Search

Background: Workplace violence is a global public health issue and a major occupational hazard cross borders and environments. Nurses are the primary victims of workplace violence due to their frontline roles and continuous interactions., Objective: The present study aimed to investigate the status of workplace violence, turnover intention, compassion fatigue, and psychological resilience among Chinese nurses, and explore the mediating role of compassion fatigue and the moderating role of psychological resilience on relationship between workplace violence and turnover intention among Chinese nurses., Method: A cross-sectional study was conducted among a convenience sample of clinical registered nurses from public hospitals in Changsha, Hunan, China. Data was collected through an online questionnaire, which included a demographic information form, the Workplace Violence Scale (WVS), the Turnover Intention Questionnaire (TIQ), the Compassion Fatigue Scale (CF-CN), and the Connor-Davidson Resilience Scale (CD-RISC). Descriptive statistics and correlation analysis were employed to examine the relationships among the main variables. A moderated mediation analysis was further conducted using the PROCESS macro for SPSS (Model 4 and Model 8) to examine the mediating role of compassion fatigue and the moderating role of psychological resilience., Result: The present survey recruited a convenience sample of 1,141 clinical registered nurses, who reported experiencing multiple types of workplace violence during the past year. Correlation analysis revealed significant positive correlations between workplace violence and turnover intention (r = 0.466, P < 0.01) as well as compassion fatigue (r = 0.452, P < 0.01), while negative correlation between workplace violence and psychological resilience (r=-0.414, P < 0.01). Moderated mediation analysis revealed that compassion fatigue mediated, while psychological resilience moderated, the positive relationship between workplace violence and turnover intention (all P < 0.05)., Conclusion: This study underscores the mediating effect of compassion fatigue and the moderating role of psychological resilience in the relationship between workplace violence and turnover intention among Chinese nurses. Future efforts should be undertaken to develop effective preventive measures and intervention strategies at individual, organizational, and national levels to mitigate workplace violence and foster supportive work environment., Clinical Trial Number: Not applicable., (© 2024. The Author(s).)

Background: Workplace violence (WPV) can have adverse psychological, physical, and emotional effects on emergency department (ED) personnel. Adaptive strategies can help them better adapt to WPV. The study aimed to explore ED personnel's experiences with adaptive strategies used in the face of WPV., Methods: In this qualitative study, 22 ED personnel (nurses, doctors, services patient care assistants, and security guards) were selected using purposive sampling from Urmia city hospitals. Deep semi-structured individual face-to-face interviews were used to collect data. After recording and implementing interviews, conventional content analysis was used to extract concepts., Results: Data analysis led to extracting an overarching theme of "mastering the situation and avoiding harm." Two categories that supported the main theme were: "effort to avoid violence" and "effort to escape suffering." The seven subcategories supported main categories included "managing patients and companions, "self-control," "seeking support, "emotional discharge," "thought diversion, "tendency to spirituality," and "seeking medical assistance.", Conclusion: Given the experiences of ED personnel regarding strategies used, health managers and policymakers are recommended to develop and implement comprehensive programs to reduce violence and empower nurses before and after dealing with violence. The following programs will help: developing and implementing guidelines such as zero-tolerance WPV policy, criminalizing violence against personnel and punishing perpetrators; holding classes related to communication skills, self-control skills, and deviant thinking skills for ED personnel; raising public awareness of the prevailing conditions in the emergency through mass media, and counseling and treating violent ED personnel., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Aim: To describe and compare the prevalence of assaults and aggressive patient behavior among frontline staff in behavioral health (BH), medical-surgical (MS), and emergency department (ED) settings and examine the impact on staff health, work stress, work engagement, and intent to leave their position., Background: Patient verbal and physical assaults have significant staff consequences, including decreased work productivity, increased burnout, job dissatisfaction, absenteeism, turnover, and intentions to leave., Methods: Using a descriptive cross-sectional design, data were collected from a sample of 432 frontline staff working in ED, BH, and MS settings across 3 healthcare systems., Results: The majority of frontline staff (74%) reported experiencing verbal aggression often/frequently, significantly impacting their mental health, work engagement, stress levels, and intent to leave. All 3 specialty groups reported a significant increase in verbal/psychological assaults and physical assaults since the pandemic's onset., Conclusion: The COVID-19 pandemic had a significant impact on assaultive/aggressive behaviors. Nurse leaders must strategize on methods to decrease the normalization of violence against healthcare workers and support research aimed at evidence-based interventions to reduce such incidences of violence and ensure the well-being of healthcare workers., Competing Interests: The authors declare no conflicts of interest., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)

Background: Exposure to workplace violence (WPV) is common in health care, and little is known about nurse practitioner (NP) students' experiences during graduate nursing clinical education., Purpose: This study described experiences of WPV among NP students during their clinical education., Methods: We conducted a cross-sectional, quantitative survey of a random sample of NPs licensed in Texas examining graduate nursing education experiences., Results: A total of 334 NPs responded, a 12% response rate. More than a quarter (27%) experienced WPV during their graduate nursing clinical experience. Preceptors were the most reported perpetrators (44%). Most NPs remained in their clinical site after their WPV experience (55%); a majority felt they had no alternative clinical placement option., Conclusions: Nurse practitioner students experience WPV, and there may be implications for educational persistence and their careers. Future work should attempt to reduce the frequency of student WPV experiences and examine implications for NP careers., Competing Interests: The authors declare no conflicts of interest., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)

Background: Violence against healthcare workers is a pervasive, yet in many cases, under-reported problem. This is due to various factors, including lack of time, support and a universal understanding of what constitutes a reportable event. This study explored facilitators and barriers to reporting workplace violence among emergency department nurses., Methods: In this descriptive, qualitative study, researchers conducted open-ended interviews with emergency nurses considered to be "high-" and "non-reporters" of violent events and analyzed for themes., Results: Participants cited consistent factors associated with less reporting, factors associated with more reporting and effectiveness of existing safety measures., Conclusions: To encourage the reporting of violent events, frequently cited barriers and facilitators should be addressed. Strategies such as integrating reporting mechanisms into the health record, creating nuanced definitions of reportable events, and consistent education with positive feedback can promote reporting by staff. These efforts should be combined with prevention strategies to ensure we are collecting correct data about the success or failure of these programs., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Background: Workplace violence (WPV) is highly prevalent in the health sector and remains a major occupational issue causing significant harm, ranging from bodily and psychological harm to death. Female healthcare workers (HCWs) are at high risk of WPV., Objectives: Identify risk factors of WPV among different professional categories of female HCWs., Data Sources: PubMed, EMBASE and Web of Science, along with their references lists January 2010 and March 2022., Eligibility Criteria: English language observational studies focusing on WPV among HCWs evaluating the risk factors, impacts and consequences of WPV in female HCWs., Method: Risk of bias was assessed for all studies by Joanna Briggs Institute critical appraisal checklists. We estimated the pooled prevalence of WPV and the associated 95% CI using a random-effects meta-analysis model. We then described the associated factors and effects of WPV., Results: 28 reviewed studies (24 quantitative, 4 qualitative and 1 mixed-method) from 20 countries were selected. From the available results of 16 studies, the pooled prevalence of WPV was estimated at 45.0% (95% CI 32% to 58%). Types of violence included verbal abuse, verbal threats, physical assaults, sexual harassment, mobbing, bullying and discrimination. Perpetrators were patients, patients' relatives, colleagues and supervisors. Nurses were the most studied HCWs category. WPV was found to affect both mental and physical health. Age, marital status, lower occupational position, substance abuse, shorter work experience and low support at work were the main socio-demographic and organisational factors associated with higher risk of WPV., Conclusion: WPV prevalence is high among female HCWs, warranting a multilevel intervention approach to address and mitigate its impact. This approach should include targeted policies and individual-level strategies to create a safer work environment and prevent adverse effects on both HCWs and the broader healthcare system. Further research is needed to better document WPV in categories of HCWs other than nurses., Prospero Registration Number: CRD42022329574., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Background: Colleague violence experiences of students negatively affect their vocational education in the short term and their desire to stay in the profession in the long term. This study aims to determine the levels of colleague violence experienced by nursing students and the affecting factors in Türkiye., Methods: This study was conducted with second-, third-, and fourth-year nursing students (N = 703) from three state universities in three different provinces in Turkey. The data were collected using the "Student Information Form" and "The Scale of Exposure to Colleague Violence" with an online questionnaire. Descriptive statistics, the Independent Samples t-test, and the ANOVA test were employed for data analysis., Results: students' total mean score on the scale was 46.72 ± 21.30. The "exposure to verbal/psychological violence" and "effect of violence on physical and mental health" subscales were 21.62 ± 10.09 and 25.10 ± 12.02, respectively. The most common reaction to the violence they were exposed to was "remain silent" (34.7%)., Conclusions: nursing students were exposed to moderate levels of verbal/psychological colleague violence, and students' physical and mental health were moderately affected by this violence. Most students remained silent as a response to colleague violence. This study contributed to the emergence of factors that affect and are related to colleagues' violence. The results highlighted the need for programs that educate people about colleague violence and what should be done.

Objective: The aim of our study is to explore the associations between multiple types of workplace violence (WPV) and burnout risk, sleep problems, and leaving intention among nurses., Methods: This cross-sectional survey recruited 1,742 nurses, and data on WPV experiences were collected through self-administered questionnaires. Work conditions, burnout risk scales, sleep quality, and leaving intentions were also evaluated. Multivariate logistic regression analyses were performed to examine the associations of WPV with burnout risk, sleep quality, and leaving intentions, adjusting for demographic characteristics and work conditions., Results: The study found that 66.7% of nurses reported experience of WPV, with 26.9% experiencing both physical and nonphysical forms. Those who experienced multiple types of WPV reported worse work conditions, higher burnout risk, poorer sleep quality, and a stronger leaving intention compared to those without such experiences. Adjusting for working conditions, logistic regression analysis showed that nurses who experienced multiple types of WPV had 2.12-fold higher odds of high personal burnout risk, 2.36-fold higher odds of high client-related burnout risk, 1.95-fold higher odds of poor sleep quality, and 1.80-fold higher odds of high leaving intention, compared to those without WPV experiences., Conclusions: Strategies by hospital managers and policymakers to monitor and reduce workplace violence are vital for sustaining nurses' mental health, well-being, and preventing early attrition from the profession., (© The Author(s) 2024. Published by Oxford University Press on behalf of the British Occupational Hygiene Society. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.)

Background: Occupational violence (OV) is a priority issue that significantly affects the safety of nurses, leading to staff burnout and poor retention issues. Security personnel are common in inpatient settings, yet there is limited research on their role, function, and impacts. The study aims to qualitatively evaluate a novel security role to reduce OV in inpatient settings. Methods : This qualitative study was conducted in a tertiary hospital in Brisbane, Queensland. A novel security role (Ambassador) was piloted in three inpatient wards over 6 months in 2020 to mitigate OV risk. Semi-structured in-depth interviews were conducted. All interviews were audio recorded. Interview transcripts were transcribed. Deductive analysis based on the Consolidated Framework for Implementation Research (CFIR) was used to identify the experiences and perceptions of the participants. Findings : 17 participants were interviewed. Five themes were identified including program characteristics, internal drivers, external drivers, individual experience, and implementation process. An Ambassador proactively engages with patients and visitors and employs behavioral strategies to de-escalate or redirect persons of concern. Participants considered Ambassadors to be important members of the health care team who supported the provision of patient and family-centered care. Successful implementation was said to require collaboration between clinical and security services and a small agile project team with authority and autonomy. Conclusion/Application to practice : This study provides many insights into the successful implementation of a novel security role in acute hospital settings. More research is needed on the effectiveness, appropriateness, feasibility, and cost of different security models., Competing Interests: Conflict of InterestThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Background: Workplace violence (WPV) against emergency nurses has been common but unavoidable. Promoting resilience may mitigate the subsequent health harms of workplace violence. Current interventions mainly focused on internal factors related to resilience, though the external factors can influence personal growth., Aim: To test the effect, feasibility, and acceptability of a Comprehensive Active Resilience Education (CARE) program on promoting resilience in emergency nurses exposed to workplace violence., Design: This is a two-armed quasi-experimental using mixed methods, following the TREND checklist., Methods: This study was conducted from March 2023 to July 2023 in a tertiary hospital in Shanghai, China. Emergency nurses exposed to workplace violence were recruited using cluster sampling and allocated to the intervention and control groups. The intervention group received the CARE program. The control group received no intervention., Results: 71participants were recruited and no participants withdrew during the intervention. The resilience and anxiety scores displayed a significant effect in the group*time interaction effect. After four months, the intervention group demonstrated a significant improvement in resilience and anxiety scores. The intervention group showed greater improvement in coping, perceived organizational support, and depression scores compared to the control group. Two themes of joyful engagement experience and effective intervention were identified from qualitative interviews with the intervention group., Conclusion: The Comprehensive Active Resilience Education (CARE) program was effective, feasible, and acceptable in increasing resilience in emergency nurses exposed to workplace violence. The CARE program we developed can be replicated and integrated into systematic education programs for all nurses to help them maintain their mental health and good job performance while dealing with workplace violence., Competing Interests: Declaration of competing interest None., (Copyright © 2024. Published by Elsevier Ltd.)

Introduction: The violence nursing students experience in the clinic may affect their attitudes towards the profession., Aim: This study was conducted to determine nursing students' exposure to violence during their clinical practice and their violence management competence levels., Design: This was a two-centred, descriptive, and correlational study., Participants: A total of 512 nursing students from two universities in Türkiye participated in this study., Methods: The study data was collected between March and April 2023 with the Student Information Form, Violence Exposure Form, and Management of Workplace Violence Competence Scale for Nursing Students. Institutional permission and ethics committee approval were obtained before starting the study (Date: 05/01/2023, No: 50). Descriptive statistics, Mann-Whitney U test, Kruskal Wallis test and linear regression analysis were used to evaluate the data. Statistical significance was accepted as p < 0.05., Results: It was determined that 17.4 % (n = 89) of the participant students felt competent in managing violence, and 94.3 % (n= 483) were concerned about being exposed to violence at various levels. In these results, 20.5 % (n = 105) of them were exposed to violence during clinical practice, 60.9 % (n = 64) of whom experienced verbal violence and 52.3 % (n = 55) psychological violence. The total mean score from the violence management competence scale was 103.29 ± 16.64. No statistically significant difference was found between the scale total and subscale scores according to gender (p > 0.05). The scale total scores of fourth-grade students with a good perceived academic success and who received training on coping with violence were statistically significantly higher (p˂0.05). The regression model created between the scale score and students' perceived academic success and receiving white code training (Training on the use of the alarm system that will enable security guards to reach the scene as soon as possible in cases where healthcare workers are exposed to all kinds of violence.) was statistically significant (F = 23.108, p < 0.001)., Conclusion: Some of the students participating in the study experienced violence in clinical practices. Their violence management competence levels were good. It can be said that academic success, coping with violence, and white code training are useful in increasing competence levels., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Aims: This study aims to reveal the violent experiences of nurses working in the emergency department and the meanings they attribute to them., Methods: This research was conducted as narrative inquiry and interpretive phenomenology and recruited 15 nurses. Interviews with nurses actively working in the emergency department and who had been exposed to violence by patients or their relatives were conducted with a semi-structured interview form. The consolidated criteria for reporting qualitative research (COREQ) checklist was used., Results: In the study, three themes were determined (1) Unpredictable event, (2) Interminable effects of violence, and (3) Like a bottomless pit. With seven sub-themes., Conclusions: This study underlined that violence applied to nurses by patients or relatives of patients in the emergency department is an unexpected situation that causes negative emotions. Violence affects all aspects of life and limits communication with the patient. Coping with a violent situation is challenging for nurses, and they demand support from the management., (© 2023 John Wiley & Sons Australia, Ltd.)

WHAT IS KNOWN ON THE SUBJECT?: Workplace violence is common in healthcare. Workplace violence remains a complex and serious occupational hazard in healthcare. WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE?: Since there is no study examining detailed explanations of experiences and perspectives of workplace violence among psychiatric nurses, this study will act as a guide for psychiatric nurses. This study provides information about how psychiatric nurses evaluate the concept of workplace violence from their perspective, what it means to them and the effects of workplace violence. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Considering the effects of workplace violence, a preventive, systematic and holistic approach should be used in psychiatry and community mental health centres. Supportive interventions should be used to improve the health and safety of psychiatric nurses and patients., Abstract: INTRODUCTION: Workplace violence is common in healthcare and remains a complex and serious occupational hazard., Aim: This research was conducted to assess the workplace violence experiences and perspectives of psychiatric nurses., Method: This study was a qualitative study conducted using a grounded theory approach method. The study was conducted between November 2022 and January 2023. The purposeful sampling method was used, and 11 psychiatric nurses were interviewed. Data were collected with an information form and a semi-structured interview form. The data were analysed using content analysis, and themes were created., Findings: The ages of the psychiatric nurses ranged from 38 to 57 years. Themes and sub-themes related to the workplace violence experiences and perspectives of psychiatric nurses included the way of violence (rising tension, eruption of the volcano, unintentional violence and turning to ash) and empowerment (ash cloud and ring of fire)., Conclusion: Psychiatric nurses stated that they were exposed to verbal and physical violence for many reasons, that this situation seriously affected their physical, mental and social health and that in addition to the devastating effects of violence, they became stronger by developing various skills to protect against violence., Implications for Practice: Supportive interventions should be used to improve the health and safety of psychiatric nurses and patients. Strategies can be developed to include psychiatric nurses in occupational health nursing courses., (© 2023 John Wiley & Sons Ltd.)

Background: Workplace violence can threaten the physical and mental health of emergency nurses, increasing their mobility and burnout rates. However, little research has focused on how to mitigate the negative effects of workplace violence., Objectives: To investigate the relationships among resilience scores, perceived organizational support, and workplace violence and to explore the mediating role of perceived organizational support in the relationship between resilience scores and workplace violence among emergency nurses., Research Design: A quantitative, cross-sectional study., Methods: From June to July 2023, 466 valid questionnaires were collected via the WeChat app Credamo Seeing Numbers. Participants were assessed using the Connor-Davidson Resilience Scale, the Perceived Organizational Support Scale, and the Fear of Future Violence at Work Scale., Ethical Consideration: The study was approved by the Ethics Committee of Hunan Normal University (No. 2023-389)., Findings: The Connor-Davidson resilience scores of emergency nurses were negatively associated with workplace violence and positively associated with emergency nurses' perceived organizational support. Emergency nurses' perceived organizational support was negatively associated with workplace violence. Perceived organizational support moderated the relationship between Connor-Davidson resilience scores and workplace violence among emergency nurses to some extent., Discussion: High levels of Connor-Davidson resilience scores can mitigate the negative effects of workplace violence. Perceived organizational support can increase with increasing levels of Connor-Davidson resilience scores. When nurses face workplace violence, support from the organization can, on the one hand, reduce the negative impacts of stress and, on the other hand, elicit positive emotions., Conclusion: To mitigate the effects of workplace violence on emergency nurses, interventions aimed at both internal and external organizational conditions must be developed to establish a supportive environment that can increase emergency nurses' Connor-Davidson resilience scores and sense of perceived organizational support, and decrease workplace violence., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Background: Conflicts with patients and relatives occur frequently in intensive care units (ICUs), driven by factors that are intensified by critical illness and its treatments. A majority of ICU healthcare professionals have experienced verbal and/or physical violence. There is a need to understand how healthcare professionals in ICUs experience and manage this workplace violence., Methods: A qualitative descriptive analysis of four hospitals in Sweden was conducted using semi-structured focus-group interviews with ICU healthcare professionals., Results: A total of 34 participants (14 nurses, 6 physicians and 14 other staff) were interviewed across the four hospitals. The overarching theme: "The paradox of violence in healthcare" illustrated a normalisation of violence in ICU care and indicated a complex association between healthcare professionals regarding violence as an integral aspect of caregiving, while simultaneously identifying themselves as victims of this violence. The healthcare professionals described being poorly prepared and lacking appropriate tools to manage violent situations. The management of violence was therefore mostly based on self-taught skills., Conclusions: This study contributes to understanding the normalisation of violence in ICU care and gives a possible explanation for its origins. The paradox involves a multifaceted approach that acknowledges and confronts the structural and cultural dimensions of violence in healthcare. Such an approach will lay the foundations for a more sustainable healthcare system., (© 2024. The Author(s).)

Background: Many people experience forms of gender-based violence and harassment (GBVH) in the context of their work. This includes a wide range of experiences, from subtle expressions of hostility to physical assault, that can also be of a sexual nature (e.g., sexual harassment or assault). This systematic review aimed to summarize findings about the prospective associations of work-related GBVH with people's health and occupational situation., Methods: We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Scopus, Web of Science, MEDLINE and PsycINFO were searched for prospective studies in English from 1990 to May 24, 2023. Studies were included if they concerned a working population, exposure to any form of GBVH in the work context, and a health outcome or manifest occupational outcome. Quality was assessed with a modified version of the Cochrane 'Tool to Assess Risk of Bias in Cohort Studies', and studies assessed as low quality were excluded from the narrative synthesis. For the narrative synthesis, we grouped the results by similar exposures and outcomes and reported the strength and statistical significance of the associations., Results: Of the 1 937 screened records, 29 studies were included in the narrative synthesis. Studies were mainly conducted in the USA and northern Europe and investigated exposure to sexual violence or harassment (SVH). Only two included studies investigated non-sexual kinds of GBVH. Consistently, studies showed associations of work-related SVH with poor mental health and there were indications of an association with hazardous substance use. There was no consistent evidence for an association of SVH with subsequent sickness absence, and there were too few studies concerning physical health and occupational outcomes to synthesize the results., Conclusions: There is consistent evidence of work-related SVH as a risk factor for subsequent poor mental health. There is no indication that the health consequences of SVH differ between women and men, although women are more often affected. There is a need for conceptual consistency, the consideration of non-sexual behaviors and prospective studies that test clear hypotheses about the temporal sequence of events., (© 2024. The Author(s).)

Introduction: Workplace violence against healthcare workers has become a serious global public health problem. The incidence of workplace violence towards Psychiatric nurses is higher than in all other medical institutions, up to 84.2% per year. It not only negatively affects many aspects of healthcare workers' lives, but also destroys the harmony of the nurse-patient relationship and reduces the quality of nursing care. The number of psychiatric nurses in China was approximately 96,000, far lower than most other countries and unable to meet the growing demand for mental health. However, the increase in workplace violence has future exacerbates the current shortage of nurses. Therefore, it is necessary to develop effective strategies to prevent psychiatric nurses from suffering from workplace violence, thereby to reduce nurse turnover and improve the quality of nursing care. A comprehensive understanding of psychiatric nurses' preferences and priorities for preventing workplace violence is an important prerequisite before formulating strategies and taking measures. Unfortunately, to date, no research has investigated the psychiatric nurses' preferences. Therefore, a discrete choice experiment (DCE) is conducting to explore the psychiatric nurses' preferences for workplace violence prevention. This article reports on methodological details of the DCE., Methods and Analysis: Six attributes were developed through a literature review, one-on-one interviews and focus group discussions. D-efficient design in NGENE was used to generate choice sets. SPSS 24.0 will be used for descriptive analysis of social Demography, and Stata 16.0 will be used for analysis of DCE data. A multinomial logit model will be used to preliminarily explore trade-offs between workplace violence prevention characteristics included in the choice tasks. Then, in a mixed logit model, we plan to choose some arbitrarily defined base violence prevention program and will use the nlcom command to evaluate the probability of an alternative violence prevention program., Ethics and Dissemination: The study was approved by the relevant ethics committees. Our findings will emphasize priority intervention areas based on the preferences of psychiatric nurses and provide references for hospitals to develop and improve workplace violence prevention strategies. The results will be shared through seminars, policy briefs, peer-reviewed journal articles and online blogs., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Xie, Li, Tao and Yang.)

Healthcare providers (HP) work in high-stress situations, interacting with patients and families who are often in crisis. HPs who work in safety net clinics, which provide care to uninsured, Medicaid recipients and other vulnerable populations, interact with patients who are frequently frustrated by long wait times, extensive paperwork, short appointments, and have generally lower health literacy. Many patients have chronic conditions and substance use disorders which has been associated with higher likelihood to be perceived as verbally aggressive and/or perpetrate workplace violence (WPV). Using interviews with 26 HPs at safety net clinics, we investigated how HPs manage interactions with aggressive patients and avoid burnout. Findings are based on emotional labor constructs describing why and how workers use emotion management strategies to smooth communication and relationships with clients/patients. According to our participants, HPs perform emotional labor to de-escalate interactions, prevent WPV, and to develop relationships with patients who might become regular clinic patients. We found that HPs perceive an influence of the clinic context on patient aggression management, hold initial perceptions that shape engagement with aggressive patients, and report emotional labor and burnout that came from interacting with aggressive patients to prevent WPV. We offer implications that extend research on emotional labor and burnout, provide guidance to healthcare organizations, and offer directions for future theory and research.

The study aimed to determine the prevalence and risk factors of workplace violence (WPV) against pediatric emergency healthcare workers and evaluate the relationship between WPV and psychological resilience. This study is cross-sectional and correlational. According to the results, the prevalence of WPV was 69.8%, and its distribution was as follows: verbal abuse (56.9%), bullying/mobbing (37.6%), physical abuse (12.8%), and sexual abuse (2.2%). Being single/separated/divorced/widowed (odds ratio [OR]: 1.85, 95% confidence interval [CI]: 1.03-3.30), being a physician (OR: 4.74, 95% CI: 1.73-12.96), being a staff member (OR: 2.57, 95% CI: 1.10-5.99), routine direct physical contact with patients/clients (OR: 2.77, 95% CI: 1.40-5.48), and lack of encouragement to report WPV (OR: 3.76, 95% CI: 2.01-7.01) were independent predictors of WPV ( P < .05), and WPV was found to be associated with low psychological resilience. Arrangements related to violence prevention, preparation, and intervention should be made and maintained in all pediatric emergency departments., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Background: Hospitalized pediatric patients with behavioral health (BH) diagnoses awaiting transfer can exhibit behaviors that may lead to workplace violence such as aggression. Workplace violence can lead to discomfort in caring for these patients. Huddles can be used as a tool to identify potential for violence, to help address workplace violence, and improve clinician situational awareness., Methods: Utilizing QI methodology, a BH specific huddle tool was created and implemented on an Acute Care floor that identified key components such as triggers and behavioral stability. Mixed methods were used to study the intervention including focus groups, surveys and measurement of agreement (surrogate for situational awareness). The aims of this quality improvement (QI) project were to 1) improve situational awareness by increasing agreement between team members 2) improve the overall comfort of the clinical team caring for BH patients by 10%., Results: Agreement between clinicians on patient stability increased by 20%. Comfort in caring for BH patients increased by 4%. Providers reported the tool increased their understanding (89%) and communication (81%) regarding plan of care., Application to Practice: Standardized huddle tool can be utilized to increase situational awareness among team members caring for patients with behavioral health diagnoses and may help to address workplace violence., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Background: Workplace violence and harassment are commonplace for healthcare workers and most incidents are unreported. Normalization of these experiences, lack of confidence in reporting systems, and fear of the consequences of reporting contribute to the invisibility of these experiences. Challenges are exacerbated in homecare settings and for precarious workforces including Personal Support Workers (PSWs). We created, piloted, and evaluated an intervention to enhance safety culture and encourage reporting of workplace violence and harassment., Methods: A multi-stakeholder steering committee designed an intervention combining policy changes, a pre-visit screening tool, education, and brief end-of-visit reporting. This was piloted with a PSW care team which provided >55,000 client visits during the 32-week intervention. Operational metrics characterized screening, education, and reporting uptake. Pre- and post-intervention surveys characterized PSWs' experiences with workplace violence and harassment, reporting experiences, training history and intervention feedback., Findings: PSWs reported increased comfort discussing workplace violence and harassment, and increased confidence managing client-to-worker incidents. The screening went smoothly with most clients in private homes. Most PSWs (75%) engaged at least once with end-of-visit reporting and nearly half submitted reports regularly. During the pilot, 21% of PSWs reported incidents and 52% of reports shared client-specific strategies for managing these situations., Application to Practice: Changes in comfort and behavior with reporting indicated a shift toward a more open culture surrounding workplace violence and harassment. Tools created for this intervention and lessons for implementation are shared for consideration by occupational health practitioners throughout the homecare sector., Competing Interests: Conflict of InterestThe author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: All authors are employed by the organization at which the quality improvement initiative was conducted.

Violence against police is a reality for many officers. Despite growing concerns over the rise in violence against police and the serious individual and societal repercussions associated with it, a comprehensive overview of the psychological and physical consequences of verbal and physical violence against police remains elusive. By performing a scoping review ( n  = 21) of studies and reports identified via database searches (Web of Science and Google Scholar), reference mining, and purposive sampling, and published between 2010 and 2023, this article is the first of its kind to map psychological and physical consequences of violence against police, as well as the risk and protective factors that respectively increase and decrease adverse consequences. Results indicate that officers experience primary victimization by a range of different adverse consequences, but also deal with secondary victimization. The literature has come to a standstill due to lack of (recent) studies and a lack of diversity on how consequences of violence against police are studied. We argue that this lack of academic attention might be influenced by predominant societal perspectives and officers' perceived victim status, and discuss the implications for police, policymakers, and research., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Importance: The US registered nurse (RN) workforce is in flux, with high rates of burnout, intention to leave, and vacancies. Rapid, repeated assessments of the nursing workforce can help hospital executives and policymakers enact effective recruitment and retention strategies., Objective: To identify changes in practicing RNs' employment plans and workplace assessments between the 2022 and 2023 surveys., Design, Setting, and Participants: This survey study compared data collected from the Michigan Nurses' Study at 2 time points: February 22 to March 1, 2022, and May 17 to June 1, 2023. Practicing RNs with an active, unrestricted license in Michigan and a valid individual email address were included., Main Outcome and Measures: The primary outcome was nurses' intention to leave their current position within 1 year. In the 2023 survey, nurses who planned to leave were queried on their next career step and the primary reason for their planned departure. Workplace assessments included questions about abusive or violent workplace events, emotional exhaustion, job satisfaction, the practice environment's delivery of high-quality care, and the clinical setting's safety rating. Regression analysis was used to examine workplace assessments and personal factors associated with planned departures., Results: This study obtained data on 9150 nurses (6495 females [71.0%]) and 7059 nurses (5134 females [72.7%]) responding to the 2022 (response rate, 8.3%) and 2023 (response rate, 7.4%) surveys, respectively. In the 2023 survey, 32.0% (2259) of nurses planned to leave their position, compared with 39.1% (3576) in the 2022 survey. Of these nurses, 957 (41.8%) planned to leave their current employer but remain in nursing, with workloads as the most frequently cited reason (29.4% [672]). Compared with the 2022 cohort, nurses in the 2023 sample reported less workplace abuse or violence (4591 [50.2%] vs 3063 [43.4%]; P < .001), fewer understaffed shifts (4407 [48.2%] vs 2898 [41.0%]; P < .001), and less frequent use of mandatory overtime (1709 [18.7%] vs 824 [11.7%]; P < .001). Factors associated with increased likelihood for planned departures included workplace abuse or violence (odds ratio [OR], 1.39; 95% CI, 1.05-1.82) and higher emotional exhaustion scores (OR, 3.05; 95% CI, 2.38-3.91). Favorable practice environments (OR, 0.37; 95% CI, 0.22-0.62) and excellent clinical setting safety ratings (OR, 0.28; 95% CI, 0.14-0.56) were associated with lower likelihood of planned departure., Conclusions and Relevance: Results of this study showed that nurses reported improved workplace conditions in the 2023 vs the 2022 survey; however, planned departure rates, abusive or violent events, and unsafe conditions remained high, and understaffing remained a primary concern for most nurses. Health system leaders and policymakers should prioritize initiatives that support nurse retention and reduce potential workforce instability.

Workplace violence (WPV) has become a crisis for health care workers, with a significant increase in violent events taking place in health care settings across the nation. Health care organizations should develop a comprehensive WPV program that includes recognition, management, and reporting of all types of WPV. A large health care system developed strategies and a program to address WPV. The health care system believes that a safe and respectful work environment is foundational to the goal of zero preventable harm. The "Safety in the Workplace" initiative was designed to raise awareness of concerning behaviors and to offer tools and resources for identifying, responding to, and reporting incidents of violence, aggression, or disruptive behaviors of WPV. During a 6-month pilot of a WPV bundle, there was a 44% reduction in physical violence reports and a 44% reduction in reported incidents of WPV. From June 2020 to June 2021, there was a 10% decrease in WPV overall., Competing Interests: The authors declare no conflict of interest., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)

Background: Research suggests that healthcare workers are at greater risk for suicide than other occupations, but most published studies focus on physicians. This study examines the prevalence of suicidal ideation (SI) and associated occupational factors among a broad group of non-physician healthcare staff., Methods: An anonymous online survey was sent to a random sample of 30 % of non-physician healthcare staff at a large urban healthcare system between September and November 2022. Weighted multivariable binary logistic regressions were conducted to determine the workplace and mental health factors associated with SI., Results: The 1084 respondents included nurses, administrative staff, research staff, medical assistants, nurse practitioners, physician assistants, and other roles. Of the sample, 8.8 % endorsed having SI over the prior two weeks. Results of the regression indicated that, after adjusting for demographic factors, greater odds of SI were associated with physical violence experienced from a patient or visitor (odds ratio [OR] = 2.15, 95 % confidence interval [CI] = 1.06-4.37), lower perceived leadership support (OR = 0.95, 95 % CI = 0.92-0.98), and positive screening for depression (OR = 4.66, 95 % CI = 2.45-8.86). Exploratory analysis suggests that depression may be a mediating factor between workplace stressors and SI., Limitations: Limitations include the response rate, the use of a single item to assess SI, and the cross-sectional design., Conclusion: Findings suggest that workplace violence and leadership support are important occupational factors associated with SI among healthcare workers. Reducing and mitigating workplace violence, enhancing leadership support, and improving access to mental health care should be considered targets for interventions to decrease suicide risk in this population., Competing Interests: Declaration of competing interest Jonathan M. DePierro receives book royalties from Cambridge University Press and compensation related to an editor in chief role with Springer Press; and is named on a U.S. patent application for a digital health intervention, an intellectual property that that has yet to be licensed. He has received honoraria from New York University, University of New Mexico, Ro Health Ventures Inc., the Canadian Institutes of Health Research, and the US Department of State. Lauren Peccoralo received honoraria from Atrium Health Wake Forest Baptist, American Society of Health-System Pharmacists, Stanford University, University of Montana and Baylor, Scott & White Health. Jonathan Ripp received honoraria for numerous speaking engagements at professional societies, academic medical centers, health care institutions; serves as a course director for the Institute for Healthcare Improvement, worked as a consultant for the well-being program at the NYU School of Medicine Long Island; served as a non-fiduciary board member of the Lorna Breen Foundation; and served on a temporary advisory board established by PEPSICO to inform employee well-being efforts, and provides consultation to Marvin Behavioral Health, Inc. The remaining authors have no conflict of interest to disclose., (Published by Elsevier B.V.)

Workplace bullying, commonly known as mobbing, persists as a significant problem across various industries, including the healthcare sector. To establish effective interventions and protocols for enhancing the well-being of healthcare workers and patients, it is vital to fully grasp the link between workplace bullying and the quality of nursing care. The analysis highlights the complex link between workplace bullying and nursing care quality, stressing the urgency of addressing this issue due to its wide-reaching impact on individuals and healthcare organizations, ultimately affecting patient safety. Emphasizing the significance of addressing workplace bullying across different professional settings is crucial for protecting the mental health and well-being of employees. The research identifies various forms of aggression and emphasizes the need to understand how these behaviors affect patient outcomes. Further investigation is needed to clarify nurses' responses to workplace violence, particularly in specialized settings like mental health facilities. The studies underscore the numerous challenges nurses encounter when trying to report incidents of workplace bullying. This insight is vital for developing effective reporting mechanisms and targeted interventions to combat bullying behaviors in medical environments. Ultimately, establishing a safer working environment for nurses is paramount. This article aims to review the associations between workplace bullying and the quality of nursing care.

Introduction: Among clinical healthcare personnel, nurses face the highest proportion of workplace violence, which has a significant impact on their physical and mental well-being as well as their personal and professional lives. However, little is known about the effects of workplace violence on inexperienced breastfeeding nurses and their experiences during and after breastfeeding when they return to work. This study aimed to explore the experiences of inexperienced breastfeeding nurses who encountered workplace violence and its resulting impacts., Methods: This study employed a descriptive qualitative design. Semi-structured in-depth interviews were conducted with 20 nurses working in various positions and departments at three tertiary hospitals. Purposive and maximum variation sampling techniques were employed. The interview data were analyzed using Colaizzi's method, and the research findings were reported according to Consolidated Criteria for Reporting Qualitative Studies (COREQ)standards., Results: Inferences regarding workplace violence and risks for inexperienced breastfeeding nurses included physical labor (such as lifting heavy objects and performing cardiopulmonary resuscitation), conflicts, inadequate job skills, role confusion, occupational exposure risks, patient violence, and pressure from older adults. An inductive thematic investigation revealed the "Challenges faced during breastfeeding," "Conflicting professional and family roles," "Out of balance," and "Coping strategies.", Conclusion: Inexperienced breastfeeding nurses experience several negative consequences due to workplace violence. Therefore, it is essential to plan and implement preventive strategies and management programs that specifically target workplace violence among inexperienced breastfeeding nurses., Competing Interests: XL was employed by Shandong Vheng Data Technology Co., Ltd. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Chen, Wang, Wang, Wang and Liu.)

Objective: Work-related violence remains a significant problem in healthcare settings, including EDs. Violence risk assessment tools have been developed to improve risk mitigation in this setting; however, incorporation of these tools into standard hospital processes remains scarce. This research aimed to explore nurses' perspectives on the Bröset Violence Checklist used in routine violence risk assessment and their recommendations for additional items., Methods: Thirty nursing staff who used the Bröset Violence Checklist (BVC) as standard practice for 5 years participated in two focus groups where 23 violence risk factors were presented. Using multiple methods, participants were asked to select and elaborate from a pre-determined list what they considered most useful in violence risk assessment in respect to descriptors and terminology., Results: Quantitative data showed most risk factors presented to the group were considered to be predictive of violence. Ten were regarded as associated with risk, and overt behaviours received the highest votes. The terms 'shouting and demanding' was preferred over 'boisterous', and 'cognitive impairment' over 'confusion'. Patient clinical characteristics and staff perceptions of harm, inability to observe subtle behaviour, imposed restrictions and interventions and environmental conditions and impact were also important considerations., Conclusions: We recommend that violence risk assessment include: history of violence, cognitive impairment, psychotic symptoms, drug and alcohol influence, shouting and demanding, verbal abuse/hostility, impulsivity, agitation, irritability and imposed restrictions and interventions. These violence risk factors fit within the four categories of historical, clinical, behavioural and situational., (© 2024 The Authors. Emergency Medicine Australasia published by John Wiley & Sons Australia, Ltd on behalf of Australasian College for Emergency Medicine.)

Objectives: The aim of this study was to investigate associations between exposure to work-related violence/threats and harassment, and future sickness absence (SA) due to common mental disorders (CMDs), taking familial factors (shared genetics and early-life environment) and neuroticism into account., Methods: The study sample included 8795 twin individuals from the Swedish Twin Project of Disability Pension and Sickness Absence (STODS), including survey data from the Study of Twin Adults: Genes and Environment (STAGE). Self-reported work-related violence and/or threats as well as work-related harassment (including bullying) and national register data on SA due to CMDs were analyzed using standard logistic regression, and conditional logistic regression among complete twin pairs discordant on exposures. Individuals were followed for a maximum of 13 years. Interactions between neuroticism and exposures were assessed using both multiplicative and additive interaction analyses., Results: Exposure to work-related violence/threats was associated with higher odds of SA due to CMDs when adjusting for age, sex, marital status, children, education, type of living area, work characteristics, and symptoms of depression and burnout (OR 2.11, 95% CI 1.52-2.95). Higher odds of SA due to CMDs were also found for exposure to harassment (OR 1.52, 95% CI 1.10-2.11) and a combined indicator of exposure to violence/threats and/or harassment (OR 1.98, 95% CI 1.52-2.59), compared with the unexposed. Analyses of twins discordant on exposure, using the unexposed co-twin as reference, showed reduced ORs. These ORs were still elevated but no longer statistically significant, potentially due to a lack of statistical power. No multiplicative interaction was found between neuroticism and exposure to work-related violence/threats, or harassment. However, a statistically significant additive interaction was found between neuroticism and exposure to violence/threats, indicating higher odds of SA due to CMDs in the group scoring lower on neuroticism., Conclusions: Exposure to work-related offensive behaviors was associated with SA due to CMDs. However, the results indicated that these associations may be partly confounded by familial factors. In addition, an interaction between exposure and neuroticism was suggested. Thus, when possible, future studies investigating associations and causality between offensive behaviors at work and mental health-related outcomes, should consider familial factors and neuroticism., (© 2024. The Author(s).)

Physical and mental health problems had been identified as the negative outcomes of workplace violence (WPV) against medical staff. Considering the proven associations between physical and mental health and suicidal ideation, it is reasonable to assume that WPV may associate with suicidal ideation. However, few studies were conducted to explore the relationship between WPV and their suicidal ideation against medical staff. Based on a cross-sectional design, 3, 426 medical staff working in general hospitals were interviewed in Shandong Province, China. Socio-demographic characteristics, work-related factors, psychological variables, WPV, and suicidal ideation were evaluated. Propensity score matching (PSM) was performed to explore the association between WPV and suicidal ideation. The prevalence of suicidal ideation among medical staff was 9.1% (312/3426), and 52.2% (1788/3426) of medical staff reported the WPV experience. Before PSM, we found that the association between WPV and suicidal ideation was statistically significant (aOR = 1.606, p  < 0.01). After PSM, there was a statistically significant correlation between WPV and suicidal ideation (aOR = 1.525, p  < 0.01). This study supported the correlations between WPV against medical staff and their suicidal ideation. The results of PSM further implied that WPV might cause suicidal ideation among medical staff. Psychological health, especially for suicidal ideation, should be paid attention for medical staff with WPV experiences.

Background: Although efforts to reduce aggression and violence in emergency departments are important, it is also critical to minimise harm and support staff where this occurs. This research describes support mechanisms emergency nurses value when they experience occupational aggression and violence., Methods: A mixed-methods design including thematic analysis of six interviews and descriptive analysis of fifty-one surveys, with experienced emergency nurse participants and respondents from a single large urban emergency department., Results: Four key themes summarised coping with aggression and violence: Minimising exacerbating factors (mental health, lack of understanding of zero tolerance in practice, and wait times); Support before violence (use of huddles and having experienced nurses on each shift); Support during violence (education including restraint, self-defence, de-escalation and legalities); and Support after violence (debriefing, incident reporting and a sense of 'toughness') CONCLUSION: Emergency nurses need preparation and support to competently manage complex mental health presentations, understand legal rights, communicate effectively with patients, families and colleagues and access event debriefing. Security staff are valued team members but also need adequate resourcing and preparation., Competing Interests: Declaration of Competing Interest All authors were involved in the design, conduct, drafting, editing and checking of final manuscript. We have no conflicts of interest to declare., (Copyright © 2023 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Aims: The aims of this study were as follows: (a) to examine the relationship between perceived organizational support and resilience; (b) to investigate the potential mediating role of general self-efficacy and cognitive reappraisal among emergency nurses who have experienced workplace violence; and (c) to explore the application of Kumpfer's resilience framework to emergency department nurses., Design: A cross-sectional study., Methods: From February 17, 2021, to March 8, 2021, 825 emergency nurses working in the emergency departments of tertiary hospitals in Shanghai, China, completed an online survey. Data on resilience, organizational support, cognitive reappraisal and general self-efficacy were collected through questionnaires. The Spearman analysis was employed to investigate the relationship between variables, while the mediation analysis was conducted using AMOS 23.0 statistical software., Results: The findings of a study involving 825 emergency nurses who reported experiencing workplace violence reveal a positive correlation between perceived organizational support and resilience. Additionally, it has been observed that the relationship between these two factors is mediated by both cognitive reappraisal and general self-efficacy. Furthermore, the mediating effect of cognitive reappraisal is more significant in this relationship., Conclusion: Kumpfer's resilience framework is found to apply to emergency nurses. Perceived organizational support, an environmental factor, affects resilience directly and positively. In addition, cognitive reappraisal and general self-efficacy, which are individual factors, mediate this influence path. These findings suggest an interaction between environmental and individual factors in determining the resilience of emergency nurses., Impact: These findings have implications for developing resilience intervention strategies for emergency nurses exposed to occupational violence. Enhancing personal attributes such as general self-efficacy and cognitive reappraisal is as significant as strengthening external organizational support environments for enhancing nurses' resilience., Patient or Public Contribution: Emergency nurses participated in the pilot test of our questionnaire survey and gave their opinions on the questionnaire design., Summary Statement: What is already known about the topic? In emergency rooms, workplace violence is prevalent, and it seriously endangers nurses' physical and mental health. Enhancing resilience can improve nurses' ability to self-regulate after experiencing violence. However, the drivers and mechanisms of resilience among emergency nurses who have experienced workplace violence remain unidentified. What this paper adds? This study confirms the applicability of Kumpfer's resilience framework to emergency nurses who have experienced workplace violence. Nurses' self-efficacy and cognitive reappraisal mediate the relationship between perceived organizational support and resilience after exposure to workplace violence. The resilience process for emergency nurses involves the interaction of individual and environmental factors. Implications for practice/policy. Managers and researchers should consider the interaction between individual and environmental factors when developing resilience intervention strategies for emergency nurses who have suffered workplace violence. It is essential to support emergency nurses from the dyadic dimensions of the environment and the individual. A supportive organizational environment and individual positive adjustment strategies are equally important in promoting resilience among nurses., (© 2023 John Wiley & Sons Ltd.)

Background: The mechanisms underlying the relationship between workplace violence (WPV) and depressive symptoms in nurses have been less studied. This study aims to examine the mediating role of fear of future workplace violence (FFWV) and burnout in the association between WPV and depressive symptoms., Methods: We conducted a cross-sectional web survey at 12 tertiary hospitals in Shandong province, China, in 2020. The Center for Epidemiologic Studies Depression Scale (CESD-10), the Chinese version of the Maslach Burnout Inventory-General Survey and the Fear of Future Violence at Work Scale were used to collect data. Descriptive statistics, independent sample t-test, one-way analysis of variance, Pearson's correlation coefficient, and ordinary least squares regression with bootstrap resampling were used to analyze the data., Results: The prevalence of depressive symptoms was 45.9% among nurses. The regression model showed that FFWV and burnout mediated the relationship between WPV and depressive symptoms. The total effects of WPV on depressive symptoms (3.109, 95% bootstrap CI:2.324 - 3.713) could be decomposed into direct (2.250, 95% bootstrap CI:1.583 - 2.917) and indirect effects (0.769, 95% bootstrap CI:0.543 - 1.012). Indirect effects mediated by FFWV and burnout were 0.203 (95% bootstrap CI:0.090 - 0.348) and 0.443 (95% bootstrap CI:0.262 - 0.642), respectively. Furthermore, serial multiple mediation analyses indicated that the indirect effect mediated by FFWV and burnout in a sequential manner was 0.123 (95% bootstrap CI:0.070 - 0.189)., Conclusion: The prevalence of depressive symptoms among Chinese nurses was high. The WPV was an important risk factor for depressive symptoms and its negative effect was mediated by FFWV and burnout. The importance of decreasing WPV exposure and level of FFWV and burnout was emphasized to prevent depressive symptoms among nurses. The findings implied that hospital managers and health policy makers should not only develop targeted interventions to reduce exposure to WPV in daily work among all nurses, but also provide psychological support to nurses with WPV experience to reduce FFWV and burnout., (© 2024. The Author(s).)

Objective: Workplace violence is a prevalent phenomenon in hospital settings which critical care nurses are particularly exposed to. The aim of this study was to research abuse against Critical Care Nurses in five European countries, and its association with and impact on Healthy Work Environments., Methods: This was a multinational cross-sectional study. The 1,183 participants were nurses working in intensive care units from five European countries: Croatia, Cyprus, Poland, Spain, and Romania. The participants were selected by the convenience sampling method from 1 January 2021 to April 2022., Results: Of 1,033 critical care nurses who answered questions about abuse, 646 reported at least one incident in the previous year. The highest number of incidents came from patients (2,050), followed by another nurse (1,453) and physicians (1,039)., Conclusion: Although nurses in ICUs are aware that a healthy working environment benefits them in their daily work, most of them still face some form of abuse. Organizations must take a realistic approach to prevent abuse and to educate nurses and nurse managers by implementing standards for healthy work environments., Competing Interests: The authors declare that they do not have any conflicts of interest., (Copyright © 2024 Friganović, Slijepčević, Režić, Cristina Alfonso-Arias, Borzuchowska, Constantinescu-Dobra, Coțiu, Estel Curado-Santos, Dobrowolska, AGutysz-Wojnicka, Hadjibalassi, Laurado-Serra, Sabou and Georgiou.)

Background: Psycho-emotional violence, a type of workplace violence targeting healthcare workers, varies across countries, occasions, and professions in the healthcare sector. Unfortunately, there is a scarcity of comprehensive studies focusing on violence against healthcare workers in Ethiopia, which may also encompass psycho-gender-based emotional violence against healthcare workers. Therefore, there is a compelling need for in-depth research to address this gap and develop effective strategies to mitigate psycho-emotional violence in the healthcare sector in Ethiopia, especially in the eastern region. Hence, we aimed to identify the prevalence of and factors associated with workplace psycho-emotional violence against healthcare providers in eastern Ethiopia., Methods: This institution-based cross-sectional study was conducted among 744 health professionals working in urban public hospitals in eastern Ethiopia. Multistage stratified random sampling was used, and data were collected using a standardized structured tool adopted from the WHO workplace violence assessment tool. Binary and multivariable logistic regression analyses were employed to identify factors associated with psycho-emotional workplace violence. Adjusted odds ratio (OR) with 95% confidence interval (CI) was reported, and a p -value of 0.05 was used as the cut-off point to declare significance., Results: Workplace psycho-emotional violence was reported by 57.39% of the healthcare workers. The absence of guidelines for gender-based abuse [AOR = 35.62, 95% CI:17.47, 72.64], presence of measures that improve surroundings (class lighting and privacy) [AOR = 0.58, 95% CI: 0.35, 0.98], training on workplace violence coping mechanism [AOR = 0.16, 95%CI: 0.26, 0.98], spending more than 50% of their time with HIV/AIDS patients [AOR = 1.96, 95%CI:1.05, 3.72], and spending more than 50% of their time with psychiatric patients [AOR = 1.92, 95%CI:1.08, 3.43] were factors significantly associated with workplace violence against health professionals., Conclusion: The prevalence of workplace psycho-emotional violence against health professionals in eastern Ethiopia was relatively high. Improving the working environment decreases the chance of workplace violence; however, there is a lack of guidelines for gender-based violence, the absence of training on coping mechanisms, and spending more time with psychiatric and HIV/AIDS patients' increases workplace violence. We recommend that health institutions develop gender abuse mitigation guidelines and provide training on coping mechanisms., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Tolera, Weldesenbet, Regassa, Tusa, Merga, Tariku, Cheru, Enyew and Gemeda.)

Objectives: The objective of this review is to investigate the effectiveness of workplace violence management or prevention interventions, including strategies, protocols, and policies, to address violence against, and provide support to, registered nursing students (RNS) following incidents of violence during clinical placement., Introduction: Workplace violence is a global issue that affects victims' physical and mental health. RNS are especially vulnerable to workplace violence because of their limited work experience and confidence. These students often feel shocked and unprepared when experiencing workplace violence due to limited education and support provided by educational institutions or clinical sites. Workplace violence can lead to anxiety, decreased confidence, and professional attrition. There is a need to systematically synthesize the evidence on workplace violence management and prevention to support nursing students during clinical placement., Inclusion Criteria: The review will consider studies assessing the effectiveness of interventions to address workplace violence or improve support for RNS. Studies that report on educational interventions or pre-clinical placement strategies and measure the preparedness of students will also be considered. Study designs will be limited to quantitative methods that evaluate intervention effectiveness., Methods: Databases to be searched include MEDLINE (Ovid), CINAHL (EBSCOhost), Web of Science Core Collection, Scopus, Embase (Ovid), Cochrane Central, ERIC (ProQuest), ProQuest Central, ProQuest Social Science Premium Collection, and ProQuest Dissertations and Theses Global. Two independent reviewers will screen, review, appraise, and extract data from eligible articles. For data synthesis, studies will be pooled using JBI SUMARI. The GRADE approach for grading the certainty of evidence will be followed and a Summary of Findings will be created., Review Registration: PROSPERO CRD42022377318., Competing Interests: SH is a senior associate editor of JBI Evidence Synthesis but was not involved in the editorial process for this manuscript. The other authors declare no conflicts of interest., (Copyright © 2023 JBI.)

Background: Workplace violence, including violent, intimidating, and disruptive acts, commonly occurs in healthcare settings. Type 2 workplace violence in nursing refers to patient/visitor behaviors directed toward clinicians, contributing to physical and psychological harm. Nurse victims often do not report these events to employers or law enforcement, making it challenging to address workplace violence., Objectives: Our research examined nurse reactions to Type 2 workplace violence by identifying what behaviors they perceived as aggressive and reportable. Specific aims included: 1) developing and testing video vignettes to portray realistic patient aggression scenarios; 2) identifying nurse understandings of aggressive events that prompt affective reactions, and; 3) examining clinical characteristics related to the nurse victim's likelihood to report., Design: Through a sequential mixed-methods design, we qualitatively developed novel video vignettes portraying Type 2 workplace violence to experimentally examine how nurses interpreted them within a quantitative repeated measures survey., Methods: Two expert nurse research panels (n = 10) created five vignettes, from which nurses (n = 282) completed a survey with 1382 unique responses. Analyses included descriptive statistics and repeated measures ANOVA/regression models., Results: Video vignettes realistically portrayed workplace violence events, eliciting negative emotional responses among nurses that increased in magnitude with statistical significance as the level of displayed aggression escalated. Statistically significant factors influencing nurse reporting of workplace violence included; 1) the level of aggression displayed by the patient; 2) the level of harm received by the nurse; 3) whether the nurse felt the patient's actions were intentional, and; 4) the nurse's perceived frequency of exposure to workplace violence., Conclusions: Results suggested that nurse victims of Type 2 workplace violence experience depression, anger, fear, and anxiety, which may contribute to long-term mental health consequences. Findings also identified factors related to nurse reporting behaviors, which may help mitigate workplace violence in healthcare settings by informing research and promoting workplace practices that encourage reporting and safety., Registration: Not registered., Tweetable Abstract: Nurse reactions to workplace violence: Video vignettes reveal escalating aggression's impact on reporting. #EndNurseAbuse #WorkplaceViolence., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Objectives: This study aimed to assess the prevalence of workplace violence (WPV) against nurses in Oman's psychiatric hospitals and explore associated factors., Methods: This cross-sectional study was conducted between October and December 2021 and included all tertiary mental healthcare hospitals in Oman (Al Masarra Hospital and Sultan Qaboos University Hospital, Muscat, Oman). The participants completed a sociodemographic survey and a questionnaire on WPV in the health sector., Results: A total of 106 participants (response rate = 80.3%) were included in this study. Most were female (52.8%) and Omani (72.6%) and aged 30-39 years. WPV prevalence was high (90.6%), with verbal (86.8%) and physical violence (57.5%) being the most common types. WPV incidents were more frequent on weekdays (26.4%) and during morning shifts (34%), while 81.1% of the nurses worked in shifts and had direct physical contact with patients (83.0%). The majority (92.5%) were aware of standardised WPV reporting procedures and 89.7% confirmed the presence of such procedures in hospitals. WPV was more prevalent among nurses in inpatient wards ( P = 0.047)., Conclusion: WPV against nurses in Omani psychiatric hospitals is alarmingly high. Future studies should investigate contributing factors among healthcare providers and emphasise violence prevention by providing staff nurses with effective training to handle violent incidents involving psychiatric patients., Competing Interests: CONFLICTS OF INTEREST: The authors declare no conflict of interest., (© Copyright 2024, Sultan Qaboos University Medical Journal, All Rights Reserved.)

Purpose: The aim of this study was to provide the perceptions of nurses, nursing supervisors, and nursing administrators about factors contributing to increased workplace violence (WPV) against nurses within the healthcare settings in Pakistan during the first wave of the COVID-19 pandemic., Methods: This study used a Descriptive Qualitative design, with a purposive sampling technique. From September to December 2021, In-depth interviews of 45 to 60 minutes, using a semistructured interview guide, we collected data from a private and a public healthcare setting in Pakistan. Given the travel restrictions during the COVID-19 pandemic, these interviews were conducted online, using Zoom audio features. Bedside nurses, nursing supervisors, and nursing administrators with at least six months of work experience participated in this study., Results: The qualitative data analysis steps suggested by Braun and Clarke (2013) were used for thematic analysis. The overarching theme emerging from the data was "Factors perceived by nurses that contributed to increased WPV in their work settings during the first wave of COVID-19, in a lower middle-income country" The subthemes from the participants' narrations were (a) highly stressed patients, attendants, and healthcare workers; (b) the financial burden on patients and their families; (c) lack of resources and shortage of staff; (d) restricted visiting policy and a weak security system; (e) lack of awareness about the seriousness of COVID-19; (f) misconceptions about COVID-19 vaccines and nurses' role in disseminating awareness., Conclusions: The current pandemic increased the intensity of WPV against nurses in healthcare settings in Pakistan. Despite any supposed reasons for WPV, exposure to violence should never be an acceptable part of nursing. The healthcare system in Pakistan needs to pay equal attention to funding, resource provision, and ensuring a safe working environment for healthcare workers., Competing Interests: Conflict of interest The authors declare no conflicts of interest., (Copyright © 2024. Published by Elsevier B.V.)

Objective: To determine the prevalence, predictors and perpetrators of violence, and its impact on the mental health of female healthcare workers., Methods: The cross-sectional study was conducted from June to October 2022 at three tertiary care hospitals after approval from the ethics review board of Rawalpindi Medical University, Rawalpindi, Pakistan, and comprised female healthcare workers, including doctors, nurses and paramedical staff. Data was collected regarding workplace violence using a structured questionnaire adopted from literature. The incidence of verbal, physical and sexual violence in the preceding 12 months was noted, and predictors were analysed. Data was analysed using SPSS 25., Results: Of the 140 subjects with an age range of 16-60 years, verbal violence was experienced by 102(72.9%) and physical violence by 26(18.6%), while verbal and physical forms of sexual violence were reported by 33(23.6%) and 13(9.3%), respectively. Those in the Medicine department had significantly lower odds of experiencing verbal violence compared to those from the Surgery department (adjusted odds ratio=0.223; 95% confidence interval: 0.078-0.036; p=0.005). Those in the Emergency department had significantly greater odds of experiencing physical violence compared to those in Surgery (adjusted odds ratio=8.716; 95% confidence interval: 1.693-44.87; p=0.01). Violence had a significant detrimental impact on the mental health of female healthcare workers (p<0.05)., Conclusions: Violence was found to be prevalent in the healthcare sector, specifically in stressful and critical-care departments, like Emergency and Surgery.

Excessive workload of medical workers resulting from insufficient staffing and prolonged stress lead, among others, to burnout, which is a serious problem in the medical community. Research shows that the incidence of anxiety and stress disorders is increasing. For years, the social climate around medical staff in Poland has also been deteriorating. The media write more often about errors and omissions, and less about the daily work of medics. This leads to a decline in public confidence, as well as hate and acts of aggression. The occurrence of the phenomenon of violence against medical staff may be a factor in the development of many diseases associated with high levels of stress and should be of interest to occupational medicine services. The aim of the work is to describe the phenomenon of violence against health care workers and its impact on the working conditions and health of workers. The literature from 2010-2022 was reviewed in PubMed and Web of Science databases by entering the following entries: "violence", "aggression", "healthcare", "stress", "nurses", "doctors", "workplace". Eighty-three works on the occurrence of the phenomenon of violence against health care workers were qualified for the study. The results of the analysis indicate a shortage of studies on Polish medical entities. The phenomenon of violence against health care workers is a serious problem of public health in the world. The most common forms of workplace violence were verbal violence, physical assault, bullying, sexual harassment and racial harassment. Most often, the violence was committed by patients and their relatives, colleagues and superiors. Aggression towards medical staff is not a new phenomenon, and Poland as a country is not alone in dealing with this problem. Aggression and violence are most often observed in hospital departments, especially psychiatric departments, hospital emergency departments and emergency rooms. Patients and their families are most often regarded as the source of rude behavior. Crisis situations, such as the COVID-19 pandemic, have intensified the scale of the phenomenon. Managing a pandemic also requires establishing preventive procedures for aggression and violence. Additional factors hindering the work of medical personnel may lead to The shortage of studies on Polish medical entities indicates the need to conduct work aimed at determining the scale of the phenomenon and its causes, taking into account the division into organizational units as well as groups of patients and their relatives. Accurate determination of the scale of the phenomenon and predisposing factors will allow to take appropriate innovative preventive actions, which will contribute to limiting the negative consequences. Managers ofmedical entities should take steps to increase the number of reports. Violence has a negative impact on the mental health of medical staff and may cause irreversible physical and mental harm to those who experience it; therefore, it is very important to involve occupational health services in actions to solve the problem.

Background: Violence against nurses is common. Previous research has recommended further development of the measurement of violence against nurses and integration of the individual and ward-related factors that contribute to violence against hospital nurses. This study was designed to address these issues by investigating the associations between violence, the listening climate of hospital wards, professional burnout, and perceived quality of care. For this purpose, we used a new operationalization of the violence concept., Methods: We sought nurses to participate in the study through social media which yielded 765 nurses working in various healthcare systems across Israel who volunteered to complete a self-administered online questionnaire. 80% of the sample were hospital nurses, and 84.7% were female. The questionnaire included validated measures of burnout, listening climate, and quality of care. Instead of using the traditional binary measure of exposure to violence to capture the occurrence and comprehensive impact of violence, this study measured the incremental load of violence to which nurses are subjected., Results: There were significant correlations between violence load and perceived quality of care and between constructive and destructive listening climates and quality of care. Violence load contributed 14% to the variance of burnout and 13% to the variance of perceived quality of care. The ward listening climate moderated the relationship between burnout and quality of care., Conclusions: The results of this study highlight the impact of violence load among nurses and the ward listening climate on the development of burnout and on providing quality care. The findings call upon policymakers to monitor violence load and allocate resources to foster supportive work environments to enhance nurse well-being and improve patient care outcomes., (© 2024. The Author(s).)

The current study assessed the effects of workplace violence (WPV) and fear related to WPV on community mental health (CMH) workers' emotional distress. This cross-sectional study used structural equation modeling (SEM) and comprised participants who were CMH workers in Korea. We used WPV questionnaires and the Korean version of the Patient-Reported Outcomes Measurement Information System® item bank to evaluate emotional distress. SEM data from 763 workers revealed significant positive effects of WPV on anxiety (β = 0.23, p = 0.009) and anger (β = 0.26, p = 0.007), and significant positive effects of fear related to WPV on anxiety (β = 0.21, p = 0.004) and anger (β = 0.19, p = 0.002). Preventive measures significantly mediated the relationship between WPV and emotional distress and between fear related to WPV and emotional distress. Findings verified the relationship between WPV and workers' emotional distress and the mediating role of preventive measures. [ Journal of Psychosocial Nursing and Mental Health Services, 62 (4), 24-32.].

Objective: The objective of this review was to determine the effect of educational programs that have been implemented in acute health care settings to manage or prevent aggressive behaviors toward staff perpetrated by patients, families, or visitors., Introduction: Health care staff working within acute-level and tertiary-level hospitals are at high risk of exposure to aggressive behaviors by patients, their family, or visitors. Negative staff and organizational impacts reported in the literature include individual psychological or emotional distress and severe harm, increased absenteeism, high staff turnover, and awarded compensation. Reports of this kind of occupational violence are increasing globally; therefore, strategies to address prevention and management are needed to mitigate the risk of harm to staff and the wider hospital service. Various educational activities have been implemented to address the issue, but the overall effect of these is unclear., Inclusion Criteria: Experimental and quasi-experimental studies were considered for inclusion if they reported on an educational program or intervention for staff working within an acute hospital setting and aimed at managing or preventing occupational violence perpetrated by patients, family, or visitors. Reports of programs implemented to address occupational violence, whether verbal or physical, were included. Studies were excluded if they reported on upward violence or bullying, patients in psychiatric or dementia facilities, or pediatric patients, due to the specific care needs of these cohorts., Methods: The following databases were searched: PubMed (PubMed Central), CINAHL (EBSCOhost), PsycINFO (EBSCOhost), Embase, ERIC (ProQuest), Cochrane Central Register of Controlled Trials (Cochrane Library), and Scopus. ProQuest Dissertations and Theses was searched for unpublished studies. To obtain a wider perspective of the issue, studies published in Chinese were also searched in WanFang Database, China National Knowledge Infrastructure, and Chongqing VIP. A date filter of 2008-2023 was applied in a deliberate effort to expand from previous work. No language filters were applied. The review was conducted in accordance with JBI methodology for systematic reviews of effectiveness, and reported as per the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines., Results: The search process retrieved 4681 citations. A total of 32 studies representing 3246 health staff were included in the review. The studies were either before-and-after or pre-test/post-test study designs. Methodological quality of studies varied, with the main issues being absence of CIs within statistical analysis, limited detail on participant selection or attrition/non-response, and underreporting of confounding factors. Educational programs varied in content and duration. Content delivery across the studies also varied, with several didactic, role-play, debriefing, group work, and simulation exercises reported. While studies reported some improvement in self-reported confidence levels, results were mixed for other outcomes. Determining overall effect of included studies was challenging due to heterogeneity within and across studies with regard to intervention types, populations, measurement tools, and outcomes., Conclusions: This review is unable to determine which workplace educational programs had an effect on staff outcomes or on the number of occupational violence incidents. In the future, educators and researchers could use the findings of this review to guide the design of educational programs and employ measures that are comparable to their settings., Review Registration: PROSPERO CRD42020190538., Supplemental Digital Content: A Chinese-language version of the abstract of this review is available [ http://links.lww.com/SRX/A33 ]., Competing Interests: MAR is an associate editor of JBI Evidence Synthesis , but was not involved in the editorial processing of the manuscript. The other authors declare no conflict of interest., (Copyright © 2023 JBI.)

Objectives: Workplace violence (WPV) against healthcare workers (HCWs) has reached significant levels globally, impeding the quality and accessibility of healthcare systems. However, there is limited available knowledge regarding the determinants linked with WPV among HCWs and the discrepancies observed across various levels of hospitals in China. The objective of the present research was to investigate the factors linked to WPV and job satisfaction among HCWs in China., Methods: A self-developed questionnaire based on WeChat was employed to collect data. The questionnaire consisted of demographic information as well as occupational factors. To measure WPV, the Chinese version of the Workplace Violence Scale was utilized. Career satisfaction was assessed through two questions regarding career choices. The collected data was analyzed using descriptive analyses, chi-square tests, and multivariate logistic regressions., Results: A total of 3,781 valid questionnaires (1,029 doctors and 2,752 nurses) were collected. Among all participants, 2,201 (58.2%) reported experiencing at least one form of WPV in the past year, with emotional abuse being the most frequent occurrence (49.7%), followed by threats (27.9%). The multivariate logistic regression analysis revealed several risk factors associated with WPV, including male gender, shift work, senior professional title, bachelor's degree education, employment in secondary-level hospitals, and working over 50 h per week ( p  < 0.05). Career satisfaction among HCWs who experienced high levels of WPV was low, with only 11.2% remaining confident in their profession, and a mere 2.0% supporting their children pursuing careers in healthcare., Conclusion: WPV poses a significant challenge within the Chinese healthcare system. Efforts should be made to address the identified risk factors and promote a safe and satisfying working environment for HCWs., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Xiao, Chen, Zhu, Li and Zong.)

Workplace violence (WPV) exposure has been particularly prevalent in emergency nurses, coupled with negative mental health outcomes. Few explored resilience after WPV exposure using the perspective of positive mental health. We aimed to identify latent profiles of resilience and examine associations with flourishing in emergency nurses with WPV exposure. A total of 1241 Chinese emergency nurses were surveyed on the frequency of WPV exposure, resilience, and flourishing. Eight hundred and twenty five participants (90.1% female, 86.6% aged 20-39) reported WPV exposure at least once in the past 3 months. Latent profile analysis identified profiles of resilience as low resilience (15.0%), moderate decision respond and interpersonal link with low rational thought and flexible adaption (18.0%), moderate resilience (31.0%), high decision respond, interpersonal link, and rational thought with moderate flexible adaption (16.0%), and high resilience (20.0%). Higher flourishing was observed in profiles of moderate resilience, high decision respond, interpersonal link, and rational thought with moderate flexible adaption, and high resilience. We differentiated profiles of resilience and the associations with flourishing in emergency nurses with WPV exposure, which informed targeted interventions for promoting positive mental health., (© 2024 John Wiley & Sons Australia, Ltd.)

Introduction: During the Coronavirus (COVID-19) pandemic, healthcare providers have overcome difficult experiences such as workplace violence. Nurses are particularly vulnerable to workplace violence. The objective of this study was to characterize violence and aggression against nurses during the COVID-19 pandemic in Latin America., Methods: An electronic cross-sectional survey was conducted in 19 Latin American countries to characterize the frequency and type of violent actions against front-line healthcare providers., Results: Of the original 3544 respondents, 16% were nurses (n = 567). The mean age was 39.7 ± 9.0 years and 79.6% (n = 2821) were women. In total, 69.8% (n = 2474) worked in public hospitals and 81.1% (n = 2874) reported working regularly with COVID-19 patients. Overall, about 68.6% (n = 2431) of nurses experienced at least one episode of workplace aggression during the pandemic. Nurses experienced weekly aggressions more frequently than other healthcare providers (45.5% versus 38.1%, p < .007). Nurses showed a trend of lower reporting rates against the acts of aggression suffered (p = .076). In addition, nurses were more likely to experience negative cognitive symptoms after aggressive acts (33.4% versus 27.8%, p = .028). However, nurses reported considering changing their work tasks less frequently compared to other healthcare providers after an assault event (p = .005)., Conclusion: Workplace violence has been a frequent problem for all healthcare providers during COVID-19 pandemic in Latin America. Nurses were a particularly vulnerable subgroup, with higher rates of aggressions and cognitive symptoms and lower rate of complaints than other healthcare providers who suffered from workplace violence. It is imperative to develop strategies to protect this vulnerable group from aggressions during their tasks., (© 2023 John Wiley & Sons Ltd.)

Aims: The aims of the study were to determine the types and prevalence of forensic mental health nurse exposure to patient aggression and explore the impact of these exposures on their physical and mental health and work absences., Design: Cross-sectional survey conducted January to April 2020., Methods: All 205 nurses working in an Australian high-security inpatient forensic mental health hospital were invited to participate. An online survey included the Perception of Prevalence of Aggression Scale to measure respondent exposure to types of patient aggression, and the SF-36v2 to measure mental and physical health. Absence from work and other work and individual characteristics were also explored., Results: Sixty-eight respondents completed the survey. Verbal abuse was the most experienced aggression type, followed by physical violence and observing violence, patient self-harming behaviours and sexual violence. Nurses who worked in acute units experienced significantly more exposure to overall aggression than nurses in non-acute units. Higher level of aggression was associated with number of days sick leave taken and days off due to aggression or violence. Higher level of aggression was associated with poorer mental health, and patient self-harming behaviour was associated with poorer physical health., Conclusions: Nurses in acute units experience higher levels of inpatient aggression and are therefore at increased risk of being impacted by the exposure. Findings indicate a psychological impact of exposure to frequent aggression and potential for an accumulative effect of exposure to traumatic events on nurse well-being. Nurses who are victim of, or witness, physical violence are most likely to take time off work., Impact: This study provides further evidence that forensic mental health nurses are frequently exposed to various forms of patient aggression. For some nurses, this exposure to patient aggression negatively impacted their mental and physical health. Employing organizations should therefore prioritize provision of formal support for nurses. No patient or public contribution., (© 2023 The Authors. Journal of Advanced Nursing published by John Wiley & Sons Ltd.)