Skip to main content
NCBI home page
Journal of Occupational Health logoLink to Journal of Occupational Health
. 2015 Dec 25;57(6):540–547. doi: 10.1539/joh.15-0111-OA

Determinants of workplace violence against clinical physicians in hospitals

Jeng‐Cheng Wu 1,2, Tao‐Hsin Tung 3,4, Peter Y Chen 5, Ying‐Lin Chen 3, Yu‐Wen Lin 3, Fu‐Li Chen 3,✉
PMCID: PMC6706174  PMID: 26423827

Abstract

Determinants of workplace violence against clinical physicians in hospitals: Jeng‐Cheng Wu, et al. Department of Urology, Taipei Medical University Hospital, Taiwan

Objective

Workplace violence in the health sector is a worldwide concern. Physicians play an essential role in health‐care teamwork; thus, understanding how organizational factors influence workplace violence against physicians is critical.

Methods

A total of 189 physicians from three public hospitals and one private hospital in Northern Taiwan completed a survey, and the response rate was 47.1%. This study was approved by the institutional review board of each participating hospital. The 189 physicians were selected from the Taipei area, Taiwan.

Results

The results showed that 41.5% of the respondents had received at least one workplace‐related physical or verbal violent threat, and that 9.8% of the respondents had experienced at least one episode of sexual harassment in the 3 months before the survey. Logistic regression analysis revealed that physicians in psychiatry or emergency medicine departments received more violent threats and sexual harassment than physicians in other departments. Furthermore, physicians with a lower workplace safety climate (OR=0.89; 95% CI=0.81−0.98) and more job demands (OR=1.15; 95% CI=1.02−1.30) were more likely to receive violent threats.

Conclusions

This study found that workplace violence was associated with job demands and the workplace safety climate. Therefore, determining how to develop a workplace safety climate and ensure a safe job environment for physicians is a crucial management policy issue for health‐care systems.

Keywords: Job demand, Physicians, Safety climate, Workplace violence

References

  • 1. ILO, ICN, WHO, PSI . Framework Guidelines for Addressing Workplace Violence in the Health Sector. [Online]. 2002. [cited 2014 May 21]: Available from: URL: http://www.who.int/violence_injury_prevention/violence/activities/workplace/en/
  • 2. World Medical Association [WMA] . WMA statement on violence in the health sector by patients and those close to them. Adopted by the 63rd WMA general assembly, Bangkok, Thailand, October 2012. [Online]. 2012 [cited 2013 Apr 25]: Available from: URL: http://www.wma.net/en/30publications/10policies/v5/ [Google Scholar]
  • 3. Magin P, Adams J, Joy E, Ireland M, Heaney S, Darab S. Violence in general practice: perceptions of cause and implications for safety. Can Fam Physician 2008; 54: 1278–84. [PMC free article] [PubMed] [Google Scholar]
  • 4. Acik Y, Deveci SE, Gunes G, et al. Experience of workplace violence during medical specialty training in Turkey. Occup Med (Lond) 2008; 58: 361–6. [DOI] [PubMed] [Google Scholar]
  • 5. Behnam M, Tillotson RD, Davis SM, Hobbs GR. Violence in the emergency department: a national survey of emergency medicine residents and attending physicians. J Emerg Med 2011; 40: 565–79. [DOI] [PubMed] [Google Scholar]
  • 6. Carmi‐Iluz T, Peleg R, Freud T, Shvartzman P. Verbal and physical violence towards hospital‐ and community‐based physicians in the Negev: an observational study. BMC Health Serv Res 2005; 5: 54. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 7. Kowalenko T, Walters BL, Khare RK, Compton S; Michigan College of Emergency Physicians Workplace Violence Task Force. Workplace violence: a survey of emergency physicians in the state of Michigan. Ann Emerg Med 2005; 46: 142–7. [DOI] [PubMed] [Google Scholar]
  • 8. Arimatsu M, Wada K, Yoshikawa T, et al. An epidemiological study of work‐related violence experienced by physicians who graduated from a medical school in Japan. J Occup Health 2008; 50: 357–61. [DOI] [PubMed] [Google Scholar]
  • 9. Wu JC, Lin YW, Chen PY, Tang CS, Chen FL. The occupational exposure profiles for physicians in Taiwan. Chinese J Occup Med 2012; 19: 125–34 (in Chinese). [Google Scholar]
  • 10. Morrison JL, Lantos JD, Levinson W. Aggression and violence directed toward physicians. J Gen Intern Med 1998; 13: 556–61. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 11. Paola F, Malik T, Qureshi A. Violence against physicians. J Gen Intern Med 1994; 9: 503–6. [DOI] [PubMed] [Google Scholar]
  • 12. Findorff MJ, McGovern PM, Wall M, Gerberich SG, Alexander B. Risk factors for work related violence in a health care organization. Inj Prev 2004; 10: 296–302. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 13. Anderson C. Training efforts to reduce reports of workplace violence in a community health care facility. J Prof Nurs 2006; 22: 289–95. [DOI] [PubMed] [Google Scholar]
  • 14. Trenoweth S. Perceiving risk in dangerous situations: risks of violence among mental health inpatients. J Adv Nurs 2003; 42: 278–87. [DOI] [PubMed] [Google Scholar]
  • 15. Hutchinson M, Wilkes L, Jackson D, Vickers MH. Integrating individual, work group and organizational factors: testing a multidimensional model of bullying in the nursing workplace. J Nurs Manag 2010; 18: 173–81. [DOI] [PubMed] [Google Scholar]
  • 16. Spector PE, Coulter ML, Stockwell HG, Matz MW. Perceived violence climate: a new construct and its relationship to workplace physical violence and verbal aggression, and their potential consequences. Work & Stress 2007; 21: 117–30. [Google Scholar]
  • 17. Yang LQ, Spector PE, Chang CH, Gallant‐Roman M, Powell J. Psychosocial precursors and physical consequences of workplace violence towards nurses: a longitudinal examination with naturally occurring groups in hospital settings. Int J Nurs Stud 2012; 49: 1091–102. [DOI] [PubMed] [Google Scholar]
  • 18. Zohar D, Luria G. A multilevel model of safety climate: cross‐level relationships between organization and group‐level climates. J Appl Psychol 2005; 90: 616–28. [DOI] [PubMed] [Google Scholar]
  • 19. Chen PY, Li Y, Tuckey M, Cigularov KP. Chapter 9: Progress and Challenges in Occupational Health and Safety Research In Leka S, Sinclair RR. eds. Contemporary Occupational Health Psychology: Global Perspectives on Research and Practice, Volume 3 John Wiley & Sons, Ltd. 2014. [Google Scholar]
  • 20. Cheng Y, Luh WM, Guo YL. Reliability and validity of the Chinese version of the job content questionnaire in Taiwanese workers. Int J Behav Med 2003; 10: 15–30. [DOI] [PubMed] [Google Scholar]
  • 21. Karasek R, Brisson C, Kawakami N, Houtman I, Bongers P, Amick B. The job content questionnaire (JCQ): an instrument for internationally comparative assessments of psychosocial job characteristics. J Occup Health Psychol 1998; 3: 322–55. [DOI] [PubMed] [Google Scholar]
  • 22. Lin YW, Chuang TH, Liu HC, Chen YJ, Chen FL. Exploring job stressors for Head Nurses and Clinical Nurses from the Perspective of Their Job Characteristics. Taiwan Journal of Public Health 2011; 30: 245–56 (in Chinese). [Google Scholar]
  • 23. Lin YH, Liu HE. The impact of workplace violence on nurses in South Taiwan. Int J Nurs Stud 2005; 42: 773–8. [DOI] [PubMed] [Google Scholar]
  • 24. Choy CS, Chiou HY, Chiu WT, Huang YW, Cheah KP, Chen YC, Chou HT. A pilot study of violence on emergency department nurses in Taipei. J Taiwan Emerg Med 2006; 8: 126–33. [Google Scholar]
  • 25. Institute of Labor, Occupational Safety and Health(ILOSH) . Survey of Perceptions of Safety and Health in the Work Environment in 2013 Taiwan. Taipei: Institute of Labor, Occupational Safety and Health, Ministry of Labor, the Executive Yuan, Taiwan; 2013. (in Chinese). [Google Scholar]
  • 26. Institute of Labor, Occupational Safety and Health(ILOSH) . Survey of Perceptions of Safety and Health in the Work Environment in 2010 Taiwan. Taipei: Institute of Labor, Occupational Safety and Health, Ministry of Labor, the Executive Yuan, Taiwan; 2010. (in Chinese). [Google Scholar]
  • 27. Cheng TM. Taiwan's new national health insurance program: genesis and experience so far. Health Aff 2003; 22: 61–76. [DOI] [PubMed] [Google Scholar]
  • 28. Gershon RRM, DeJoy DM, Borwegen B, et al. Chapter 6: Health and Safety Culture, In U.S. National Institute for Occupational Safety and Health [NIOSH]. A NORA report: State of the sector / health care and social assistance. DHHS (NIOSH) Publication No. 2009‐139, 2009: 87–97. [Online]. 2009 [cited 2012 Jun 7]: Available from: URL: http://www.cdc.gov/niosh/docs/2009‐139/pdfs/2009‐139.pdf
  • 29. Geiger‐Brown J, Lipscomb J. The health care work environment and adverse health and safety consequences for nurses. Annu Rev Nurs Res 2010; 28: 191–231. [DOI] [PubMed] [Google Scholar]
  • 30. Hudson P. Applying the lessons of high risk industries to health care. Qual Saf Health Care 2003; 12 (Suppl 1): i7–12. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 31. Flin R, Burns C, Mearns K, Yule S, Robertson EM. Measuring safety climate in health care. Qual Saf Health Care 2006; 15: 109–15. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 32. Eliseo LJ, Murray KA, White LF, Dyer S, Mitchell PA, Fernandez WG. EMS providers' perceptions of safety climate and adherence to safe work practices. Prehosp Emerg Care 2012; 16: 53–8. [DOI] [PubMed] [Google Scholar]
  • 33. Smith DR, Muto T, Sairenchi T, et al. Hospital safety climate, psychosocial risk factors and needle‐stick injuries in Japan. Ind Health 2010; 48: 85–95. [DOI] [PubMed] [Google Scholar]
  • 34. Gershon RRM, Pearson JM, Sherman MF, Samar SM, Canton AN, Stone PW. The prevalence and risk factors for percutaneous injuries in registered nurses in the home health care sector. Am J Infect Control 2009; 37: 525–33. [DOI] [PubMed] [Google Scholar]
  • 35. McCaughey D, DelliFraine JL, McGhan G, Bruning NS. The negative effects of workplace injury and illness on workplace safety climate perceptions and health care worker outcomes. Safety Science 2013; 51: 138–47. [Google Scholar]
  • 36. Tyler IV, Hau M, Buxton JA, et al. Canadian medical students' perceptions of public health education in the undergraduate medical curriculum. Acad Med 2009; 84: 1307–12. [DOI] [PubMed] [Google Scholar]

Articles from Journal of Occupational Health are provided here courtesy of Oxford University Press

RESOURCES