Research article Special Issues

Professional and personal experiences of workplace violence among Italian mental health nurses: A qualitative study

  • Received: 29 April 2024 Revised: 30 June 2024 Accepted: 23 August 2024 Published: 06 December 2024
  • Background 

    Violence against healthcare workers in psychiatric settings is a concern in the literature. Violence effects for healthcare professionals and organizations include an absence from work due to injury or illness, a decreased job satisfaction, and a lower quality of work. The aim of this study is to identify the consequences of violence on the health, work habits, and performance of nurses working with psychiatric patients.

    Methods 

    The study was conducted using semi-structured interviews with 18 nurses from different hospitals and territorial psychiatric settings in Southern Italy. The interviews were conducted from July to December 2020 by telephone and were recorded with the consent of the participants. The collected data were transcribed and analyzed.

    Results 

    The narratives revealed five main themes: (1) Feelings about the violence experienced; (2) the effects of violent incidents on nurses; (3) features of the mental health setting related to the phenomenon of the assault; (4) the care and organizational aspects to prevent the assault; and (5) the care in psychiatric settings during the COVID-19 pandemic. The aggressions resulted in a change in the nurses' work habits and performances; they were more careful after the aggression and modified their approach to the patient. Additionally, the nurses discussed developing skills and strategies to protect themselves and avoid aggression.

    Conclusions 

    Aggression has a negative impact on the health and work performance of nurses. Adopting personal and nursing strategies in place to prevent aggression allows them to improve the patient care and to protect themselves from such incidents. The creation of a safer work environment by healthcare organizations in which professionals work can improve their health, job performance, and the effectiveness of psychiatric nursing care.

    Citation: Ilenia Piras, Igor Portoghese, Massimo Tusconi, Federica Minafra, Mariangela Lecca, Giampaolo Piras, Paolo Contu, Maura Galletta. Professional and personal experiences of workplace violence among Italian mental health nurses: A qualitative study[J]. AIMS Public Health, 2024, 11(4): 1137-1156. doi: 10.3934/publichealth.2024059

    Related Papers:

  • Background 

    Violence against healthcare workers in psychiatric settings is a concern in the literature. Violence effects for healthcare professionals and organizations include an absence from work due to injury or illness, a decreased job satisfaction, and a lower quality of work. The aim of this study is to identify the consequences of violence on the health, work habits, and performance of nurses working with psychiatric patients.

    Methods 

    The study was conducted using semi-structured interviews with 18 nurses from different hospitals and territorial psychiatric settings in Southern Italy. The interviews were conducted from July to December 2020 by telephone and were recorded with the consent of the participants. The collected data were transcribed and analyzed.

    Results 

    The narratives revealed five main themes: (1) Feelings about the violence experienced; (2) the effects of violent incidents on nurses; (3) features of the mental health setting related to the phenomenon of the assault; (4) the care and organizational aspects to prevent the assault; and (5) the care in psychiatric settings during the COVID-19 pandemic. The aggressions resulted in a change in the nurses' work habits and performances; they were more careful after the aggression and modified their approach to the patient. Additionally, the nurses discussed developing skills and strategies to protect themselves and avoid aggression.

    Conclusions 

    Aggression has a negative impact on the health and work performance of nurses. Adopting personal and nursing strategies in place to prevent aggression allows them to improve the patient care and to protect themselves from such incidents. The creation of a safer work environment by healthcare organizations in which professionals work can improve their health, job performance, and the effectiveness of psychiatric nursing care.



    加载中

    Acknowledgments



    The authors would like to thank the mental health nurses who volunteered their time and professionalism to participate in the study.

    Authors' contribution



    Ilenia Piras: Conceptualization, Formal analysis, Supervision, Writing original draft. Igor Portoghese: Formal analysis, Writing original draft. Massimo Tusconi: Conceptualization, Writing original draft. Federica Minafra: Data collection, Formal analysis. Mariangela Lecca: Data collection, Formal analysis. Giampaolo Piras: Data collection, Critical review and editing. Paolo Contu: Supervision, Writing original draft, Critical review and editing. Maura Galletta: Supervision, Writing original draft, Critical review and editing.

    Conflict of interest



    All authors declare that they have no competing interests in this paper.

    [1] ILOEliminating violence and harassment in the world of work: Convention No. 190, Recommendation No. 206, and the accompanying resolution (2019). Avaiable from: https://www.ilo.org>media>download
    [2] Liu J, Gan Y, Jiang H, et al. (2019) Prevalence of workplace violence against healthcare workers: A systematic review and meta-analysis. Occup Environ Med 76: 927-937. https://doi.org/10.1136/oemed-2019-105849
    [3] Arnetz JE (2022) The joint commission's new and revised workplace violence prevention standards for hospitals: A major step forward toward improved quality and safety. Jt Comm J Qual Patient Saf 48: 241-245. https://doi.org/10.1016/j.jcjq.2022.02.001
    [4] (2024) ILOPreventing and addressing violence and harassment in the world of work through occupational safety and health measures. Geneva: International Labour Office. Available from: https://www.ilo.org/publications/major-publications/preventing-and-addressing-violence-and-harassment-world-work-through
    [5] OSHAGuidelines for preventing workplace violence for healthcare and social service workers (2016). Available from: https://www.osha.gov/sites/default/files/publications/osha3148.pdf
    [6] Konttila J, Holopainen A, Pesonen HM, et al. (2021) Occurrence of workplace violence and the psychological consequences of it among nurses working in psychiatric outpatient settings. J Psychiatr Ment Health Nurs 28: 706-720. https://doi.org/10.1111/jpm.12723
    [7] Farrell GA, Shafiei T (2012) Workplace aggression, including bullying in nursing and midwifery: A descriptive survey (the SWAB study). Int J Nurs Stud 49: 1423-1431. http://dx.doi.org/10.1016/j.ijnurstu.2012.06.007
    [8] Daffern M, Howells K (2002) Psychiatric inpatient aggression: A review of structural and functional assessment approaches. Aggress Violent Beh 7: 477-497. https://doi.org/10.1016/S1359-1789(01)00073-8
    [9] Välimäki M, Lantta T, Lam YTJ, et al. (2022) Perceptions of patient aggression in psychiatric hospitals: A qualitative study using focus groups with nurses, patients, and informal caregivers. BMC Psychiatry 22: 344. https://doi.org/10.1186/s12888-022-03974-4
    [10] Zhang S, Zhao Z, Zhang H, et al. (2023) Workplace violence against healthcare workers during the COVID-19 pandemic: A systematic review and meta-analysis. Environ Sci Pollut Res Int 30: 74838-74852. https://doi.org/10.1007/s11356-023-27317-2
    [11] Ramzi ZS, Fatah PW, Dalvandi A (2022) Prevalence of workplace violence against healthcare workers during the COVID-19 pandemic: A systematic review and meta-analysis. Front Psychol 13: 896156. https://doi.org/10.3389/fpsyg.2022.896156
    [12] Somani R, Muntaner C, Velonis AJ, et al. (2024) Factors contributing to increased workplace violence against nurses during COVID-19 in the healthcare settings of a lower middle-income country: A qualitative study. Asian Nurs Res (Korean Soc Nurs Sci) 18: 148-158. https://doi.org/10.1016/j.anr.2024.04.008
    [13] Legge 14 agosto 2020, n. 113“Disposizioni in materia di sicurezza per gli esercenti le professioni sanitarie e socio-sanitarie nell'esercizio delle loro funzioni” (2020). Available from: https://www.gazzettaufficiale.it/eli/id/2020/09/09/20G00131/sg
    [14] Gazzetta UfficialeDecreto 13 gennaio 2022 “Istituzione dell'Osservatorio nazionale sulla sicurezza degli esercenti le professioni sanitarie e socio-sanitarie” (2022). Available from: https://www.gazzettaufficiale.it/atto/serie_generale/caricaDettaglioAtto/originario?atto.dataPubblicazioneGazzetta=2022-02-18&atto.codiceRedazionale=22A01153&elenco30giorni=false
    [15] Ministero della SaluteRaccomandazione per prevenire gli atti di violenza a danno degli operatori sanitari (2007). Available from: https://www.salute.gov.it/imgs/C_17_pubblicazioni_721_allegato.pdf
    [16] Ebrahimi H, Hassankhani H, Negarandeh R, et al. (2017) Violence against new graduated nurses in clinical settings: A qualitative study. Nurs Ethics 24: 704-715. https://doi.org/10.1177/0969733015624486
    [17] Hassankhani H, Parizad N, Gacki-Smith J, et al. (2018) The consequences of violence against nurses working in the emergency department: A qualitative study. Int Emerg Nurs 39: 20-25. http://dx.doi.org/10.1016/j.ienj.2017.07.007
    [18] Sisawo EJ, Ouédraogo SYYA, Huang SL (2017) Workplace violence against nurses in the Gambia: Mixed methods design. BMC Health Serv Res 17: 311. https://doi.org/10.1186/s12913-017-2258-4
    [19] Ramacciati N, Ceccagnoli A, Addey B, et al. (2018) Violence towards emergency nurses. The Italian national survey 2016: A qualitative study. Int J Nurs Stud 81: 21-29. https://doi.org/10.1016/j.ijnurstu.2018.01.017
    [20] Najafi F, Fallahi-Khoshknab M, Ahmadi F, et al. (2018) Antecedents and consequences of workplace violence against nurses: A qualitative study. J Clin Nurs 27: e116-e128. https://doi.org/10.1111/jocn.13884
    [21] Vrablik MC, Chipman AK, Rosenman ED, et al. (2019) Identification of processes that mediate the impact of workplace violence on emergency department healthcare workers in the USA: Results from a qualitative study. BMJ Open 9: e031781. http://dx.doi.org/10.1136/bmjopen-2019-031781
    [22] Hashemi-Dermaneh T, Masoudi-Alavi N, Abedzadeh-Kalahroudi M (2019) Nurses' experiences of workplace violence in Kashan/Iran: A qualitative content analysis. Nurs Midwifery Stud 8: 203-209. http://dx.doi.org/10.4103/nms.nms_53_18
    [23] Morphet J, Griffiths D, Beattie J, et al. (2019) Managers' experiences of prevention and management of workplace violence against health care staff: A descriptive exploratory study. J Nurs Manag 27: 781-791. https://doi.org/10.1111/jonm.12761
    [24] Catlette M (2005) A descriptive study of the perceptions of workplace violence and safety strategies of nurses working in level I trauma centers. J Emerg Nurs 31: 519-525. https://doi.org/10.1016/j.jen.2005.07.008
    [25] Stevenson KN, Jack SM, O'Mara L, et al. (2015) Registered nurses' experiences of patient violence on acute care psychiatric inpatient units: An interpretive descriptive study. BMC Nurs 14: 35. https://doi.org/10.1186/s12912-015-0079-5
    [26] Colaizzi PF (1978) Psychological research as the phenomenologist views it. Existential-phenomenological alternatives for psychology. New York: Oxford University Press 48-71.
    [27] Ceballos JB, Frota OP, Nunes HFSS, et al. (2020) Physical violence and verbal abuse against nurses working with risk stratification: Characteristics, related factors, and consequences. Rev Bras Enferm 73: e20190882. https://doi.org/10.1590/0034-7167-2019-0882
    [28] Sim IO, Ahn KM, Hwang EJ (2020) Experiences of psychiatric nurses who care for patients with physical and psychological violence: A phenomenological study. Int J Environ Res Public Health 17: 5159. http://dx.doi.org/10.3390/ijerph17145159
    [29] Lim ZY, Idris DR, Abdullah MAL, et al. (2023) Violence towards staff in the inpatient psychiatric setting: Nurses' perspectives: A qualitative study. Arch Psychiatr Nurs 46: 83-90. https://doi.org/10.1016/j.apnu.2023.08.008
    [30] Schablon A, Wendeler D, Kozak A, et al. (2018) Prevalence and consequences of aggression and violence towards nursing and care staff in Germany- A survey. Int J Environ Res Public Health 15: 1274. https://doi.org/10.3390/ijerph15061274
    [31] Bekelepi N, Martin P (2022) Experience of violence, coping and support for nurses working in acute psychiatric wards. S Afr J Psychiatr 28: 1700. https://doi.org/10.4102/sajpsychiatry.v28i0.1700
    [32] Lim MC, Jeffree MS, Saupin SS, et al. (2022) Workplace violence in healthcare settings: The risk factors, implications and collaborative preventive measures. Ann Med Surg (Lond) 78: 103727. https://doi.org/10.1016/j.amsu.2022.103727
    [33] Küçük Öztürk G, Başer E, Engin E (2024) ‘On the slope of an erupting volcano’: A qualitative study on the workplace violence experiences of psychiatric nurses. J Psychiatr Ment Health Nurs 31: 515-524. https://doi.org/10.1111/jpm.13003
    [34] Soenen C, Van Overmeire R, Six S, et al. (2023) Aggression in mental health care: Opportunities for the future-a qualitative study on the challenges when defining and managing aggression across inpatient disciplines. J Psychiatr Ment Health Nurs 30: 773-780. https://doi.org/10.1111/jpm.12904
    [35] Fletcher A, Crowe M, Manuel J, et al. (2021) Comparison of patients' and staff's perspectives on the causes of violence and aggression in psychiatric inpatient settings: An integrative review. J Psychiatr Ment Health Nurs 28: 924-939. https://doi.org/10.1111/jpm.12758
    [36] Weltens I, Bak M, Verhagen S, et al. (2021) Aggression in the psychiatric ward: Prevalence and risk factors. A systematic review of the literature. PloS One 16: e0258346. https://doi.org/10.1371/journal.pone.0258346
    [37] Weltens I, Drukker M, van Amelsvoort T, et al. (2023) Staff and ward factors associated with aggression development on an acute closed psychiatric ward: An experience sampling method study. BMJ Open 13: e067943. http://dx.doi.org/10.1136/bmjopen-2022-067943
    [38] Ferri P, Silvestri M, Artoni C, et al. (2016) Workplace violence in different settings and among various health professionals in an Italian general hospital: A cross-sectional study. Psychol Res Behav Manag 9: 263-275. http://dx.doi.org/10.2147/PRBM.S114870
    [39] Aguglia A, Belvederi Murri M, Conigliaro C, et al. (2020) Workplace violence and burnout among mental health workers. Psychiatr Serv 71: 284-288. https://doi.org/10.1176/appi.ps.201900161
    [40] Devi S (2020) COVID-19 exacerbates violence against health workers. Lancet 396: 658. https://doi.org/10.1016/S0140-6736(20)31858-4
  • Reader Comments
  • © 2024 the Author(s), licensee AIMS Press. This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0)
通讯作者: 陈斌, bchen63@163.com
  • 1. 

    沈阳化工大学材料科学与工程学院 沈阳 110142

  1. 本站搜索
  2. 百度学术搜索
  3. 万方数据库搜索
  4. CNKI搜索

Metrics

Article views(145) PDF downloads(19) Cited by(0)

Article outline

Figures and Tables

Tables(3)

/

DownLoad:  Full-Size Img  PowerPoint
Return
Return

Catalog