Violence risks in nursing--results from the European 'NEXT' Study

BACKGROUND: Recent research suggests that violence in health care is increasing and that it strongly influences the recruitment and retention of nurses as well as sick leave and burnout levels. AIMS: To identify the prevalence of violence in nursing and to provide a basis for appropriate interventions. METHODS: Nurses from 10 European countries answered to a questionnaire and to a follow-up assessment. Stepwise adjusted multiple logistic regression was used to assess the association between frequency of violence, factors related to teamwork and other work-related factors and outcomes, such as burnout, intention to leave nursing and intention to change institution. RESULTS: A total of 39,894 nurses responded to the baseline questionnaire (51% response rate). After adjustment for age, gender and other risk factors, quality of teamwork appeared to be a major factor with odds ratio (OR) 1.35 (1.24-1.48) for medium quality and 1.52 (1.33-1.74) for low quality. Uncertainty regarding patients' treatments was linked with violence, with a clear gradient (OR 1.59, 1.47-1.72 for medium uncertainty and 2.13, 1.88-2.41 for high uncertainty). Working only night shift was at high risk (OR 2.17, 1.76-2.67). High levels of time pressure and physical load were associated with violence OR 1.45 (1.24-1.69) and 1.84 (1.66-2.04), respectively. High and medium frequency of violence was associated with higher levels of burnout, intent to leave nursing and intent to change institution. A 1-year follow-up assessment indicated stability in the relationships between outcomes. CONCLUSION: This study supports efforts aimed at improving teamwork-related factors as they are associated with a decrease in violence against nurses.