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      Workplace violence against doctors: Characteristics, risk factors, and mitigation strategies

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          Abstract

          Workplace violence is a major occupational issue concerning doctors that has a significant impact on their physical and psychological well-being. This ultimately affects the health care services of the country. Patient-led episodes of verbal violence are more prevalent in Asian countries, especially in the emergency department, psychiatric wards, and intensive care units, mostly faced by junior doctors and residents. Some common precursors of violence against doctors are patients and their attendants' dissatisfaction and low impulse control, poor administration, miscommunication, infrastructural issues especially differences in services between private and public hospitals, and negative media portrayal of doctors. The assessment of risk factors, development and implementation of workplace violence programs, and addressing underreporting of violent episodes have been suggested as some successful organizational mitigation strategies. Recommendations on the management of workplace violence include the development of participative, gender-based, culture-based, nondiscriminatory, and systematic strategies to deal with issues related to violence. This article aims to present a comprehensive review of workplace violence against doctors, discussing the prevalence, degree of violence, predictors, impact on physical and psychological health and intervention strategies to devise practical actions against workplace violence.

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          Most cited references29

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          Prevalence of workplace violence against healthcare workers: a systematic review and meta-analysis

          We aim to quantitatively synthesise available epidemiological evidence on the prevalence rates of workplace violence (WPV) by patients and visitors against healthcare workers. We systematically searched PubMed, Embase and Web of Science from their inception to October 2018, as well as the reference lists of all included studies. Two authors independently assessed studies for inclusion. Data were double-extracted and discrepancies were resolved by discussion. The overall percentage of healthcare worker encounters resulting in the experience of WPV was estimated using random-effects meta-analysis. The heterogeneity was assessed using the I 2 statistic. Differences by study-level characteristics were estimated using subgroup analysis and meta-regression. We included 253 eligible studies (with a total of 331 544 participants). Of these participants, 61.9% (95% CI 56.1% to 67.6%) reported exposure to any form of WPV, 42.5% (95% CI 38.9% to 46.0%) reported exposure to non-physical violence, and 24.4% (95% CI 22.4% to 26.4%) reported experiencing physical violence in the past year. Verbal abuse (57.6%; 95% CI 51.8% to 63.4%) was the most common form of non-physical violence, followed by threats (33.2%; 95% CI 27.5% to 38.9%) and sexual harassment (12.4%; 95% CI 10.6% to 14.2%). The proportion of WPV exposure differed greatly across countries, study location, practice settings, work schedules and occupation. In this systematic review, the prevalence of WPV against healthcare workers is high, especially in Asian and North American countries, psychiatric and emergency department settings, and among nurses and physicians. There is a need for governments, policymakers and health institutions to take actions to address WPV towards healthcare professionals globally.
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            Workplace Violence against Health Care Workers in the United States

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              Reducing the adverse consequences of workplace aggression and violence: the buffering effects of organizational support.

              This study examined the buffering effects of 2 types of organizational support--instrumental and informational--on the relationships between workplace violence/aggression and both personal and organizational outcomes. Based on data from 225 employees in a health care setting, a series of moderated multiple regression analyses demonstrated that organizational support moderated the effects of physical violence, vicariously experienced violence, and psychological aggression on emotional well-being, somatic health, and job-related affect, but not on fear of future workplace violence and job neglect. These findings have implications for both research and intervention related to workplace violence.
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                Author and article information

                Journal
                J Postgrad Med
                J Postgrad Med
                JPGM
                Journal of Postgraduate Medicine
                Wolters Kluwer - Medknow (India )
                0022-3859
                0972-2823
                Jul-Sep 2020
                14 July 2020
                : 66
                : 3
                : 149-154
                Affiliations
                [1]Department of Obstetrics and Gynaecology, AIIMS, New Delhi, India
                [1 ]Department of Medicine, AIIMS, New Delhi, India
                [2 ]Department of Home Science, AIIMS, New Delhi, India
                [3 ]Department of Psychiatry and National Drug Dependence Treatment Centre, AIIMS, New Delhi, India
                Author notes
                Address for correspondence: Dr. Ranjan P, E-mail: drpiyushaiims@ 123456gmail.com
                Article
                JPGM-66-149
                10.4103/jpgm.JPGM_96_20
                7542052
                32675451
                f3bea66c-dab2-4026-99af-8831248f14ea
                Copyright: © 2020 Journal of Postgraduate Medicine

                This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.

                History
                : 06 February 2019
                : 29 March 2020
                : 11 May 2020
                Categories
                Review Article

                aggression,hospitals,physical abuse,physicians,trauma,workplace violence

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