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Despite many calls to reduce or eliminate the use of mechanical restraint, it is still widely used in many countries. Studies using patient interviews have a very clear message: Patients experience mechanical restraint as the most humiliating intervention. There seems to be a lack of alternatives for violent patients if all other approaches to prevent the use of coercion have failed. We developed a method using 30 kg bags, originally designed for fitness purposes, to be attached to a patient's wrist or ankle under 1:1 supervision. The method was tested with 10 experienced nurses and de-escalation trainers. A video was made and presented to six outpatients who had previously experienced mechanical restraint. All participants were interviewed. Transcribed interviews were analysed using qualitative content analysis. All participants approved of the method as a milder and less humiliating alternative to mechanical restraint. The nurses' main concerns were the risk of falls and the use of the bags as weapons. The latter could be controlled by using an additional bag. Patients were generally positive, especially if there was a history of abuse. The method should be further developed to replace at least some mechanical restraints. As with all 'milder means', care should be taken to really replace restraint and not to introduce additional coercion. [ABSTRACT FROM AUTHOR]

Aim: To explore and describe the daily experiences of non‐psychiatric nurses working in selected acute psychiatric wards in South Africa. Design: A qualitative explorative and descriptive study design was used. Methods: Individual face‐to‐face semi‐structured interviews were used to gather data from fifteen non‐psychiatric nurses with a minimum of one month of experience working in acute psychiatric wards in Limpopo Province, South Africa. Data were analysed using eight Tech techniques. The study is reported following consolidation criteria for reporting qualitative research. Results: Findings on non‐psychiatric nurses' daily experience revealed three themes: (1) Unsafe working environment, (2) Managing difficulties due to lack of skills and (3) Strategies to support non‐psychiatric nurses in acute psychiatric wards. Findings suggested institutional and managerial interventions in the form of orientation, in‐service training and workshops and resource provision. Future studies should be done to develop a model for supporting non‐psychiatric nurses in Limpopo Province, South Africa's acute psychiatric wards. [ABSTRACT FROM AUTHOR]

Aggression towards medical staff in the healthcare workplace is a common global concern. Measures to mitigate consequences of patient aggression include training through Aggression Management Programs (AMPs), which have been shown to increase students' self-efficacy and self-confidence. To encourage better engagement with a 30 h required AMP training, the study piloted an adapted photovoice activity with 58 students of medicine and nursing. Each student took one to three photos depicting their perceptions, feelings, and experiences of patient aggression in the workplace and discussed them in a course session. Their photos showed types of aggression in psychiatric settings, and their consequences for patients and students. Photo strategies included showing 'actors' or toy figures in aggressive encounters; tools to control aggression in psychiatric settings (e.g., mechanical restraints and syringes); and symbolic photos showing violence to the heart (emotional impact). Adding photovoice elements to the established AMP training appeared to contribute to student reflection on their individual perspectives on patient aggression in the workplace and help students to link their subjective experiences and theoretical learning. In future, incorporating pre-test and post-test questionnaires measuring empathy, attitudes, or critical thinking could help to decipher any changes in AMP effectiveness due to the use of a self-directed photovoice activity. [ABSTRACT FROM AUTHOR]

Background: As a primary form of work-related violence in the healthcare sector, patient mistreatment negatively impacts nurses' well-being. To date, there has yet reached a definitive conclusion on the mediating mechanism and boundary conditions behind the influence of patient mistreatment on nurses' emotional exhaustion. Methods: This study employed a convenience sampling method to recruit a sample of 1672 nurses from public hospitals in Western China. The data were collected through anonymous self-report questionnaires and analyzed using hierarchical regression and conditional processes to investigate a theoretical framework encompassing patient mistreatment, emotional exhaustion, social sharing of negative events, organizational support, and trait resilience. Results: Patient mistreatment led to emotional exhaustion among nurses (β = 0.625, p <.001), and social sharing of negative events mediated this positive relationship (effect = 0.073, SE = 0.013). The combined effects of organizational support and resilience moderated the mediating effect of the social sharing of negative events between patient mistreatment and emotional exhaustion (β=-0.051, p <.05). Specifically, nurses with a high level of resilience would benefit from organizational support to alleviate emotional exhaustion caused by patient mistreatment. Conclusions: This study validated a significant positive association between patient mistreatment and emotional exhaustion, which aligns with previous research findings. Integrating conservation of resources theory and goal progress theory, we addressed previous contradictory findings on the impact of social sharing of negative events on emotional exhaustion. Social sharing of negative events served as a mediator between patient mistreatment and emotional exhaustion. Additionally, the moderating effect of organizational support on the relationship between social sharing of negative events and emotional exhaustion depended on individual trait of resilience. [ABSTRACT FROM AUTHOR]

Mental health providers sometimes encounter patients who are exceptionally altruistic toward others and, at the same time, are willing to ignore their own needs and even significantly harm themselves to best achieve these ends for others. Traditionally, therapists have seen it to be their role to discern patients' negative symptoms, then seek to reduce them. This article reviews gains based on positive psychology that highlight the importance of therapists giving priority to supporting patients' strengths, particularly the sources of meaning they have in their lives. As is consistent with this view, it is suggested that therapists working with this group of self-harming, altruistic patients not only support their altruism, but particularly consider and remain cautious as to whether or not they should explore unconscious factors with the patient that might fuel their altruism. It is suggested that the discovery of such factors might be harmful because it could risk decreasing the degree to which these patients continue to show and personally value their altruism, thus potentially decreasing the meaning they derive from their altruism. [ABSTRACT FROM AUTHOR]

Episodes of direct violence against healthcare workers and social workers represent a worrying and widespread phenomenon in Western countries. These violent attacks, whether verbal or physical, occur in various work environments, targeting professionals working in private facilities, medical practices, or those employed within the National Health System facilities. We conducted a search using a single search engine (PubMed) using the terms "violence against healthcare workers AND Western" for the period 2003–2023, identifying 45 results to which we added to the literature through hand searching. Our review thus analyzed the sector literature to highlight the phenomenon of violence against healthcare workers, particularly in Western countries. We began with an analysis of the problem and then focused on the true purpose of the study, which is to propose new solutions to protect healthcare workers in all work settings. Consequently, we aim to improve both the working environment for healthcare professionals and to enhance the overall healthcare and public health outcomes. [ABSTRACT FROM AUTHOR]

Background: This study aimed to understand the experiences of nurses working in the integrated nursing care service, a relatively recent addition to the Korean hospital infrastructure, to suggest ways in which to address their grievances and needs and improve their job satisfaction, thereby reducing turnover. Methods: This study adopted a qualitative approach to explore subjects' vivid experiences. Data were collected through in-depth interviews with 17 nurses with over one year of experience working in integrated nursing care wards. The main question asked was "Can you describe your experiences in the integrated nursing care ward?" All interviews were recorded, transcribed, and analyzed using Colaizzi's method for phenomenological research. Results: Six theme clusters were derived from the analysis: "distorted perceptions of the integrated nursing care ward," "challenges owing to distorted perceptions of the integrated nursing care ward," "loneliness and fighting alone," "being ridiculed," "practicing textbook holistic care," and "the satisfaction felt only in the integrated nursing care ward." For the overarching theme, we identified "Satisfaction in providing holistic care despite the challenges." Conclusions: While working in the integrated nursing care ward, nurses practiced holistic nursing care, which in turn built their self-esteem. However, they experienced greater levels of stress as a result of misinformation. Therefore, dissemination of accurate information is necessary to correct public misunderstandings of the integrated nursing care wards. Further, adequate compensation and support systems are needed to relieve the stress nurses felt because of such misunderstandings. Additionally, nurses should be motivated to continue to provide quality care for the patients and take pride in their work. Future research should explore the physical and mental concerns of nurses working in integrated care wards. [ABSTRACT FROM AUTHOR]

A paucity of cognitive and affective features of empathy can be correlated with violent behavior. We aimed to identify differences in empathy among four groups in a sample of 100 male participants: (1) 27 violent offenders with schizophrenia, (2) 23 nonviolent patients with schizophrenia, (3) 25 patients with antisocial personality disorder, and (4) 25 subjects from the general population, who formed the control group. Schizophrenia symptoms were quantified with the Positive and Negative Syndrome Scale. Empathy was measured with the empathy quotient. Theory of mind was evaluated using (a) the first-order false-belief task, (b) the hinting task, (c) the faux pas recognition test and (d) the "reading the mind in the eyes" test (revised). Differences noted among the groups were age (controls were younger) and educational status (antisocials were less educated). The empathy quotient scoring (p < 0.001) and theory-of-mind tests (p < 0.001) were distinct between the control group and the three other groups of participants, but not among the three patient groups. Patients with antisocial personality disorder, violent psychotic offenders and psychotic nonviolent patients show no remarkable differences in affective or cognitive empathy tests, but they all present deficits in empathy and theory of mind when compared to controls. [ABSTRACT FROM AUTHOR]

Background: Over the previous decades, violence against physicians has risen. To comprehend the issue connected with it, we need to know the nature of violence and doctor's views on the current state of safety at their disposal. The purpose of the study was to assess the incidence and nature of violence against doctors in tertiary health care centers in Karnataka, India. Objectives: The objectives were to collect data from three tertiary care centers, evaluate the incidence of violence against doctors in tertiary care centers, and evaluate the nature of violence against doctors in tertiary care centers. Methods: From the list of all tertiary care centers in Dakshina Kannada, three tertiary care hospitals were randomly chosen. Approval of the Ethical Committee from the Institutional Ethics Committee (IEC) of KVG Dental College and permission from chosen hospitals were obtained. A pre-validated questionnaire was handed over to the available physicians and surgeons in these hospitals to be filled. The total number of participants in the study was 330. Results: Nearly half (48.02% of physicians) reported experiencing violence during working hours. The Department of Obstetrics and Gynaecology recorded 43.2% of instances, while surgery, medicine, and other departments reported 23.6%, 22.8%, and 10.4%, respectively. Conclusions: Violence against physicians continues to be a huge issue that must be addressed through decisive measures by the police and hospitals. This impacts the healthcare system in the nation and often cripples it owing to the loss of human resources and working hours. [ABSTRACT FROM AUTHOR]

This study examines how the once prestigious medical profession in China has become the subject of criticism and accused of pervasive impropriety to the point of inducing widespread violence from patients. Drawing on archival documents, media articles, interviews, and secondary sources, we trace the lengthy and uneven trajectory by which the profession moved away from enjoying widespread collective approval toward ambivalence and eventual stigmatization. We develop a process model of professional stigmatization that identifies the dynamics that precipitate and then catalyze that trajectory and highlight the underpinning mechanisms. By unpacking the complex process of stigmatization, the study extends existing understanding of how aspects of stigma emerge and are attached by different stakeholders to a profession and the consequences that follow. We conclude by highlighting the implications for research on stigma and the challenge of stigma containment. [ABSTRACT FROM AUTHOR]

Aim. The purpose of this study was to examine the association among doctor-patient communication, trust, and patients' negative stereotypes for healthcare professionals during COVID-19. Background. Patients' negative stereotypes for healthcare professionals have been considered a major cause of violence against healthcare professionals. During COVID-19, since the fear for illness could exacerbate patients' negative stereotypes for healthcare professionals, therefore, how to inhibit patients' negative stereotypes for healthcare professionals has become a top priority. Methods. From January 2020 to April 2020, a cross-sectional survey study was performed in which a total of 2000 patients were convenience-sampled from different regions of China. The survey measured doctor-patient communication, institutional trust, interpersonal trust, and patients' negative stereotypes for healthcare professionals, respectively. After standardizing the total data scores, the association between doctor-patient communication, trust and patients' negative stereotypes for healthcare professionals using the bootstrap method was built. Results. There was a moderate to the high correlation between doctor-patient communication, patients' negative stereotypes for healthcare professionals, interpersonal trust, and institution trust (r = 0.36–0.68, p < 0.01). Mediation analysis showed that patients' interpersonal trust (β = −0.25, 95% CI: −0.312–−0.209) than patients' institution trust (β = −0.02, 95% CI: −0.042–−0.007) played a greater role in suppressing negative stereotypes through doctor-patient communication. Conclusions. Through communication, healthcare professionals and patients increase their familiarity and identification, thereby reducing patients' negative stereotypes. Moreover, because interpersonal trust connotes emotional and cognitive trust, it was more beneficial than institution trust in reducing negative stereotypes. Implications for Nursing Management. The results of this study can tell governments, healthcare organizations, communities, and healthcare professionals that reducing violent behaviors based on negative stereotypes requires attention to institutional trust building, interpersonal trust development, and communication improvement. [ABSTRACT FROM AUTHOR]

Background: Fangcang shelter hospitals have played an important role in the battle against the COVID-19 epidemic in China. Patients' verbal and physical attacks on medical workforce are prone to occur in such hospitals. This study explored the impacts of patient mistreatment on healthcare workers' role behaviors (service performance and patient-oriented organizational citizenship behavior). Methods: We examined the influence of patient mistreatment on service performance and patient-oriented organizational citizenship behavior, as well as the mediating effect of emotional exhaustion and the moderating effect of displaced aggression by patients, using hierarchical linear regression and conditional process analysis. Results: Patient mistreatment was positively associated with emotional exhaustion among healthcare workers, while emotional exhaustion was negatively associated with service performance and patient-oriented organizational citizenship behavior. Mediation analysis revealed that emotional exhaustion mediated the association between patient mistreatment and both types of role behaviors. Moderated mediation analysis found that the mediation effect was weaker when the displaced aggression by patients was high. Conclusions: The findings clarified the relationship among patient mistreatment, emotional exhaustion, service performance, and patient-oriented organizational citizenship behavior. Additional assistance should be provided to healthcare workers dealing with patient mistreatment. Displaced aggression by patients attenuates the positive effects of patient mistreatment on the emotional exhaustion of healthcare workers. Our findings reveal the mechanism and boundary conditions of patient mistreatment affecting healthcare workers' service performance and patient-oriented organizational citizenship behavior. [ABSTRACT FROM AUTHOR]

Background: The COVID-19 pandemic and virility of the violence against medical personnel have been parallel phenomena in Indian public health administration. The safety and security medical and paramedical have been attracting attention for quite a long time. Still, no central legislation has piloted to enhance their therapeutic and surgical acumen in epidemics and pandemics. The health care of the patients and the covenant of Medicare service persons and institutions doctors missed in the myopic perception of the health administration's tilt towards the criminal administration of justice. Method: The clasping of 125 years of age epidemic control law and 162 years of age criminal statute stinks the Indian feel in the present context. Result: The significant outcome of the COVID-19 pandemic is showcased in the Epidemic Diseases (Amendment) Ordinance, 2020, ensuring harassment-free workplaces for the medical fraternity. The criminal sanction afforded by the 23 state enactments on the protection of medical care personnel and institutions in states in India, but there is no central legislation. Despite the Indian Medical Association's recommendation for the Protection of Medical Service Persons and Medical Service Institutions (Prevention of Violence and Damage or Loss of Property) Act, 2017, we witnessed Epidemic Diseases (Amendment) Ordinance, 2020 in enhancing the robust workplace for the doctors during the pandemic. The legal strategy camouflaging 'disaster' under Section 2 (d) of the Disaster Management Act, 2005 in pandemic and lockdown is sobering but astonishing. Conclusion: The paper locates the legal response to violence against the doctors in the sociology of medicine and medical professions as professional socialization and social system during the COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

Background: Workplace violence (WPV) is a significant problem in both developed and developing countries, especially among healthcare workers. It has widespread implications for their overall health and well-being. Objective: The study was conducted to assess the problem of violence among doctors and other healthcare workers in healthcare settings. Material and Methods: A cross-sectional survey was conducted using a validated questionnaire from August 21 to September 18, 2021, based on purposive and snowball-sampling techniques for data collection. Appropriate statistical methods were applied to study the association between sociodemographics and characteristics of violence. Results: A total of 601 responses were analyzed. The results showed that approximately 75% of the participants experienced violence in some form at their workplace. These episodes lead to a significant impact on the physical and mental health of these workers. Around one-third of the participants felt uncomfortable reporting these incidents. Some of the most common risk factors and mitigation strategies were also reported by the participants.Conclusion: The findings of this study can be used by the legislators, administrators, and policymakers to develop strategies that can help in mitigating these episodes of violence for the better functioning of the healthcare system. [ABSTRACT FROM AUTHOR]

Objectives: This study sought to learn more about psychiatric nurses’ experiences working in Iraq because it has been reported that the field of mental health nursing is challenging and has low job satisfaction. Methods: This research is a qualitative study and draws on lived experience conducted on 24 nurses working at Al-Rashad a special hospital in Baghdad that included psychiatric wards selected via purposeful sampling in, 2021-2022. Data were gathered using smartphonerecorded interviews. The seven steps of Colaizzi’s data analysis were used by Husserlian phenomenology. To aid in the bracketing and reflection process, each nurse’s interview was verbatim recorded, along with their thoughts, feelings, and past experiences in this hospital. Results: Three themes were identified as the root reasons for participants’ dissatisfaction (DSS) with their jobs in mental hospitals; insufficient training for providing psychiatric treatment, a negative reputation for psychiatric nurses in the public, and concerns of nurses. These findings were collected during the interview sessions, and notes and ideas were classified and assorted. Analysis of the qualitative data provided insights into the barriers to psychiatric nurses’ satisfaction. Discussion: The present research contributes to the experiences of clinical nurses concerning clinical intervention and care processes in Iraqi psychiatric hospitals. Confrontation of mental patients by nurses in the work environment remains crucial. The findings emphasize the importance of listening to psychiatric nurses and considering how the name of the hospital and patient type and contexts affect nursing satisfaction. Understanding the challenges in the nursing workplace has increased the quality of care providers and satisfaction in the nursing and psychiatric field. [ABSTRACT FROM AUTHOR]

Background: A report reveals that patient and family dissatisfaction with the services of health staff is often expressed through violence. This dissatisfaction arises due to the behavior of staff who are less competent and less concerned about the patient's situation. However, until now, information about the caring behavior of nurses in Indonesia is still inadequate. It can hinder efforts to improve care services for Indonesia's most prominent health profession. Objective: This review aims to find prevalence of the poor caring behavior among Indonesian nurses who work in hospitals. Methods: The study design was systematic review and meta-analysis. Study selection, critical appraisal of the study, data extraction, and data synthesis were carried out according to the JBI methodology for systematic review of prevalence. Searches were made through the PubMed, ScienceDirect, ProQuest, and Garda Reference Digital (Garuda) databases to identify published or not published studies in English and Indonesian from inception to August 23, 2021. The keywords used to search for literature consist of caring behavior, nurse, hospital, and Indonesia. Results: Ten studies from nine provinces in Indonesia were included in this review. All studies were cross-sectional. The review results showed that the prevalence of poor caring behavior among Indonesian nurses ranged from 12% to 71%, with a pooled prevalence of 40% (CI: 28% to 53%). Conclusion: The prevalence of poor caring behavior among Indonesian nurses is high. It is suggested to the nursing care provider to improve their nurses' caring behavior to prevent the emergence of violence against nurses or other staff in the workplace. [ABSTRACT FROM AUTHOR]

Background: Patient and visitor perpetrated workplace violence (WPV) is a problem within healthcare and is known to be underreported by nurses and other healthcare workers. However, there are multiple and diverse reasons identified in the literature as to why nurses do not report. This systematic review aimed to investigate nurses' reasons and rationale related to underreporting of violence that occurs in the workplace. Methods: Following PRISMA guidelines for systematic review reporting, studies conducted between 2011 and early 2022 were identified from MEDLINE, CINAHL, APA PsychInfo, and Psychological and Behavioral Sciences Collection via EBSCOHost. Quantitative studies related to patient and visitor perpetrated violence containing explanations, reasons, or rationale related to underreporting were included. Results: After quality appraisals, 19 studies representing 16 countries were included. The resulting categories identified nursing, management, and organizational factors. The most prominent nursing factors included nurses' fear of consequences after reporting, nurses' perceptions, and their lack of knowledge about the reporting process. Common management factors which contributed to nursing underreporting included lack of visible changes after reporting, non-supportive culture in which to report, and the lack of penalties for perpetrators. Organizational factors included the lack of policies/procedures/training for WPV, as well as a lack of an efficient and user-friendly reporting system. Supportive interventions from management, organizations, and community sources were summarized to provide insight to improve nurse reporting of WPV events. Conclusion: Underreporting of WPV is a complex and multi-faceted problem. An investigation into the rationale for underreporting a workplace violent event illustrates nurses, management, and organizations contribute to the problem. Clear and actionable interventions such as educational support for staff and the development of a clear and concise reporting processes are recommended to encourage staff reporting and to help address WPV in healthcare. [ABSTRACT FROM AUTHOR]

Introduction. Safety is an essential factor in patient recovery, occupational well-being, and a well-functioning care environment. To identify and understand potential safety risks, information from safety incidents is needed. Aim. To describe safety incidents that occurred on psychiatric inpatient wards. Method. A retrospective register study. The data were collected from a web-based incident reporting database (HaiPro) from six Finnish psychiatric inpatient wards. The incident reports (N = 76) were analysed with descriptive statistics and inductive content analyses. Results. The incidents were verbally or physically aggressive situations, rule violations, or challenges in the ward's basic activities. The incidents resulted in consequences for patients, personnel, and the wards with varying severity. Some of the incidents could have possibly been prevented with simple, practical measures, such as sharing information, being prepared for safety practices, and having comprehensively planned care. Discussion. Safety incidents cause fear and challenges and could partly be prevented with multiprofessional and multilevel cooperation. Implications for Practice. Preventative actions include multidisciplinary and ward-specific education for safety practices, ensuring resources and not having too many patients on the ward. Multiprofessional communication and mutual understanding, including patient participation, are central. Wards should be designed or renovated so that safe environments can be guaranteed. [ABSTRACT FROM AUTHOR]

Background: Workplace violence is a global threat to healthcare professionals' occupational health and safety and the situation has worsened during the COVID-19 pandemic. This study aimed to explore workplace violence directed against assistant and registered nurses working on surgical wards in Sweden. Methods: This cross-sectional study was conducted in April 2022. Using a convenience sampling procedure, 198 assistant and registered nurses responded to an online questionnaire developed for this specific study. The questionnaire comprised 52 items and included, among other items, subscales from validated and previously used instruments. Data analysis included descriptive statistics, the chi-square test, and independent-samples t-test. Results: The most frequently reported type of workplace violence was humiliation (28.8%), followed by physical violence (24.2%), threats (17.7%), and unwanted sexual attention (12.1%). Patients and patients' visitors were reported as the main perpetrators of all kinds of exposure. Additionally, one third of the respondents had experienced humiliation from colleagues. Both threats and humiliation showed negative associations with work motivation and health (p < 0.05). Respondents classified as working in a high- or moderate-risk environment were more frequently exposed to threats (p = 0.025) and humiliation (p = 0.003). Meanwhile, half of the respondents were unaware of any action plans or training regarding workplace violence. However, of those who indicated that they had been exposed to workplace violence, the majority had received quite a lot or a lot of support, mainly from colleagues (range 70.8-80.8%). Conclusion: Despite a high prevalence of workplace violence, and especially of humiliating acts, there appeared to be low preparedness within the hospital organizations to prevent and/or handle such incidents. To improve these conditions, hospital organizations should place more emphasis on preventive measures as part of their systematic work environment management. To help inform such initiatives, it is suggested that future research should focus on the identification of suitable measures regarding different types of incidents, perpetrators, and settings. [ABSTRACT FROM AUTHOR]

Background: Nurses experience an alarming rate of violence in the workplace. While previous work has indicated that working conditions play an important role in workplace violence outcomes, these studies have not used comprehensive and systematically operationalized variables. Methods: Through cross-sectional survey responses from 4066 British Columbian nurses, we identified which of the 13 psychosocial factors, as outlined in the National Standard of Psychological Workplace Health and Safety, are most predictive of workplace violence perpetrated against nurses by patients and their visitors (Type II violence) and organizational employees (Type III violence). Results: Eighty-seven percent of respondents indicated that they had experienced Type II violence, whereas 48% indicated they had experienced Type III violence over the last year. Lack of physical safety, workload management, and psychological protection were the top three psychosocial factors in the workplace predictive of Type II violence, whereas lack of civility and respect, organizational culture, and psychological support were the top three factors associated with Type III violence. Conclusions: The findings in this study shed light on the distinct psychosocial factors in the workplace in need of investment and intervention to address Type II and III violence. [ABSTRACT FROM AUTHOR]

To prevent discontinuity of long-term care service and guarantee the quality of care, it is important to clarify the determinants of turnover intentions of long-term care workers. They are at a higher risk of experiencing violence—including physical, emotional, and sexual—from patients or their families, possibly leading to high turnover intention. This study aims to verify how having experienced client violence affect turnover intention of long-term care workers and to suggest implications to prevent frequent turnover in long-term care field. Logistic regression analysis was conducted between groups who have experienced client violence and who have not, using 2019 Korean LTC Survey data. Results revealed that, first, there were differences in determinants of turnover intention depending on groups. Second, having experienced client violence had a different effect on turnover intention based on personal characteristics. Third, gender and occupational differences were found. Based on our results, we highlighted the need for discussions on interventions to address client violence exposure among long-term care workers. [ABSTRACT FROM AUTHOR]

Purpose. To analyse the concept of patient violence towards mental health nurses. Design and Methods. A hybrid model was adopted with literature review of 103 studies and interviews with seven mental health nurses. Findings. Patient violence was defined as a violent incident committed by patients towards nurses vulnerable to physical, verbal, emotional, and sexual violence. It was a common and frequent phenomenon with multifactorial causes and is prone to be unreported. Practice Implications. Our study findings function as the conceptual framework to measure patient violence in relevant research and allow policy development to protect mental health nurses at the practice. [ABSTRACT FROM AUTHOR]

Objective: to create educational technology in the form of a booklet aimed at women on pregnant women's rights during labor and situations that characterize Obstetric Violence. Method: a methodological and qualitative research study; semi-structured interviews were conducted with 14 nurses from the Obstetric Nursing Residency program of the Federal University of Pará. Content analysis was used to identify meaning, followed by textual elaboration, selection of illustrations and finalization of the booklet. Results: Obstetric Violence is characterized as physical, psychological, negligence, and discrimination, and can take place during prenatal care, delivery, puerperium and miscarriage. Information as a foundation for women's knowledge through the booklet can effectively contribute to their empowerment and leading role. Final considerations: the process of building the booklet, developed in a participatory and dialogical way, was enriching and provided the opportunity to disseminate information with a scientific basis for action with the target population. [ABSTRACT FROM AUTHOR]

Copyright of Texto & Contexto Enfermagem is the property of Universidade Federal de Santa Catarina, Programa de Pos-Graduacao de Enfermagem and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The 10th Biennial Conference of the European Association for the History of Medicine and Health, titled "Crisis in Health and Medicine," was held at the University of Oslo from August 30 to September 2, 2023. The conference focused on various crises, including the COVID-19 pandemic, climate change, war, economic and political crises, refugees and displacement, environmental crises, personal crises, and crisis in relations. Invited speakers discussed topics such as the archive of an Arctic healer, medical waste pollution, the history of disasters, and the relationship between the history of medicine and environmental humanities. The conference also featured the awarding of prizes for the best monograph on the history of medicine and the best scientific article in the field. The role of medical historians in contextualizing crisis situations and providing quality information was emphasized. [Extracted from the article]

This study aimed to illuminate the essential meanings of carers' lived experience of regulating themselves when caring for patients with mental illnesses in forensic inpatient care. Qualitative analysis was used to analyse data from narrative interviews with open-ended questions conducted with nine carers, which were analysed using a phenomenological-hermeneutic approach. Findings revealed three themes, "preserving oneself as a carer," "building an alliance with the patient" and "maintaining stability in the community." Carers not only regulated emotions related to patients but also the ward to facilitate a caring climate. For carers, encounters with patients meant facing expressions of suffering that evoked unwanted emotions. Regulating one's emotions also meant being emotionally touched and facing one's vulnerability. Regulating oneself was a strategy used by carers to get closer to the patient and establishing a trusting relationship. Regulating oneself meant becoming aware of one's shortcomings, not projecting them onto others, which may impair establishing relationships with patients and fulfilling the aim and caring task of forensic psychiatry. This study stresses the importance of carers being guided to manage their conflicting emotions and vulnerabilities and finding courage and an approach that allows a permissive climate of self-reflection. [ABSTRACT FROM AUTHOR]

Patient aggression and violence comprise a wide range of behaviors and actions that may include verbal aggression and physical aggression. The aim of this study is to report dental students' experience with, impact from, and response to patient aggression in Saudi Arabia. A cross-sectional analytical study was conducted among dental students from various health universities representing each region of Saudi Arabia. Data were collected using a self-administered, structured and validated questionnaire. A total of 375 participants responded to the questionnaire and 121 (32.3%) study participants reported experiencing patient aggression. Out of those, 91 (75.21%) experienced patients displaying anger or raising their voice toward them, 37 (30.58%) reported being insulted by a patient, 22 (18.18%) reported being threatened, 12 (6.2%) had experienced sexual harassment, and 65 (50.41%) had experienced verbal harassment. Furthermore, 91 (75.21%) participants reported being abandoned by patients because they were students. A total of 55 (45.45%) participants stated that aggressive patient behavior had an impact on their clinical performance, and 44 (36.36%) considered themselves stressed out. A total of 24 (19.83%) participants took time off due to incidents and 22 (18.18%) thought about quitting dentistry. Prevalence of patient aggression was significant among dental students in Saudi Arabia. These episodes of patient aggression negatively impacted students' academic performance and wellbeing, necessitating urgent attention. Educational institutions should conduct periodic workshops for students in order to address these issues. Policymakers should develop better policies in order to reduce violence and aggression against health care providers. [ABSTRACT FROM AUTHOR]

Introduction/Objectives: Workplace violence against healthcare workers has been a global problem including Thailand. However, the study has been limited partly due to lack of the standardized tool in Thai context. Therefore, this study aims to translate "Workplace Violence in the Health Sector Country Case Studies Research instruments," conducted by WHO, and to validate Thai version questionnaire. Methods: The study was conducted to translate Workplace Violence in the Health Sector Questionnaire by WHO from English to Thai. A sample of 92 participants was accidentally selected among physicians, nurses, and health-supporting workers who took part on examined the validity and reliability of the questionnaire. The internal consistency was calculated using Cronbach's Alpha Coefficient. Results: The study demonstrated that the index of item-objective congruence (IOC) of Thai version questionnaire is 0.75 to 1. Cronbach's Alpha Coefficient in Physical violence is.879, Verbal abuse is.934, Bullying/mobbing is.510, and health sector employer is.842. Conclusion: The Thai Version of Workplace Violence in the Health Sector Questionnaire apparently shows good validity and reliability. The questionnaire could be applied to be a useful tool for studying workplace violence in the health sector. [ABSTRACT FROM AUTHOR]

Copyright of Anaesthesiologie & Intensivmedizin is the property of DGAI e.V. - Deutsche Gesellschaft fur Anasthesiologie und Intensivmedizin e.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Turkish Journal of Trauma & Emergency Surgery / Ulusal Travma ve Acil Cerrahi Dergisi is the property of KARE Publishing and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Workplace violence (WPV) has been recognized as a major occupational hazard worldwide. Healthcare professions are particularly at a higher risk of WPV. Patients and their relatives are commonly the most common perpetrators for WPV against physicians. Trainings on the universal precautions of violence, how to effectively anticipate, recognize and manage potentially violent situation is recommended by OSHA as a part of a written, effective, comprehensive, and interactive WPV prevention program. Objective: To implement and evaluate the effectiveness of a training session delivered to nurses. The training session aimed to increase nurses' ability to identify potentially violent situations and to effectively manage these situations in a teaching hospital in Egypt. Methodology: A total of 99 nurses attended the training sessions. Confidence in coping with aggressive patient scale, along with nurses' attitudes toward WPV, were used to assess the effectiveness of the training sessions. Results: Nurses' perceived confidence to deal with aggression increased after attending the training sessions. Nurses' attitudes toward WPV positively changed after attending the training session. Conclusion and recommendations: Increasing awareness of the problem among healthcare professions as well as the public is warranted. Violence prevention program with a zero-tolerance policy is warranted. [ABSTRACT FROM AUTHOR]

Introduction: Workplace violence has emerged as a global phenomenon requiring immediate attention. The nursing profession is primarily affected, and the unique vulnerability of nurses to workplace violence is particularly evident in the field of mental health nursing. Aims: This study explores the experiences of mental health nurses with work-related violence and attempts to combat this violence in the context of inpatient mental health facilities in Saudi Arabia. Methods: This research comprises a qualitative exploratory study consisting of semistructured interviews with 16 participants using open-ended questions. The participants are psychiatric/mental health nurses with experience in the field, so this methodological approach facilitates a detailed investigation of their encounters with workplace violence. Results: This study reveals that nurses experience violence in accordance with two main themes and subthemes: experiences of workplace violence, the influence of violence on work settings, and efforts required to combat violence. Data show that these participants consider of prime importance access to training to increase safety through knowledge, improved communication, and protective skills, along with adequate staffing and a safe built environment. Conclusion: The research findings confirm the urgency of addressing the needs of mental health nurses in inpatient psychiatric hospitals. Policymakers in the healthcare field must be aware of the inpatient psychiatric care climate and the need for support from those who staff these areas of practice. Training in specialized knowledge and skills is required to ensure a safe work environment as well as appropriate staffing levels, and a safe built environment. These conditions may be required to recruit and retain mental health nurses capable of providing best-practice care. [ABSTRACT FROM AUTHOR]

Background: Individuals diagnosed with schizophrenia or bipolar affective disorder (BAD) are not always violent or make violent responses. However, psychiatric disorders such as schizophrenia and BAD are associated with violent acts of patients in various forms such as physical, verbal, and emotional violence. The victims to these violent acts by individuals suffering from schizophrenia or BAD are the caregivers most of the times. In addition, the treating team experiences violence by psychiatric patients during their stay in the hospital, especially in the initial days of hospitalization. Materials and Methods: This study was a cross-sectional, descriptive research. A total of 104 caregivers were selected for the study as per the inclusion and exclusion criteria. Sociodemographic and clinical details were collected through semi-structured interview schedule. Data were collected including sociodemographic details, Family Violence Scale, Family Burden Interview Schedule, and Depression Anxiety and Stress Scale. Results: The study states that caregivers of individuals diagnosed with schizophrenia or BAD experience overall burden. The experience is associated with being a victim of violence made by the relative suffering with psychiatric disorder. In addition, the events of violence create adverse impact on the psychological well-being of the caregivers, causing stress, anxiety, and depression. Conclusion: The study clearly indicates the need to attend the psychological needs of the caregivers of individuals suffering from schizophrenia or BAD. [ABSTRACT FROM AUTHOR]

Background. Workplace violence (WPV) is a major healthcare problem with important consequences in healthcare areas and may impact negatively not only healthcare workers but also the quality and safety of patient care. Objectives: This an observational online web-based survey using Google® Modules, specifically aiming to investigate the phenomenon of WPV in Italian healthcare services. Methods. Data collection for this study lasted one month, with the questionnaire available from 1 May 2021 to 31 May 2021. Continuous variables were considered as either mean ± standard deviation (SD) or median and interquartile range (IQR) based on their distribution. Comparison between groups was assessed by unpaired t-test or Mann-Whitney U test according to variable distribution. Categorical variables were analyzed using the chi-squared test. Results. The study population consisted of 203 healthcare workers, represented by nurses (61.6%), medical doctors (16.8%), patient care assistants (4.9%), and others (16.7%). Female gender was associated with a 2.6 times higher risk for the presence of aggression (p = 0.034), and nurse as a job with about 4 times increased risk for the presence of aggression (p = 0.006). The risk for aggression increased by 5% for each year of work experience. Conclusions. WPV is still matter of concern in Italian healthcare services. A strong organizational effort is demanded from healthcare institutions in order prevent internal and external violence in healthcare settings. [ABSTRACT FROM AUTHOR]

Background. Workplace violence is a common issue worldwide that strikes all professions, and healthcare is one of the most susceptible ones. Verbal and nonverbal miscommunications between healthcare workers and patients are major inducers for violent attacks. Aim. To study the potential impact of verbal and nonverbal miscommunications between the patients and healthcare workers upon workplace violence from the patients' perspectives. Methods. A descriptive cross-sectional study was performed from November to December 2020. Patients and previously hospitalized patients were asked to complete a self-reported questionnaire that involved items of verbal and nonverbal miscommunication. With the use of a suitable available sample composed of 550 participants, 505 had completed the questionnaire and were included in the study. The data were analyzed by using SPSS version 22 software. Results. 7.2% of the study population reported participating in nonverbal violence and 19.6% participated in verbal violence against healthcare workers. The nonverbal and verbal violence was characteristically displayed by the patients who are male, younger than 30 years old, and bachelor's degree holders. The results of the study demonstrated that the verbal and nonverbal miscommunications between the patients and healthcare workers were the major factors in provoking violent responses from patients. Factors, such as age, gender, and level of education, were significant indicators of the type of patients who were more likely to respond with violence. Conclusion. Workplace violence, either verbal or nonverbal, in the health sector is a public health concern in Palestine. The verbal and nonverbal communication skills of healthcare workers should be developed well enough to overcome the effect of miscommunication provoking violent acts from patients and their relatives as well. [ABSTRACT FROM AUTHOR]

Aim: This study aimed to investigate the frequency of documented aggression, on the part of cognitively impaired individuals, against health professionals in home care services and to highlight related factors. Design: A retrospective cross‐sectional study was conducted using data obtained from the nursing documentation of six home care service organizations in Switzerland. Methods: We analysed the nursing documentation of 1,186 clients in six home care services, between July 2019–September 2019, using the Cohen‐Mansfield Agitation Inventory. We conducted a factor analysis as well as a descriptive data analysis and logistic regression using IBM SPSS Statistics. Results: A factor analysis revealed in five factors, of which three represented aggressive behaviour in the sample. These factors were physically aggressive behaviour, verbally aggressive behaviour and importunate behaviour. Aggressive incidents, documented in the nursing records of 14.7% of clients in our sample, tended to be associated with cognitive, communication and mobility difficulties. Impact statement: This retrospective cross‐sectional survey gives an overview of the frequency and forms of documented aggressive behaviour on the part of persons with cognitive impairments towards health professionals in home care services.One of the motivating factors for this study was the awareness that aggressive behaviour on the part of clients may stress health professionals in various ways which in turn may have an impact on the quality of care provided.The study revealed that healthcare specialists, rather than more qualified general or psychiatric nurses, were routinely assigned to assisting such clients and therefore specific educational and training interventions for these specific group of staff are indicated. [ABSTRACT FROM AUTHOR]

Background: Violence against healthcare personnel is a major public health problem. Healthcare personnel are at the frontline dealing with people in stressful and unpredictable situations. Therefore, this study was conducted to determine the prevalence and associated factors of violence against health care personnel.Methods: A cross sectional study was conducted in the district Peshawar. Healthcare personnel from public and private sectors working in both the primary and tertiary levels of healthcare were invited to participate. Violence was assessed through a structured questionnaire previously used in Pakistan and was defined as experiencing and/or witnessing any form of violence in the last 12 months. Mental health was assessed through the General Health Questionnaire. Logistic regression was used to estimate the association of violence against healthcare personnel with psychological distress and demographic characteristics. Data entry and analysis were conducted in STATA 14.Results: A total of 842 healthcare personnel participated in the study. The prevalence of violence experienced and/or witnessed by healthcare personnel in Peshawar was 51%. Verbal violence remained the predominant form of violence and almost half of the healthcare personnel (45%) were exposed to it. A quarter of the respondents (24%) reported physical violence alone or in combination with other forms of violence. In almost two third of the incidents the perpetrators were either attendants, relatives or the patients. The emergency unit and wards within healthcare facilities were the most common places where violent events took place. The major factors responsible for the violent incidents were communication failure, unreasonable expectations and perceived substandard care. No uniform policy/procedure existed to manage the incidents and the healthcare personnel adopted different responses in the wake of violent events targeting health care. Working in public healthcare facilities and having a larger number of co-workers/colleagues significantly increased the risk of violence in the healthcare settings while being a paramedic significantly reduced the risk as compared to physicians.Conclusions: Violence against healthcare personnel is a serious public health issue and the prevalence is quite high. A holistic effort is needed by all stakeholders including healthcare community, the administration, lawmakers, law enforcement, civil society, and international organizations. [ABSTRACT FROM AUTHOR]

World Health Organisation defined workplace violence as incidents where employees are abused, threatened, assaulted or subjected to other offensive behaviour in circumstances related to their work. According to an ongoing study by the Indian Medical Association, over 75% of doctors have faced violence at work, majority of the cases were reported from emergency wards and Intensive Care Units. In the last decade, Governments of 19 states in India have passed laws for the protection of physicians. However, the law is not being effectively implemented either due to lack of awareness or resistance from administration. A questionnaire based study was conducted on MBBS students to assess their level of awareness about violence on doctors and protection laws. The knowledge among the students about these laws was very low, which could be improved if the topic "Violence on Doctors" is included in the new competency based curriculum, separately in Forensic Medicine subject. [ABSTRACT FROM AUTHOR]

Background: Sexual harassment is complex and has occupational hazards in nursing. Nurses experienced it than other employees. Female nurses are with the highest rate in the profession. Our aim was to determine the prevalence of sexual harassment against female nurses, the types, perpetrators, and health consequences of the harassment. Method: We undertook a systematic review to synthesize quantitative research studies found in Pubmed, Scopus, ProQuest, Web of Science and Google Scholar databases. The studies included were observational, on sexual harassment against female nurse, full text, and published in peer-reviewed English journals up to August 2018. Two independent reviewers searched the articles and extracted data from the articles. The quality of the articles was evaluated using the Modified Newcastle Ottawa Scale for Cross-Sectional Studies Quality Assessment Tool. A descriptive analysis was done to determine the rate of items from the percentages or proportions of the studies. Result: The prevalence of sexual harassment against female nurses was 43.15%. It ranged 10 to 87.30%. The 35% of the female nurses were verbally, 32.6% non-verbally, 31% physically and 40.8% were being harassed psychologically. The 46.59% of them were harassed by patients, 41.10% by physicians, 27.74% by patients' family, 20% by nurses and 17.8% were by other coworker perpetrators. The 44.6% of them were developed mental problems, 30.19% physical health problems, 61.26% emotional, 51.79% had psychological disturbance and 16.02% with social health problems. Conclusion: The prevalence of sexual harassment against female nurses is high. Female nurses are being sexually harassed by patients, patient families, physicians, nurses, and other coworkers. The harassment is affecting mental, physical, emotional, social and psychological health of female nurses. It is recommended policymakers to develop guidelines on work ethics, legality and counseling programs. Nursing associations to initiate development of workplace safety policy. A safe and secure working environment is needed in the nursing practice and nursing curriculum in prevention strategy. Research is needed on factors associated with sexual harassment. Since only female nurses were the participants, it could not be representative of all nurses. There was no fund of this review. [ABSTRACT FROM AUTHOR]

Aim: To identify the incidence of workplace violence against nurses in the Czech Republic and Slovakia, its sources, ways of dealing with violence against nurses, the intensity of nurse's psychological problems as a result of their experience of workplace violence. Design: A cross-sectional study. Methods: Workplace Violence in the Health Sector Country Case Study - Questionnaire was used. The sample consisted of 526 nurses from selected healthcare settings in the Czech Republic and Slovakia. Data was collected from June to November 2016. Results: Verbal as well physical violence against nurses is a frequent phenomenon in nurses' workplace in the Czech Republic and Slovakia. We identified statistically significant difference in verbal aggression from patients and higher intensity of nurse's psychological problems as a result of patients' aggression. In both countries, we have found an incomplete problem solution by the management of healthcare facilities. Conclusion: Verbal as well physical violence against nurses is a frequent phenomenon in the workplace of Czech and Slovak nurses. The management of healthcare facilities must establish appropriate procedures to reduce the occurrence of this phenomenon. [ABSTRACT FROM AUTHOR]

Background: Child and adolescent mental health has scarcely been studied in developing countries, though it is an important aspect of health. Mental health problems in youth often continue into adulthood if not diagnosed or treated in time. Methods: The Sistema de Evaluación de Niños y Adolescentes (SENA) [Child and Adolescent Evaluation System] was used to evaluate mental health indicators in a sample of students in Northern Chile. Two age-appropriate versions of the assessment were applied to a total sample of 5043 students, which included an elementary education sample of 1953 schoolchildren from fourth grade through sixth grade (ages 8 to 13 years), and a Secondary School sample of 3090 schoolchildren from seventh grade (the last year of elementary school) through the last year of Secondary school (senior high school) (ages 12 to 19 years). For each group, the version of the assessment used was determined by the students' grade level. Both samples included municipal, government-subsidized, and private schools. Results: In this student population, depression, anxiety, and behavioral disorders were the main mental health problems identified, and indicators revealed a progressive increase in cases over the years, coinciding with the global epidemiological scenario. Males showed a greater presence of externalizing behaviors related to mental health problems associated with aggression and defiant behavior. However, females showed the highest number of mental health issues overall, especially regarding problems related to internalization. There are significant differences between school types. Conclusions: Our sample population analysis indicates that early intervention is necessary for the diagnosis and treatment of youth, with the goal of reducing the probability that psychiatric disorders will be prolonged, evolving, and worsening in adulthood. [ABSTRACT FROM AUTHOR]

Copyright of Enfermería Nefrológica is the property of Sociedad Espanola de Enfermeria Nefrologica and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction. Medical residents (MR) are an important pillar for a future effective health system. As such, it is important to study all the factors throughout their training that may influence their professional development, like gender-based violence (GV). Objetive. To design and evaluate the psychometric proprieties of subtle GV among medical residents' assessment scale (SGEVRA). Method. The design was carried out in two phases: (1) in the qualitative phase, three focus groups were interviewed to obtain information about GV during medical training; and (2) in the quantitative phase, the information was incorporated into the instrument and the psychometric properties were tested. Results. A total of 1,645 medical residents (MRs) completed the instrument. Exploratory factor analysis led to a final two factor model comprised of 31 items that explained 74.9% of the variance. The factors were labelled as gender discrimination (factor 1) and sexual violence (factor 2); both demonstrated high internal consistency using Cronbach's alpha (factor 1: .987; factor 2: .935). Discussion and conclusion. The SGEVRA is a brief, valid, and reliable instrument for assessing subtle GV among MR. [ABSTRACT FROM AUTHOR]

This study explored nurses' perspective of work-related violence and traumatic experience related to workplace violence in Indonesia. A qualitative approach with Focus Group Discussions (FGDs) was conducted to forty nurses who are working in one of referral mental health hospital West Java, Indonesia. This study found that nurses experienced violence included: physical assault, verbal violence, sexual harassment, and intimidation of family, the threat of a lawsuit. Their responses to the violence were unpredictable situation, desire to leave the job, anticipatory and spiritual responses. Director in a mental hospital should have an attention to developing protection and insurance programs for nurses. [ABSTRACT FROM AUTHOR]

Background: Workplace violence (WPV) in the health care sector remains a prominent, under-reported global occupational hazard and public health issue. Objective: To determine the types and prevalence of WPV among doctors. Methods: Primary papers on WPV in medicine were identified through a literature search in 4 health databases (Ovid Medline, EMBASE, PsychoINFO and CINAHL). The study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines for the mapping and identification of records. To assess the studies included in our review, we used the Critical Appraisal Skills Programme cohort review checklist and the Risk of Bias Assessment. Results: 13 out of 2154 articles retrieved were reviewed. Factors outlining physician WPV included (1) working in remote health care areas, (2) understaffing, (3) mental/emotional stress of patients/visitors, (4) insufficient security, and (5) lacking preventative measures. The results of 6 studies were combined in a meta-analysis. The overall prevalence of WPV was 69% (95% CI 58% to 78%). Conclusion: The impact of WPV on health care institutions is profound and far-reaching; it is quite common among physicians. Therefore, steps must be taken to promote an organizational culture where there are measures to protect and promote the well-being of doctors. [ABSTRACT FROM AUTHOR]

Copyright of Portuguese Journal of Mental Health Nursing / Revista Portuguesa de Enfermagem de Saúde Mental is the property of Portuguese Society of Mental Health Nursing and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background. South Africans experience high levels of contact crime, including assault, robbery and hijacking. Emergency medical services (EMS) are frequently called to the scene of such incidents. Their presence in these potentially hostile environments increases the risk of South African (SA) paramedics and paramedic students becoming victims of crime and violence. A 2015 study showed that ~66% of SA EMS staff reported being assaulted while on duty. During a 10-month period in 2016, Western Cape Province recorded >40 incidents of physical violence against their EMS personnel. Questions are being asked about how well prepared EMS staff are to operate in potentially hostile environments. Objectives. To explore emergency medical care (EMC) students' experiences of violence and crime and their views on the need for hostile environment awareness training (HEAT) as part of their undergraduate degree programmes. Methods. A self-designed, non-validated, cross-sectional online survey questionnaire was used to document the experiences, views and opinions of 113 undergraduate EMC students from 4 SA universities. The questionnaire consisted of 24 closed-ended questions with pre-set Likert scale options focusing on documenting participants' experiences, views and opinions regarding hostile environments and the need for HEAT. Results. A high percentage of participants (92%) indicated feeling unsafe while engaging in clinical learning shifts; 63% specified that they had personally witnessed violence against EMS crews, and 32% indicated that they had been assaulted while on duty. Unsurprisingly, 81% of the respondents felt that there is a need for inclusion of HEAT in the undergraduate curriculum. Conclusions. Participation in clinical learning shifts in the current SA prehospital EMS environment increases the risk of exposure to potentially hostile environments. Consequently, students feel unsafe and support the inclusion of HEAT as part of their undergraduate degree programmes. [ABSTRACT FROM AUTHOR]

Objectives: This cross-sectional study aimed to assess the prevalence, factors, and consequences of physical violence by mentally ill patients against mental health professionals. Methods: 124 of 145 mental health professionals at a Nigerian neuropsychiatric hospital satisfactorily completed a questionnaire on their experiences with physical assault. Results: 77 (62.1%) staff had been assaulted during their whole career; 38 (30.6%) of them were assaulted in the past 12 months. The most common type of assault was pushing (32.9%). The most common antecedent event to assault was calming an aggressive patient (44.1%). In their whole career, 22.1% of assaulted staff sustained injuries that required medical attention; 42.4% of assaulted staff sometimes or frequently/always experienced posttraumatic stress disorder symptoms. Physical assault in the whole career was associated with older age (p = 0.04), longer years of practice (p = 0.01), and job dissatisfaction (p = 0.05). Conclusions: Physical violence encountered by mental health professionals at a Nigerian neuropsychiatric hospital is substantial. Policy review of staff safety, training, and support is recommended. [ABSTRACT FROM AUTHOR]