Table 2.
Main causes of violence against nurses in developed countries
| Main Category | Themes |
|---|---|
| Individual Causes (Patient and Companion) | Unstable mental state and psychiatric disorders |
| Unmet needs of patients and companions | |
| Death of the patient | |
| Dissatisfaction with the treatment process | |
| Personal problems | |
| Dissatisfaction with the arrangement of medical staff | |
| Male gender | |
| Low level of education | |
| Very young or very old age | |
| Pain and discomfort | |
| Lack of trust in medical staff and the hospital | |
| Increased patient awareness of their rights | |
| Substance and alcohol abuse | |
| Lack of awareness of medical and hospital procedures | |
| Disrespectful behavior | |
| Non-compliance with rules | |
| history of violence | |
| Receiving distressing news | |
| Conflict between patient and companion | |
| Emergency or critical condition | |
| High cost of treatment | |
| Lack of effective communication staff | |
| Deprivation from or forced use of medication | |
| Restriction on personal activities | |
| Inability to leave the ward | |
| Sexual abuse | |
| Low socioeconomic status | |
| Ethnic and cultural characteristics | |
| Use of weapons | |
| Individual Causes – Staff | Ineffective communication with the patient |
| Negative attitude about nursing | |
| Lack of compassion and empathy | |
| Limited clinical skills or work experience | |
| Staff conflicts | |
| Feeling of insecurity in the workplace | |
| Fear and vulnerability of nurses | |
| High workload | |
| Time constraints | |
| Lack of skills in managing violence | |
| Failure to deliver appropriate care | |
| Being alone during the shift | |
| Staff marital status | |
| Cultural and religious background | |
| Age | |
| Low resilience | |
| Nursing error | |
| Lower educational level | |
| Transfer of physician-patient conflicts to nurse | |
| Employment in emergency or intensive care units | |
| Evening shifts | |
| Lack of teamwork | |
| Failure to report incidents of violence | |
| Organizational causes | Long waiting time |
| Being big hospital | |
| High treatment cost | |
| Low service quality | |
| Delays in admission or discharge | |
| Insufficient security infrastructure | |
| staff shortages | |
| Overcrowding and noise | |
| Lack of space | |
| Lack of privacy | |
| Absence of risk assessment mechanisms | |
| Limited visiting hours | |
| Tobacco bans | |
| Shift changes of nurses | |
| Enforcement of regulations | |
| Limited access to background information on the high-risk behaviors of patients and their attendants | |
| Lack of empowerment and violence prevention training programs for hospital staff | |
| Heavy workload | |
| Delayed security or police response | |
| No scheduled rest breaks | |
| Inadequate post-violence support | |
| Lack of violence reporting | |
| Poor monitoring of visitors | |
| Evening shift | |
| Limited financial resources | |
| Lack of financial and psychological support after incidents of violence | |
| Social causes | Negative media portrayal |
| Lack of public appreciation for healthcare workers | |
| Specific cultural behaviors | |
| Social conflict | |
| Gender discrimination | |
| Marginalization of ethnic and immigrant minorities | |
| Political causes | Insufficient government investment |
| Poor hospital oversight | |
| Ineffective legal system | |
| Weak health insurance coverage | |
| Restrictive regulations | |
| Lack of strict visitation policies | |
| Absence of legal frameworks for penalizing offenders |