Workplace violence and its aftermath in China’s health sector: implications from a cross-sectional survey across three tiers of the health system

Objectives To determine the prevalence of physical violence and threats against health workers and the aftermath in tertiary, secondary and primary care facilities in China.Design A cross-sectional questionnaire study.Setting 5 tertiary hospitals, 8 secondary hospitals and 32 primary care facilities...

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Main Authors: Dan Wu, Lu Li, Kai Sing Sun, Sheng Zhi Yang, Nan Wang, Therese Hesketh
Format: Article
Language:English
Published: BMJ Publishing Group 2019-09-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/9/9/e031513.full
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author Dan Wu
Lu Li
Kai Sing Sun
Sheng Zhi Yang
Nan Wang
Therese Hesketh
author_facet Dan Wu
Lu Li
Kai Sing Sun
Sheng Zhi Yang
Nan Wang
Therese Hesketh
author_sort Dan Wu
collection DOAJ
description Objectives To determine the prevalence of physical violence and threats against health workers and the aftermath in tertiary, secondary and primary care facilities in China.Design A cross-sectional questionnaire study.Setting 5 tertiary hospitals, 8 secondary hospitals and 32 primary care facilities located in both urban and rural areas of Zhejiang Province, China, were chosen as the study sites.Participants A total of 4862 health workers who have contact with patients completed a survey from July 2016 to July 2017.Outcome measures The prevalence of physical violence, threats and Yi Nao, specific forms of physical violence and their aftermath were measured by a self-designed and verified questionnaire. Multivariable logistic regression models were used to examine the association between perceived organisational encouragement of reporting workplace violence (WPV) and physical violence, threats and Yi Nao after controlling for age, sex, level of facility, professional ranking and type of health worker.Results Among all respondents, 224 (4.6%) were physically attacked and 848 (17.4%) experienced threats in the past year. Respondents in secondary hospitals were more likely to experience physical violence (AOR=3.29, 95% CI 2.21 to 4.89), threats (AOR=1.61, 95% CI 1.32 to 1.98) and Yi Nao (AOR=2.47, 95% CI 2.10 to 2.91), compared with primary care providers. Lack of organisational policies to report WPV was associated with higher likelihood of physical violence (AOR=3.64, 95% CI 2.57 to 5.18) and threats (AOR=2.21, 95% CI 1.76 to 2.78). Among physical violence cases, only 29.1% reported the attack to police mainly because most felt it useless to do so (58.8%). Only 25.7% were investigated and 72.4% of attackers received no punishment. Of all those attacked or threatened, 59.4% wanted to quit current post and 76.0% were fearful of dealing with urgent or severe cases.Conclusions Proper management of the aftermath of violence against health workers is inadequate. Formal guidelines for reporting and managing WPV are urgently needed.
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spelling doaj-art-11bb1f85d24c4990bee82f85f6a31eef2025-08-20T02:49:05ZengBMJ Publishing GroupBMJ Open2044-60552019-09-019910.1136/bmjopen-2019-031513Workplace violence and its aftermath in China’s health sector: implications from a cross-sectional survey across three tiers of the health systemDan Wu0Lu Li1Kai Sing Sun2Sheng Zhi Yang3Nan Wang4Therese Hesketh53 Department of Clinical Research, London School of Hygiene & Tropical Medicine, London, UK1 Shanghai Ji Ai Genetics and IVF Institute, Obstetrics and Gynecology Hospital, Fudan University, Shanghai, ChinaCentre for Health Systems and Policy Research, The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China1 Institute for Social and Family Medicine, School of Medicine, Zhejiang University, Hangzhou, ChinaWenzhou Collaborative Innovation Center of Gastrointestinal Cancer in Basic Research and Precision Medicine, Wenzhou Key Laboratory of Cancer-related Pathogens and Immunity, Department of Microbiology and Immunology, Institute of Molecular Virology and Immunology, Institute of Tropical Medicine, School of Basic Medical Sciences, Wenzhou Medical University, Wenzhou, Zhejiang, Chinaprofessor of global health, Centre for International Health and Development, University College LondonObjectives To determine the prevalence of physical violence and threats against health workers and the aftermath in tertiary, secondary and primary care facilities in China.Design A cross-sectional questionnaire study.Setting 5 tertiary hospitals, 8 secondary hospitals and 32 primary care facilities located in both urban and rural areas of Zhejiang Province, China, were chosen as the study sites.Participants A total of 4862 health workers who have contact with patients completed a survey from July 2016 to July 2017.Outcome measures The prevalence of physical violence, threats and Yi Nao, specific forms of physical violence and their aftermath were measured by a self-designed and verified questionnaire. Multivariable logistic regression models were used to examine the association between perceived organisational encouragement of reporting workplace violence (WPV) and physical violence, threats and Yi Nao after controlling for age, sex, level of facility, professional ranking and type of health worker.Results Among all respondents, 224 (4.6%) were physically attacked and 848 (17.4%) experienced threats in the past year. Respondents in secondary hospitals were more likely to experience physical violence (AOR=3.29, 95% CI 2.21 to 4.89), threats (AOR=1.61, 95% CI 1.32 to 1.98) and Yi Nao (AOR=2.47, 95% CI 2.10 to 2.91), compared with primary care providers. Lack of organisational policies to report WPV was associated with higher likelihood of physical violence (AOR=3.64, 95% CI 2.57 to 5.18) and threats (AOR=2.21, 95% CI 1.76 to 2.78). Among physical violence cases, only 29.1% reported the attack to police mainly because most felt it useless to do so (58.8%). Only 25.7% were investigated and 72.4% of attackers received no punishment. Of all those attacked or threatened, 59.4% wanted to quit current post and 76.0% were fearful of dealing with urgent or severe cases.Conclusions Proper management of the aftermath of violence against health workers is inadequate. Formal guidelines for reporting and managing WPV are urgently needed.https://bmjopen.bmj.com/content/9/9/e031513.full
spellingShingle Dan Wu
Lu Li
Kai Sing Sun
Sheng Zhi Yang
Nan Wang
Therese Hesketh
Workplace violence and its aftermath in China’s health sector: implications from a cross-sectional survey across three tiers of the health system
BMJ Open
title Workplace violence and its aftermath in China’s health sector: implications from a cross-sectional survey across three tiers of the health system
title_full Workplace violence and its aftermath in China’s health sector: implications from a cross-sectional survey across three tiers of the health system
title_fullStr Workplace violence and its aftermath in China’s health sector: implications from a cross-sectional survey across three tiers of the health system
title_full_unstemmed Workplace violence and its aftermath in China’s health sector: implications from a cross-sectional survey across three tiers of the health system
title_short Workplace violence and its aftermath in China’s health sector: implications from a cross-sectional survey across three tiers of the health system
title_sort workplace violence and its aftermath in china s health sector implications from a cross sectional survey across three tiers of the health system
url https://bmjopen.bmj.com/content/9/9/e031513.full
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