Workplace violence against hospital healthcare workers in China: a national WeChat-based survey

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Abstract

Background

Workplace violence (WPV) is a serious issue for healthcare workers and leads to many negative consequences. Several studies have reported on the prevalence of WPV in China, which ranges from 42.2 to 83.3%. However, little information is available regarding the correlates of WPV among healthcare workers and the differences across the different levels of hospitals in China. This study aimed to explore the correlates of WPV and career satisfaction among healthcare workers in China.

Methods

A self-designed WeChat-based questionnaire was used that included demographic and occupational factors. The Chinese version of the Workplace Violence Scale was used to measure WPV. Career satisfaction was assessed using two questions about career choices. Descriptive analyses, chi-square tests and multivariate logistic regressions were used.

Results

A total of 3706 participants (2750 nurses and 956 doctors) responded to the survey. Among the 3684 valid questionnaires, 2078 (56.4%) reported at least one type of WPV in the last year. Multivariate logistic regressions revealed that male sex, shift work, bachelor’s degree education, a senior professional title, working more than 50 h per week and working in secondary-level hospitals were risk factors associated with WPV. Healthcare workers who had experienced higher levels of WPV were less likely to be satisfied with their careers.

Conclusions

WPV remains a special concern for the Chinese healthcare system. Interventions to reduce WPV should be implemented by health authorities to create a zero-violence practice environment.

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Most cited references 31

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China's human resources for health: quantity, quality, and distribution.

Sudhir Anand, Victoria Y Fan, Junhua Zhang … (2008)

In this paper, we analyse China's current health workforce in terms of quantity, quality, and distribution. Unlike most countries, China has more doctors than nurses-in 2005, there were 1.9 million licensed doctors and 1.4 million nurses. Doctor density in urban areas was more than twice that in rural areas, with nurse density showing more than a three-fold difference. Most of China's doctors (67.2%) and nurses (97.5%) have been educated up to only junior college or secondary school level. Since 1998 there has been a massive expansion of medical education, with an excess in the production of health workers over absorption into the health workforce. Inter-county inequality in the distribution of both doctors and nurses is very high, with most of this inequality accounted for by within-province inequalities (82% or more) rather than by between-province inequalities. Urban-rural disparities in doctor and nurse density account for about a third of overall inter-county inequality. These inequalities matter greatly with respect to health outcomes across counties, provinces, and strata in China; for instance, a cross-county multiple regression analysis using data from the 2000 census shows that the density of health workers is highly significant in explaining infant mortality.

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Violence toward nurses, the work environment, and patient outcomes.

Christine Catling-Paull, Michael Roche, Donna Diers … (2010)

To relate nurses' self-rated perceptions of violence (emotional abuse, threat, or actual violence) on medical-surgical units to the nursing working environment and to patient outcomes. Cross-sectional collection of data by surveys and primary data collection for 1-week periods on 94 nursing wards in 21 hospitals in two states of Australia. Nursing Work Index-Revised (NWI-R); Environmental Complexity Scale (ECS) PRN-80 (a measure of patient acuity); and a nursing survey with three questions on workplace violence; combined with primary data collection for staffing, skill mix, and patient outcomes (falls, medication errors). About one third of nurses participating (N=2,487, 80.3% response rate) perceived emotional abuse during the last five shifts worked. Reports of threats (14%) or actual violence (20%) were lower, but there was great variation among nursing units with some unit rates as high as 65%. Reported violence was associated with increased ward instability (lack of leadership; difficult MD and RN relationships). Violence was associated with unit operations: unanticipated changes in patient mix; proportion of patients awaiting placement; the discrepancy between nursing resources required from acuity measurement and those supplied; more tasks delayed; and increases in medication errors. Higher skill mix (percentage of registered nurses) and percentage of nurses with a bachelor of science in nursing degrees were associated with fewer reported perceptions of violence at the ward level. Intent to leave the present position was associated with perceptions of emotional violence but not with threat or actual assault. Violence is a fact of working life for nurses. Perceptions of violence were related to adverse patient outcomes through unstable or negative qualities of the working environment. Perceptions of violence affect job satisfaction. In order to manage effectively the delivery of nursing care in hospitals, it is essential to understand the complexity of the nursing work environment, including the relationship of violence to patient outcomes.

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The impact of workplace violence on job satisfaction, job burnout, and turnover intention: the mediating role of social support

Xiaojian Duan, Xin Ni, Lei Shi … (2019)

Background Workplace violence (WPV) is a global public health problem and has caused a serious threat to the physical and mental health of healthcare workers. Moreover, WPV also has an adverse effect on the workplace behavior of healthcare workers. This study has three purposes: (1) to identify the prevalence of workplace violence against physicians; (2) to examine the association between exposure to WPV, job satisfaction, job burnout and turnover intention of Chinese physicians and (3) to verify the mediating role of social support. Methods A cross-sectional study adopted a purposive sampling method to collect data from March 2017 through May 2017. A total of nine tertiary hospitals in four provinces, which provide healthcare from specialists in a large hospital after referral from primary and secondary care, were selected as research sites based on their geographical locations in the eastern, central and western regions of China. Descriptive analyses, a univariate analysis, a Pearson correlation, and a mediation regression analysis were used to estimate the prevalence of WPV and impact of WPV on job satisfaction, job burnout, and turnover intention. Results WPV was positively correlated with turnover intention (r = 0.238, P < 0.01) and job burnout (r = 0.150, P < 0.01), and was negatively associated with job satisfaction (r = − 0.228, P < 0.01) and social support (r = − 0.077, P < 0.01). Social support was a partial mediator between WPV and job satisfaction, as well as burnout and turnover intention. Conclusions The results show a high prevalence of workplace violence in Chinese tertiary hospitals, which should not be ignored. The effects of social support on workplace behaviors suggest that it has practical implications for interventions to promote the stability of physicians’ teams. Trial registration (Project Identification Code: HMUIRB2014005), Registered March 1, 2014. Electronic supplementary material The online version of this article (10.1186/s12955-019-1164-3) contains supplementary material, which is available to authorized users.

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Author and article information

Contributors

Yamin Li: aminny@csu.edu.cn

Jiansong Zhou: zhoujs2003@csu.edu.cn

Journal

Journal ID (nlm-ta): BMC Public Health

Journal ID (iso-abbrev): BMC Public Health

Title: BMC Public Health

Publisher: BioMed Central (London )

ISSN (Electronic): 1471-2458

Publication date (Electronic): 29 April 2020

Publication date PMC-release: 29 April 2020

Publication date Collection: 2020

Volume: 20

Electronic Location Identifier: 582

Affiliations

[1 ]GRID grid.452708.c, ISNI 0000 0004 1803 0208, Clinical Nursing Teaching and Research Section, , The Second Xiangya Hospital, Central South University, ; Changsha, 410011 China

[2 ]GRID grid.452708.c, ISNI 0000 0004 1803 0208, Department of Psychiatry & Mental Health Institute, , The Second Xiangya Hospital, Central South University, ; Changsha, 410011 China

[3 ]GRID grid.216417.7, ISNI 0000 0001 0379 7164, XiangYa School of Nursing, Central South University, ; Changsha, 410013 China

[4 ]GRID grid.86715.3d, ISNI 0000 0000 9064 6198, Department of Psychiatry, , CIUSSSE-CHUS - Hôtel-Dieu, Université de Sherbrooke, ; 580, rue Bowen Sud, Sherbrooke, Québec Canada

Article

Publisher ID: 8708

DOI: 10.1186/s12889-020-08708-3

PMC ID: 7189471

PubMed ID: 32349727

SO-VID: fb2ad44b-35af-4287-bb39-b9ea25a91d14

License:

Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

History

Date received : 3 January 2020

Date accepted : 15 April 2020

Funding

Funded by: FundRef http://dx.doi.org/10.13039/501100001809, National Natural Science Foundation of China;

Award ID: 81571341

Award Recipient : Jiansong Zhou

Funded by: FundRef http://dx.doi.org/10.13039/501100004735, Natural Science Foundation of Hunan Province;

Award ID: 2019JJ40424

Award Recipient : Jiansong Zhou

Custom metadata

ScienceOpen disciplines: Public health

Keywords: healthcare workers,workplace violence,survey

Data availability:

ScienceOpen disciplines: Public health

Keywords: healthcare workers, workplace violence, survey

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Workplace violence against hospital healthcare workers in China: a national WeChat-based survey

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Abstract

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Chinese Journal of School Health

Most cited references 31

China's human resources for health: quantity, quality, and distribution.

Violence toward nurses, the work environment, and patient outcomes.

The impact of workplace violence on job satisfaction, job burnout, and turnover intention: the mediating role of social support

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Cited by 44

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