Aggression and violence in Psychiatric, Emergency and General Hospital settings: an Italian experience

IntroductionHealth care professionals, especially nurses, are at the highest risk of violence in the workplace. Nurses present 16 times more frequent risk of victimization than other workers and psychiatric nurses report the highest rate of violent assault in comparison to other nurses. The National Institute of Occupational Safety and Health (NIOSH) (2002) defines violence in the workplace as “all situations of physical assault, threatening behavior or verbal abuse that occur in the workplace”. This phenomenon, which is steadily increasing, may affect the professional resilience of operators and may account for the high rate of burn out syndrome in health care professionals.AimIt is a preliminary cross-sectional investigation among nurses in order to evaluate the rate and the features of violence incidents that occurred during the previous 3 years in the following health care settings: Emergency, Psychiatric and General Hospital.Materials and MethodsA self-assessment questionnaire, “Violent Incident Form” (VIF) (Arnetz, 1998), was subministered in order to identify the following features of aggressiveness occurred during the previous 3 years in the health care workplaces above mentioned.ResultsIn Psychiatric Wards, violence appeared more frequent inside the ward, without a specific pattern in comparison to nurse shifts; physical attack was prevalent; aggressors were more frequently young and male patients; most consequences were physical damages reported by professionals, but their reaction was never represented by a police report.In Emergency Departments, verbal aggression was prevalent and took place most frequently in waiting rooms during night shifts; aggressors were more frequently male relatives of patients, with an age ranged between 40-49 years; the most frequent reaction of professionals was a police report even without physical damages reported.In General Hospital Wards, violence was less frequent than in the other settings; verbal attacks were prevalent and most frequently occurred inside the ward during day shifts; aggressors were represented similarly by both patients and relatives, with an age ranged between 50-59 years; the most frequent reactions of professionals were both police and incident reports.Discussion and ConclusionOur results, in accordance with the literature, highlight that aggressiveness in health care settings is a frequent and notable phenomenon which can be strongly conditioned by illnesses of patients and by the way they are assisted them in each setting.