Perceived aggression towards nurses: study in two Italian health institutions

AIMS: The goal of the present study was to quantify the perceived aggression towards nurses working in two Italian health care institutions and to verify the hypothesis of an association between the characteristics of aggressors and the type of aggression. BACKGROUND: Violence and aggressiveness, particularly aimed at nurses, are a common, but inadequately investigated phenomenon in Italian health care institutions. DESIGN: A cross-sectional study. METHODS: The study was performed, studying a sample of 700 nurses (37% of the personnel in 94 units) in two health care institutions in northeast Italy using an anonymous multiple-choice questionnaire. RESULTS: Forty-nine percent of the nurses responded that they had experienced aggression in the previous year, 82% of that was only verbal. This happened more often to female nurses working in the emergency department and in geriatric and psychiatric units. A statistically significant association (p < 0.001) was found between the perception of fatigue, stress and work dissatisfaction and the frequency of aggression. Aggressors were usually patients or their relatives (57%) and were mainly men (66%). Fifty-three percent of assaulted nurses did not ask for help after the event. CONCLUSIONS: This study confirms the high incidence of perceived, mainly verbal aggression towards nurses. RELEVANCE TO CLINICAL PRACTICE: Action to prevent aggressive episodes may include concentrating on job motivation, encouraging participatory leadership and promoting the best possible working conditions. The absence of any systematic event reporting and documentation makes the assaulted workers feel defenceless.