Risk factors of workplace violence at hospitals in Japan

BACKGROUND: Patients and their relatives exposed to mental stress caused by hospitalization or illness might use violence against healthcare staff and interfere with quality healthcare. OBJECTIVE: The aim of this study was to investigate incidences of workplace violence and the attributes of healthcare staff who are at high risk. DESIGN: A questionnaire-based, anonymous, and self-administered cross-sectional survey. SETTING: Healthcare staff (n = 11,095) of 19 hospitals in Japan. MEASUREMENTS: Incidence rates and adjusted odd ratios of workplace violence were calculated to examine the effect of attributes of healthcare staff to workplace violence by using logistic regression analysis. RESULTS: The response rate for survey completion was 79.1% (8711/11,095). Among the respondents, 36.4% experienced workplace violence by patients or their relatives in the past year; 15.9% experienced physical aggression, 29.8% experienced verbal abuse, and 9.9% experienced sexual harassment. Adjusted odds ratios of physical aggression were significantly high in psychiatric wards, critical care centers/intensive care units (ICU)/cardiac care units (CCU), long-term care wards, for nurses, nursing aides/care workers, and for longer working hours. Adjusted odds ratios of verbal abuse were significantly high in psychiatric wards, long-term care wards, outpatient departments, dialysis departments, and for longer years of work experience, and for longer working hours. Adjusted odds ratios of sexual harassment were significantly high in dialysis departments, for nurses, nursing aides/care workers, technicians, therapists and females. The general ward and direct interaction with patients were common risk factors for each type of workplace violence. CONCLUSIONS: The mechanisms and the countermeasures for each type of workplace violence at those high-risk areas should be investigated.