Validation of the Italian Version of the Perception of Aggression Scale (POAS): A Cross-Sectional Study

BACKGROUND: Aggression in healthcare settings is a persistent occupational hazard that affects staff well-being, the quality of patient care, and organizational dynamics. Understanding healthcare professionals' perceptions of aggression is crucial for designing effective interventions and improving workplace safety. This study aimed to validate the Italian version of the short-form Perception of Aggression Scale (POAS) and to examine how demographic and professional variables influence staff attitudes toward aggression in clinical settings.. METHODS: The POAS was administered to a heterogeneous sample of 475 healthcare professionals across multiple hospital departments and educational settings. Psychometric properties, including internal consistency and test-retest reliability, were evaluated. Bivariate and multivariate analyses assessed associations between perceptions of aggression and sociodemographic variables. RESULTS: The Italian POAS demonstrated strong psychometric performance, with high internal consistency (α = 0.82 for dysfunctional; α = 0.76 for functional aggression) and temporal stability. While dysfunctional interpretations of aggression were prevalent across the sample, functional perceptions, viewing aggression as contextually meaningful or communicative, were more common among male participants and physicians. Multivariate analysis revealed a strong inverse relationship between functional and dysfunctional perceptions, suggesting a polarized interpretive schema. CONCLUSIONS: The validated Italian POAS is a reliable tool for assessing healthcare workers' attitudes toward aggression. Its integration into clinical training, audits, and risk management systems could facilitate early identification of negative attitudes and support the development of targeted de-escalation strategies. Future research should investigate longitudinal shifts in perception and the tool's adaptability across diverse healthcare settings.