Design Retrospective case series. Setting Seven hospitals in Zhejiang province, China. Participants 62 patients admitted to hospital with laboratory confirmed SARS-Cov-2 infection. Data were collected from 10 January 2020 to 26 January 2020. Main outcome measures Clinical data, collected using a standardised case report form, such as temperature, history of exposure, incubation period. If information was not clear, the working group in Hangzhou contacted the doctor responsible for treating the patient for clarification. Results Of the 62 patients studied (median age 41 years), only one was admitted to an intensive care unit, and no patients died during the study. According to research, none of the infected patients in Zhejiang province were ever exposed to the Huanan seafood market, the original source of the virus; all studied cases were infected by human to human transmission. The most common symptoms at onset of illness were fever in 48 (77%) patients, cough in 50 (81%), expectoration in 35 (56%), headache in 21 (34%), myalgia or fatigue in 32 (52%), diarrhoea in 3 (8%), and haemoptysis in 2 (3%). Only two patients (3%) developed shortness of breath on admission. The median time from exposure to onset of illness was 4 days (interquartile range 3-5 days), and from onset of symptoms to first hospital admission was 2 (1-4) days. Conclusion As of early February 2020, compared with patients initially infected with SARS-Cov-2 in Wuhan, the symptoms of patients in Zhejiang province are relatively mild.
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            The role of telehealth during COVID-19 outbreak: a systematic review based on current evidence

            Elham Monaghesh, Alireza Hajizadeh (2020)
            Background The outbreak of coronavirus disease-19 (COVID-19) is a public health emergency of international concern. Telehealth is an effective option to fight the outbreak of COVID-19. The aim of this systematic review was to identify the role of telehealth services in preventing, diagnosing, treating, and controlling diseases during COVID-19 outbreak. Methods This systematic review was conducted through searching five databases including PubMed, Scopus, Embase, Web of Science, and Science Direct. Inclusion criteria included studies clearly defining any use of telehealth services in all aspects of health care during COVID-19 outbreak, published from December 31, 2019, written in English language and published in peer reviewed journals. Two reviewers independently assessed search results, extracted data, and assessed the quality of the included studies. Quality assessment was based on the Critical Appraisal Skills Program (CASP) checklist. Narrative synthesis was undertaken to summarize and report the findings. Results Eight studies met the inclusion out of the 142 search results. Currently, healthcare providers and patients who are self-isolating, telehealth is certainly appropriate in minimizing the risk of COVID-19 transmission. This solution has the potential to prevent any sort of direct physical contact, provide continuous care to the community, and finally reduce morbidity and mortality in COVID-19 outbreak. Conclusions The use of telehealth improves the provision of health services. Therefore, telehealth should be an important tool in caring services while keeping patients and health providers safe during COVID-19 outbreak.
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              Prevalence of workplace violence against healthcare workers: a systematic review and meta-analysis

              Jianxin Liu, Yong Gan, Heng Jiang … (2019)
              We aim to quantitatively synthesise available epidemiological evidence on the prevalence rates of workplace violence (WPV) by patients and visitors against healthcare workers. We systematically searched PubMed, Embase and Web of Science from their inception to October 2018, as well as the reference lists of all included studies. Two authors independently assessed studies for inclusion. Data were double-extracted and discrepancies were resolved by discussion. The overall percentage of healthcare worker encounters resulting in the experience of WPV was estimated using random-effects meta-analysis. The heterogeneity was assessed using the I 2 statistic. Differences by study-level characteristics were estimated using subgroup analysis and meta-regression. We included 253 eligible studies (with a total of 331 544 participants). Of these participants, 61.9% (95% CI 56.1% to 67.6%) reported exposure to any form of WPV, 42.5% (95% CI 38.9% to 46.0%) reported exposure to non-physical violence, and 24.4% (95% CI 22.4% to 26.4%) reported experiencing physical violence in the past year. Verbal abuse (57.6%; 95% CI 51.8% to 63.4%) was the most common form of non-physical violence, followed by threats (33.2%; 95% CI 27.5% to 38.9%) and sexual harassment (12.4%; 95% CI 10.6% to 14.2%). The proportion of WPV exposure differed greatly across countries, study location, practice settings, work schedules and occupation. In this systematic review, the prevalence of WPV against healthcare workers is high, especially in Asian and North American countries, psychiatric and emergency department settings, and among nurses and physicians. There is a need for governments, policymakers and health institutions to take actions to address WPV towards healthcare professionals globally.
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                Author and article information

                Journal
                Journal ID (nlm-ta): Jt Comm J Qual Patient Saf
                Journal ID (iso-abbrev): Jt Comm J Qual Patient Saf
                Title: Joint Commission Journal on Quality and Patient Safety
                Publisher: Published by Elsevier Inc. on behalf of The Joint Commission.
                ISSN (Print): 1553-7250
                ISSN (Electronic): 1938-131X
                Publication date PMC-release: 13 June 2021
                Publication date (Electronic): 13 June 2021
                Affiliations
                [1 ]Vicerrectorado de Investigación. Escuela de Medicina Humana. Escuela de Postgrado, Universidad Católica de Santa María, Arequipa, Perú
                [2 ]Escuela de Publicidad y Multimedia, Universidad Católica de Santa María, Arequipa, Perú
                [3 ]Dirección General de Investigación, Desarrollo e Innovación, Universidad Científica del Sur, Lima, Perú
                [4 ]CONEVID, Unidad de Conocimiento y Evidencia, Facultad de Medicina, Alberto Hurtado, Universidad Peruana Cayetano Heredia, Lima, Perú
                Author notes
                [* ]Corresponding author: Agueda Muñoz del Carpio-Toia, Urb. San José s/n Umacollo, Arequipa, Perú, Telephone: +51997972467.
                [a]

                ORCID: https://orcid.org/0000-0003-0501-7314

                [b]

                ORCID: https://orcid.org/0000-0002-0262-0196

                [c]

                ORCID: https://orcid.org/0000-0002-0861-6606

                [d]

                ORCID: https://orcid.org/0000-0003-0300-4683

                [e]

                ORCID: https://orcid.org/0000-0002-7828-300X

                Article
                Publisher Item ID: S1553-7250(21)00154-9
                DOI: 10.1016/j.jcjq.2021.06.002
                PMC ID: 8200256
                PubMed ID: 34257040
                SO-VID: 66061690-aa3c-412d-8dcb-ff0461ebbdae
                Copyright © © 2021 Published by Elsevier Inc. on behalf of The Joint Commission.
                License:

                Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.

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                Categories
                Subject: Article

                Keywords: workplace violence,physicians,emergency unit,covid-19
                Data availability:
                Keywords: workplace violence, physicians, emergency unit, covid-19

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