Background Workplace violence (WPV) against healthcare workers (HCWs) is a critical global public health issue that undermines staff safety, psychological well-being, and care quality. In China, HCWs experience substantial levels of WPV, yet evidence on modifiable factors negatively and positively associated with WPV, particularly those related to professional values remains limited. Methods We conducted a multi-center cross-sectional survey among HCWs in 25 hospitals across China. A total of 4,267 respondents completed validated questionnaires assessing demographic and professional characteristics, professional values (intrinsic, extrinsic, social, altruistic, and leisure dimensions), and exposure to five types of WPV (physical violence, psychological abuse, threats, verbal sexual harassment, and physical sexual harassment) during the preceding 12 months. We used binary logistic regression to identify factors associated with any WPV exposure and ordered logistic models to examine correlates of increasing violence frequency. Results More than half of participants (53.77%) reported psychological abuse in the previous year, 30.40% experienced threats, and 20.15% reported physical violence. Verbal and physical sexual harassment were less frequent but non-negligible (11.31 and 6.91%, respectively). Male HCWs reported higher overall WPV exposure than females in terms of violence frequency (OR = 0.686 for females in ordered logistic regression, p 0.001). Higher monthly income (with OR reaching 2.376 for those earning 8,000 CNY versus 2,000 CNY; p 0.001), and higher scores on intrinsic value dimension (OR = 1.037, p = 0.010) and altruistic value dimension (OR = 1.065, p = 0.015). Factors negatively associated with WPV included older age (50 years; OR = 0.612, 95% CI 0.395–0.946; p 0.05), holding an administrative position (OR = 0.530, 95% CI 0.377–0.746; p 0.001), working outside general medicine (e.g., general surgery: OR = 0.786; auxiliary departments: OR = 0.719; both p 0.05), being a formally employed staff member (OR = 0.555, 95% CI 0.322–0.960; p 0.05), absence of night shift work (OR = 0.744, 95% CI 0.635–0.871; p 0.001), no teaching responsibilities (OR = 0.798, 95% CI 0.679–0.939; p 0.001), employment in a tertiary C hospital (OR = 0.111, 95% CI 0.013–0.979; p 0.05), perceived alignment between workload and income (OR = 0.686, 95% CI 0.495–0.951; p 0.05), and higher external, social, and leisure value scores. Ordered logistic models produced generally consistent patterns, indicating that these factors were also associated with the frequency and escalation of WPV. Conclusion WPV against HCWs in China is highly prevalent and multifactorial, arising from the interaction of individual, professional, organizational, economic, and value-related factors. Our findings challenge conventional risk profiles—such as the assumption that female staff are universally at higher risk—and highlight the complex role of professional values, whereby strong intrinsic and altruistic orientations may paradoxically increase vulnerability. Targeted, multi-level prevention strategies should prioritize high-risk groups such as nurses, younger staff, and those working night shifts; enhance organizational safeguards and staffing; improve alignment between workload and compensation; and integrate staff well-being and professional value orientation into comprehensive violence prevention and support programs.
Luo et al. (Tue,) studied this question.