Original Research

Risk factors of workplace violence at hospitals in Japan

Abstract

Abstract

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/emntensive 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. Journal of Hospital Medicine 2012;. © 2011 Society of Hospital Medicine.

Copyright © 2011 Society of Hospital Medicine

Patients and their relatives exposed to mental stress caused by hospitalization or illness might use violence against healthcare staff. Previous surveys reported that healthcare staff experience more workplace violence than other industry workers.13 Workplace violence by patients or their relatives may cause psychological problems or somatic effects on healthcare staff, such as losing self‐respect, depression, post‐traumatic stress disorder, stomachache, headache, or insomnia. Because those effects might lead to higher than usual turnovers of healthcare staff at a hospital, and interfere with high‐quality healthcare services, workplace violence at healthcare settings became a global concern; a lot of studies investigating those circumstances mainly were conducted in developed countries.415 Those studies revealed that the psychiatric ward, the emergency room, or the long‐term care facilities were the high‐risk areas of workplace violence; the incidence rate of physical aggression in the past year ranged from 3% to 35%; and the incidence rate of verbal abuse in the past year ranged from 26% to 64%. But the overall circumstances are still unclear, because most of the subjects in those studies were limited to nurses or some departments, such as the psychiatric ward or the emergency room. There might be other professions or departments with higher risk of workplace violence.

The aim of this study was to investigate the incidence of workplace violence and the attributes of healthcare staff, such as profession, age, gender, departments, and so on, who are at high risk of experiencing workplace violence.

METHODS

A questionnaire‐based, anonymous, and self‐administered cross‐sectional survey was conducted at 19 hospitals in Japan from January to December 2009. Among the 19 hospitals, 8 hospitals had less than 200 beds, 7 hospitals had 200 to 500 beds for acute care, and 4 hospitals had more than 500 beds for acute care. Thirteen of 19 hospitals were teaching hospitals. Eight out of 19 hospitals were located in urban areas. The characteristics of the 19 hospitals are shown in Table 4 of Supporting Appendix (in the online version of this article). The questionnaires were distributed to all 11,095 healthcare staff with a sealed reply envelope, and were collected anonymously using a collection box at each hospital.

The questionnaire contained questions about workplace violence, the work environment, and other topics. This study classifies workplace violence into physical aggression, verbal abuse, and sexual harassment. The respondents were requested to reply in regard to their experiences with each of these 3 types of workplace violence by patients or their relatives, over the past year. In this article, only those 3 questions and some background information of respondents were used for analysis. The race of patients and medical staff was not investigated because Japan is a racially homogeneous nation, and more than 99% of the population is Asian.

Logistic regression analysis with forced entry of all variables to examine the effect of attributes of healthcare staff to workplace violence was used. In this analysis, random effects of each hospital or area were not taken into account. All analyses were performed using SPSS 18.0 (SPSS, Inc, Chicago, IL), and P < 0.05 was used to determine significance.

In this study, workplace violence was defined as an event that was subjectively recognized by healthcare staff as violence caused by patients or their relatives. The violence among healthcare staff was excluded.

RESULTS

The response rate was 79.1% (8711/11,095). Among the 8771 respondents, 36.4% experienced workplace violence by patients or their relatives over the past year; 15.9% experienced physical aggressions, 29.8% experienced verbal abuse, and 9.9% experienced sexual harassment. Table 1 provides characteristics of the respondents; Table 2 shows the proportion of victims for workplace violence.

Characteristics of Respondents
  No. of Respondents
n(%)*
  • Abbreviations: CCU, cardiac care unit; ICU, intensive care unit; NICU, neonatal intensive care unit.

  • Proportion of respondents among the total population.

  • Physicians usually do not belong to 1 section, but are included in the physicians' department.

No. of beds in their hospital<200 beds1298(14.8)
200‐500 beds3041(34.7)
500 beds or more4432(50.5)
SectionGeneral ward2377(27.1)
Administration department989(11.3)
Outpatient department675(7.7)
Physicians' department610(7.0)
Dietary department435(5.0)
Long‐term care ward331(3.8)
Rehabilitation department318(3.6)
Critical care center, ICU, or CCU306(3.5)
Obstetrics and gynecology ward, perinatal ward, or NICU287(3.3)
Clinical laboratory or physiology department266(3.0)
Operation department264(3.0)
Pharmaceutical department209(2.4)
Pediatric ward203(2.3)
Radiology department197(2.2)
Dialysis department104(1.2)
Psychiatric ward56(0.6)
Others1144(13.0)
ProfessionNurse4298(49.0)
Clerk1208(13.8)
Doctor610(7.0)
Nursing aide or care worker585(6.7)
Technician547(6.2)
Dietician or cook435(5.0)
Therapist313(3.6)
Pharmacist183(2.1)
Others592(6.7)
Years of experience in their own specialty or profession<5 yr3497(39.9)
6‐10 yr1618(18.4)
11‐15 yr1041(11.9)
16‐20 yr761(8.7)
21 yr or more1218(13.9)
Not reported636(7.3)
Working hours per week<20 hr640(7.3)
20‐40 hr1720(19.6)
40‐60 hr4638(52.9)
60 hr or more655(7.5)
Not reported1118(12.7)
GenderMale1941(22.1)
Female6272(71.5)
Not reported558(6.4)
Direct interaction or contact with patientsHaving those contacts7227(82.4)
Not having those contacts1001(11.4)
Not reported543(6.2)
Total 8771(100.0)
Proportion of Victims for Workplace Violence
  No. of RespondentsPhysical Aggression ExperienceVerbal Abuse ExperienceSexual Harassment ExperienceExperience of at Least 1 of the 3 Kinds of Violence
  nn(%)*n(%)*n(%)*n(%)*
No. of beds in their hospital<200 beds1298244(18.8)306(23.6)109(8.4)413(31.8)
200‐500 beds3041503(16.5)971(31.9)354(11.6)1173(38.6)
500 beds or more4432645(14.6)1338(30.2)406(9.2)1606(36.2)
SectionPsychiatric ward5633(58.9)37(66.1)8(14.3)42(75.0)
General ward2377852(35.8)1057(44.5)536(22.5)1371(57.7)
Dialysis department1045(4.8)44(42.3)24(23.1)55(52.9)
Critical care center, ICU, or CCU30690(29.4)108(35.3)41(13.4)151(49.3)
Long‐term care ward331108(32.6)109(32.9)38(11.5)157(47.4)
Outpatient department67547(7.0)268(39.7)44(6.5)292(43.3)
Physicians' department61033(5.4)193(31.6)6(1.0)203(33.3)
Pediatric ward20323(11.3)50(24.6)13(6.4)62(30.5)
Rehabilitation department31853(16.7)70(22.0)31(9.7)96(30.2)
Administration department98910(1.0)247(25.0)16(1.6)251(25.4)
Clinical radiology department19711(5.6)40(20.3)2(1.0)48(24.4)
Operation department26411(4.2)38(14.4)9(3.4)43(16.3)
Clinical laboratory or physiology department2664(1.5)37(13.9)9(3.4)43(16.2)
Obstetrics and gynecology ward, perinatal ward, or NICU2873(1.0)26(9.1)2(0.7)28(9.8)
Dietary department4357(1.6)39(9.0)8(1.8)42(9.7)
Pharmaceutical department2091(0.5)15(7.2)5(2.4)19(9.1)
Others1144101(8.8)237(20.7)77(6.7)289(25.3)
ProfessionNurse42981150(26.8)1694(39.4)729(17.0)2155(50.1)
Doctor61033(5.4)193(31.6)6(1.0)203(33.3)
Nursing aide or care worker585104(17.8)151(25.8)39(6.7)191(32.6)
Therapist31353(16.9)71(22.7)31(9.9)96(30.7)
Clerk120815(1.2)311(25.7)23(1.9)314(26.0)
Technician54715(2.7)79(14.4)19(3.5)97(17.7)
Dietician or cook4357(1.6)38(8.7)8(1.8)41(9.4)
Pharmacist1830(0.0)13(7.1)5(2.7)17(9.3)
Others59215(2.5)65(11.0)9(1.5)78(13.2)
Years of experience in their own specialty or profession<5 yr3497527(15.1)919(26.3)384(11.0)1183(33.8)
6‐10 yr1618316(19.5)510(31.5)183(11.3)636(39.3)
11‐15 yr1041210(20.2)350(33.6)125(12.0)421(40.4)
16‐20 yr761111(14.6)253(33.2)58(7.6)294(38.6)
21 yr or more1218160(13.1)422(34.6)85(7.0)475(39.0)
Not reported63668(10.7)161(25.3)34(5.3)183(28.8)
Working hours per week<20 hr64050(7.8)148(23.1)39(6.1)173(27.0)
20‐40 hr1720234(13.6)473(27.5)157(9.1)583(33.9)
40‐60 hr4638798(17.2)1424(30.7)498(10.7)1726(37.2)
60 hr or more655103(15.7)242(36.9)50(7.6)279(42.6)
Not reported1118207(18.5)328(29.3)125(11.2)431(38.6)
GenderMale1941185(9.5)471(24.3)77(4.0)529(27.3)
 Female62721137(18.1)2004(32.0)752(12.0)2494(39.8)
 Not reported55870(12.5)140(25.1)40(7.2)169(30.3)
Direct interaction or contact with patientsHaving those contacts72271325(18.3)2395(33.1)834(11.5)2945(40.7)
Not having those contacts100117(1.7)100(10.0)7(0.7)107(10.7)
Not reported54350(9.2)120(22.1)28(5.2)140(25.8)
Total 87711392(15.9)2615(29.8)869(9.9)3192(36.4)

Because of missing values, 6654 out of 8771 (75.9%) replies were used for the logistic regression analysis. Nagelkerke R2 for physical aggression was 0.33, for verbal abuse was 0.16, for sexual harassment was 0.23, and for at least one of the above types of violence was 0.23. The proportions of respondents, who had experienced each type of workplace violence, were not significantly different among the replies with missing data and with the effective data actually used.

Factors Associated With Higher Risk of Violence

Adjusted odds ratios of physical aggression were significantly high in general wards, psychiatric wards, critical care centers/emntensive care units (ICU)/cardiac care units (CCU), and long‐term care wards; and for nurses, nursing aides/care workers; for longer working hours; and for direct interaction with patients (Table 3).

Odds Ratio of Workplace Violence by Patients or Relatives
  Physical AggressionVerbal AbuseSexual HarassmentAt Least 1 of the 3 Kinds of Violence
  POdds Ratio (95%Cl)POdds Ratio (95%Cl)POdds Ratio (95%Cl)POdds Ratio (95%Cl)
  • Abbreviations: CCU, cardiac care unit; ICU, intensive care unit; NICU, neonatal intensive care unit.

  • P < 0.05.

  • Odds ratio of pharmaceutical department against physical aggression was not calculated because no staff experienced physical aggressions in the data set.

  • In order to avoid multicollinearity, Pharmacist and Dietician or cook were included in Others because they are correlated to the Pharmaceutical department and the Dietary department, respectively.

No. of beds in their hospital<200 beds 1.00  1.00  1.00  1.00 
200‐500 beds0.510.90(0.67‐1.22)<0.01*1.64(1.30‐2.07)0.191.27(0.89‐1.80)<0.01*1.45(1.16‐1.81)
500 beds or more0.02*0.69(0.51‐0.94)<0.01*1.57(1.24‐1.98)0.490.88(0.62‐1.26)0.01*1.32(1.06‐1.65)
SectionPhysicians' department 1.00  1.00  1.00  1.00 
Psychiatric ward<0.01*9.28(4.39‐19.62)<0.01*3.33(1.65‐6.70)0.690.80(0.27‐2.40)<0.01*4.55(2.07‐1.02)
Long‐term care ward<0.01*2.48(1.55‐3.96)<0.01*1.90(1.27‐2.86)0.651.15(0.63‐2.09)<0.01*2.20(1.50‐3.24)
General ward<0.01*3.00(2.18‐4.13)<0.01*1.73(1.36‐2.21)<0.01*1.89(1.32‐2.69)<0.01*1.98(1.57‐2.51)
Dialysis department0.02*0.32(0.12‐0.83)0.04*1.65(1.02‐2.66)0.01*2.21(1.23‐3.97)0.02*1.81(1.12‐2.92)
Critical care center, ICU, or CCU<0.01*2.44(1.60‐3.74)0.491.13(0.79‐1.61)0.561.17(0.70‐1.94)0.04*1.43(1.01‐2.01)
Administration department0.220.55(0.21‐1.44)0.071.38(0.98‐1.93)0.290.64(0.27‐1.48)0.071.37(0.98‐1.91)
Clinical radiology department0.531.42(0.48‐4.21)0.511.21(0.69‐2.12)0.02*0.17(0.04‐0.78)0.571.17(0.69‐1.98)
Rehabilitation department0.930.93(0.18‐4.77)0.881.08(0.42‐2.80)0.821.22(0.22‐6.79)0.771.14(0.46‐2.85)
Outpatient department<0.01*0.41(0.26‐0.65)0.03*1.35(1.02‐1.78)0.02*0.56(0.35‐0.90)0.401.12(0.86‐1.47)
Dietary department0.331.94(0.51‐7.35)0.661.13(0.65‐1.99)0.851.13(0.30‐4.26)0.841.06(0.61‐1.82)
Clinical laboratory or physiology department0.400.53(0.12‐2.34)0.851.06(0.59‐1.89)0.210.52(0.18‐1.45)0.870.96(0.55‐1.65)
Pediatric ward0.270.72(0.41‐1.29)0.080.69(0.45‐1.05)0.02*0.43(0.21‐0.90)0.03*0.65(0.43‐0.97)
Pharmaceutical department   0.050.52(0.26‐1.01)0.711.26(0.36‐4.38)0.140.63(0.34‐1.17)
Operation department<0.01*0.24(0.12‐0.48)<0.01*0.36(0.23‐0.55)<0.01*0.21(0.09‐0.48)<0.01*0.27(0.18‐0.41)
Obstetrics and gynecology ward, perinatal ward, or NICU<0.01*0.04(0.01‐0.18)<0.01*0.19(0.12‐0.32)<0.01*0.02(0.00‐0.18)<0.01*0.14(0.08‐0.22)
ProfessionDoctor 1.00  1.00  1.00 <0.01*1.00 
Nurse<0.01*4.09(2.41‐6.95)0.161.27(0.91‐1.76)<0.01*11.64(4.38‐30.90) 1.64(1.19‐2.26)
Therapist0.104.03(0.76‐21.28)0.830.90(0.34‐2.39)0.05*7.11(1.02‐49.3)0.831.11(0.43‐2.83)
Nursing aide or care worker0.03*1.95(1.07‐3.55)0.090.71(0.47‐1.05)<0.01*4.66(1.63‐13.31)0.190.77(0.53‐1.14)
Clerk0.03*0.36(0.14‐0.90)0.270.80(0.54‐1.19)0.172.26(0.70‐7.27)0.090.72(0.49‐1.06)
Technician0.270.55(0.19‐1.60)<0.01*0.37(0.22‐0.61)<0.01*6.92(2.20‐21.76)<0.01*0.46(0.28‐0.74)
Others<0.01*0.21(0.08‐0.57)<0.01*0.39(0.25‐0.60)0.242.14(0.60‐7.63)<0.01*0.39(0.25‐0.59)
Years of experience in their own specialty or profession<5 yr 1.00  1.00  1.00  1.00 
6‐10 yr<0.01*1.42(1.17‐1.72)0.01*1.22(1.05‐1.42)0.840.98(0.78‐1.22)0.01*1.22(1.05‐1.42)
11‐15 yr<0.01*1.64(1.31‐2.05)<0.01*1.45(1.22‐1.73)0.301.14(0.89‐1.47)<0.01*1.35(1.13‐1.60)
16‐20 yr0.301.16(0.88‐1.52)<0.01*1.47(1.21‐1.79)0.090.75(0.54‐1.04)<0.01*1.34(1.10‐1.63)
21 yr or more0.581.07(0.84‐1.37)<0.01*1.65(1.39‐1.96)<0.01*0.63(0.47‐0.85)<0.01*1.38(1.16‐1.64)
Working hours per week<20 hr 1.00  1.00  1.00  1.00 
20‐40 hr0.04*1.49(1.01‐2.19)0.521.08(0.85‐1.39)0.121.40(0.91‐2.15)0.101.23(0.96‐1.56)
40‐60 hr<0.01*1.80(1.25‐2.58)0.03*1.28(1.02‐1.60)0.05*1.50(1.00‐2.24)<0.01*1.39(1.11‐1.74)
60 hr or more<0.01*2.14(1.37‐3.34)<0.01*1.62(1.21‐2.17)0.141.49(0.88‐2.50)<0.01*1.90(1.43‐2.54)
Gender(Female vs male)0.690.95(0.76‐1.20)0.161.12(0.95‐1.32)<0.01*1.59(1.18‐2.12)0.01*1.22(1.05‐1.43)
Direct interaction or contact with patients(Constant and direct interaction with patients vs no interaction)0.02*2.17(1.11‐4.22)<0.01*2.46(1.87‐3.24)<0.01*6.80(2.43‐19.03)<0.01*2.58(1.97‐3.37)

Adjusted odds ratios of verbal abuse were significantly high in hospital with 200 beds or more, in general wards, psychiatric wards, long‐term care wards, outpatient departments, and dialysis departments; and for longer years of experience in their own specialty; for longer working hours; and for direct interaction with patients.

Adjusted odds ratios of sexual harassment were significantly high in general wards, and dialysis departments; for nurses, nursing aides/care workers, technicians, therapists; for females; and for direct interaction with patients.

Adjusted odds ratios for at least 1 of the 3 kinds of workplace violence were significantly high in hospitals with 200 beds or more, in general wards, psychiatric wards, critical care centers/ICU/CCU, long‐term care wards, and dialysis departments; for nurses; for longer years of experience in their own specialty; for longer working hours; for females; and for direct interaction with patients.

Factors Associated With Lower Risk of Violence

Adjusted odds ratios of physical aggression were significantly low in dialysis departments; outpatient departments; operation departments; obstetrics and gynecology wards, perinatal wards, or neonatal intensive care units (NICU); and for clerks.

Adjusted odds ratios of verbal abuse were significantly low in operation departments; obstetrics and gynecology wards, perinatal wards, or NICU; and for technicians.

Adjusted odds ratios of sexual harassment were significantly low in clinical radiology departments; outpatient departments; pediatric wards; operation departments; obstetrics and gynecology wards, perinatal wards, or NICU; and for longer years of experience in their own specialty.

Adjusted odds ratios for at least 1 of the 3 kinds of workplace violence were significantly low in pediatric wards; operation departments; obstetrics and gynecology wards, perinatal wards, or NICU; and for technicians.

DISCUSSION

Among the healthcare staff, 36.4% experienced workplace violence by patients or their relatives over the past year; 15.9% experienced physical aggressions, 29.8% verbal abuse, and 9.9% sexual harassment. The risk factors of workplace violence identified in the present study were similar to those studies conducted not only in Japan, but also in Western countries. Though the target population was limited to Asians, our results can be applicable to other races, countries, and cultures.

Incidence of Workplace Violence

Most previous studies covered only specific professions at hospitals, such as nurses or critical care center staff, and there are only few multicenter studies covering entire sections and professions like this study.510, 1214 A Spanish study including about 8000 healthcare workers reported that 11% had experienced physical aggression, 64% had experienced threatening behavior, intimidation, or insults in the past year.11 The incidence of physical aggression was similar in both studies, but the incidence of verbal abuse was about twice as high as that of this study. The low response rate in the Spanish study (24%) might have contributed to a higher number of verbal abuse incidents, because those with experience of workplace violence would likely have answered the questionnaire. It is difficult to compare the incidence of workplace violence among different studies because the definitions of workplace violence differ widely. Ethnic culture might also affect the acknowledgement of workplace violence. The European NEXT study including about 30,000 nurses in 8 European countries reported a range of 10.4% incidence of workplace violence in the Netherlands, and 39.1% in France.10

Risk Factors of Physical Aggression

Previous studies reported that the prevalence of physical aggression is high in psychiatric wards, critical care centers, or long‐term care wards.1015 In these departments, patients with mental illness, postoperative delirium, or dementia are likely to be admitted.

Nurses and nursing aides are reported to be likely to experience physical aggression.3, 11, 15 Nurses and nursing aides have longer work hours with direct interaction with patients than other professions, and are considered to be at high risk of physical aggression.

Some studies, which did not examine influences by profession or department, reported that male was a risk factor for physical aggression and verbal abuse.6, 10, 11, 13 In this study though, the male gender was not associated with physical aggression or verbal abuse. Male nurses and nursing aides are likely to be assigned to high‐risk departments or to care for high‐risk patients. Gender may be confounded with variables such as profession or department.15

Longer work hours mean more frequent interaction with patients, and the risk for physical aggression might increase. Constant and direct interaction with patients is a risk factor, not only for physical aggression, but also for verbal abuse and sexual harassment.10

Risk Factors of Verbal Abuse

Previous studies reported that incidents of verbal abuse are high for nurses and nursing aides.15 Although in this study the proportion of verbal abuse was the highest in nurses (39.4%), adjusted odds ratio was not significant. Factors other than nurse profession, such as department and direct interaction with patients relating to the nurse profession, might be the higher risk factors for verbal abuse.

As reported in previous studies, psychiatric wards and long‐term care wards are risk factors of verbal abuse also in this study.10, 13, 15 Long waiting time at outpatient departments might increase the risk of verbal abuse.

Dialysis departments are at high risk of verbal abuse and sexual harassment. Compared to other outpatients, dialysis patients are forced to stay a long time in hospitals and there is, therefore, more interaction with nurses and technicians. The characteristic personality of dialysis patients, such as neuroticism or psychoticism, might also affect verbal abuse or sexual harassment.16

Because longer working hours mean more frequent interaction with patients, the risk of verbal abuse might increase.17 Managers with longer work experience might be at high risk for verbal abuse, because they often assume responsibility and take on the task of dealing with patients and their relevant complaints.11

Risk Factors of Sexual Harassment

Nurses are likely to experience sexual harassment because their public image seems to combine sexuality and maternalism.18 Nursing aides, technicians, and therapists also experience sexual harassment. The common risk factor among those professions is the direct contact with the patient's body during the patient's transfer. A lot of studies reported that female gender is a risk factor of sexual harassment.17, 19

Safety Factors of Workplace Violence

Adjusted odds ratios of operation departments, and obstetrics and gynecology wards, perinatal wards, or NICU were common safety factors for each type of workplace violence. Usually, the patients in operation rooms cannot talk or move a finger carelessly during the surgery. The fact that there are no adult male patients in obstetrics and gynecology wards, perinatal wards, or NICU, might have an influence on lower occurrence of workplace violence in these areas.

Limitations

This study used a questionnaire survey asking about subjective experiences of workplace violence over the 1 year before the study. There is the possibility of recall bias, and the same incident recognized as workplace violence by one person might not have been recognized as such by another person, because sensitivity differs among respondents.

In some categories with fewer respondents, such as the pharmaceutical department, it might be difficult to examine the exact confidence intervals of odds ratio. Further study with increased respondents of those categories is needed to confirm the odds ratios and the confidence intervals.

The rates of victims or risk for workplace violence were considered to vary with the character of the residents of each area or policy of each hospital. Therefore, a further analysis with adjustment for those factors is needed.

CONCLUSIONS

This study reveals that a significant proportion of healthcare staff (36.4%) has experienced workplace violence over the 1 year before the study was conducted and suggests that workplace violence is a serious problem. The attributes of healthcare staff who are at risk of workplace violence could be identified for each type of workplace violence. The mechanisms and the countermeasures for each type of workplace violence at those high‐risk areas should be further investigated. Further studies are necessary to confirm whether these findings are applicable to different races and different countries with different cultures.

References

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