Research on the characteristics and influencing factors of workplace violence in a specialized hospital and its affiliated medical consortium members

04/12/2025

Zhonghua Lao Dong Wei Sheng Zhi Ye Bing Za Zhi. 2025 Nov 20;43(11):818-824. doi: 10.3760/cma.j.cn121094-20241011-00464.

ABSTRACT

Objective: To investigate the characteristics, influencing factors, consequences, coping strategies, and preventive measures of workplace violence in medical consortiums. Methods: Medical professionals from a specialized hospital in South China and its consortium members (2 primary-level, 1 secondary-level, and 1 tertiary-level hospitals) were surveyed in December 2022 and July 2023. Quantitative research included 1013 participants, while qualitative research involved 35 participants. Workplace violence was assessed using the “National Case Study Tool for Workplace Violence in Healthcare Institutions-Survey Questionnaire”, with qualitative analysis conducted through semi-structured interviews. Inter-group comparisons employed chi-square tests or Fisher’s exact probability test, with logistic regression models for bivariate analysis. Results: The overall incidence rates of violence, psychological violence, and physical violence in this medical consortium were 31.7% (321/1, 013) , 30.6% (310/1, 013) , and 3.3% (33/1, 013) , respectively. Specifically, the overall violence rates in Level 1, Level 2, and Level 3 hospitals were 22.7% (41/181) , 27.4% (43/157) , and 35.1% (237/675) . The physical violence rates were 1.1% (2/181) , 10.2% (16/157) , and 2.2% (15/675) , respectively. The psychological violence rates stood at 22.7% (41/181) , 24.8% (39/157) , and 34.1% (230/675) . The total violence in tertiary hospitals was significantly higher than that in tertiary hospitals (F=10.10, P=0.002) , and the incidence of psychological violence in tertiary hospitals was significantly higher than that in tertiary hospitals (F(level 1 vs level 3)=8.61, P=0.003; F(level 2 vs level 3)=4.96, P=0.026) , incidence of verbal insults (F(level 1 vs level 3)=8.25, P=0.004; F(level 2 vs level 3)=6.36, P= 0.012) was significantly higher than that of level 1 and level 2 hospitals. The incidence of physical violence in secondary hospitals was significantly higher than that of other two-level hospitals (P<0.001) . Compared with other types of violence, the incidence of verbal insults is highest in hospitals at all levels. Higher anxiety about violence was a risk factor for psychological violence in hospitals at all levels (F(level1 hospital)=15.44, P=0.004; F(level2 hospital)=22.87, P<0.001; F(level3 hospital)=84.12, P<0.001) . Health workers in all three levels of hospitals has a high level of approval of existing workplace violence interventions. The main causes of workplace violence were poor communication between doctors and patients (13.2%) , service attitude problems (12.5%) and patient illness (16.9%) . Conclusion: Workplace violence remains prevalent within this medical consortium. Targeted measures should be implemented based on hospital size, functions, and patient demographics.