Digital violence against healthcare workers in Heilongjiang Province of China: prevalence and associated factors

Digitalization has extended patient–healthcare worker interactions beyond clinical settings, creating opportunities for violence against healthcare workers in digital environments. Evidence on digital violence in healthcare and its relationship with physical and psychological workplace violence remains limited. This study aimed to investigate the prevalence and correlates of digital violence among healthcare workers in tertiary public hospitals in Heilongjiang Province, China, and to examine its associations with physical and psychological workplace violence and selected exploratory indicators. A cross-sectional survey was conducted from March to May 2025 among healthcare workers from 35 tertiary public hospitals across nine cities in Heilongjiang Province, China. Participants reported their experiences of digital, physical, and psychological violence during the previous 12 months. Logistic regression models were used to identify factors associated with digital violence and examine its associations with cognitive, behavioral, and occupational outcomes. Among 3,408 participants, 22.4% reported experiencing digital violence during the previous 12 months. Of those exposed, 41.6% experienced digital violence alone, whereas 58.4% also reported physical and/or psychological workplace violence. Physical and psychological workplace violence were both significantly associated with digital violence. Higher odds of digital violence were observed among male healthcare workers, those in general hospitals, those holding administrative positions, and those working in low-resource cities, whereas holding an associate senior or senior professional title was associated with lower odds. Digital violence was also associated with the overall distributions of worry, monitoring of online evaluations, reduced online expression, and attitudes toward children entering the same profession, but not with willingness to choose the profession again or turnover intention. Digital violence was common among healthcare workers and may represent a partially distinct yet interconnected form of occupational violence. Although it shared some risk environments with traditional workplace violence, it also demonstrated unique exposure patterns and broader occupational implications. These findings support incorporating digital violence into workplace violence surveillance and prevention frameworks in healthcare settings.