An Integrative Review of Factors Contributing to Workplace Violence Against Nurses in Thai Emergency Departments

J Emerg Nurs. 2025 May 22:S0099-1767(25)00137-0. doi: 10.1016/j.jen.2025.04.007. Online ahead of print.

ABSTRACT

INTRODUCTION: Workplace violence in health care settings, especially in emergency departments, is a significant concern worldwide. Both physical and psychological violence affect emergency nurses as frontliners. This integrative review aimed to synthesize the literature on the factors contributing to workplace violence in Thai emergency departments.

METHODS: This study was conducted using Whittemore and Knafl’s framework. A search strategy used 7 databases, including PubMed, CINAHL, ERIC, PsycINFO, MEDLINE, Google Scholar, and ThaiJo, covering articles from 2014 to 2024. Eleven studies were included in the final review. Data were extracted into individual, patient, environmental, organizational, and Thai cultural factors.

RESULTS: The results suggested that nurses with less than 10 years of experience had a high risk of workplace violence. Patient-related factors, such as substance abuse and mental health conditions such as schizophrenia, bipolar disorder, and severe depression, were significant contributors to violence. Environmental factors such as overcrowding, understaffing, and a lack of security measures exacerbated the risk. Organizational issues, such as insufficient procedures and reporting systems, increased the violence, given that the lack of reporting mechanisms allowed violence to go unaddressed, worsening workplace safety. Cultural factors in Thailand, such as a lack of understanding of patient screening severity, contribute to the complexity of workplace violence.

DISCUSSION: Addressing workplace violence in Thai emergency departments requires a multifaceted approach, including policy reforms, staff training, improved security, and cultural sensitivity. Effective interventions can lead to safer working environments for nurses and improved patient care.

PMID:40407769 | DOI:10.1016/j.jen.2025.04.007