Occupational Medicine Advance Access originally published online on January 21, 2008
Occupational Medicine 2008 58(2):107-114; doi:10.1093/occmed/kqm142
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Violence risks in nursing—results from the European ‘NEXT’ Study
1 Service Central de Médecine du Travail Hôpitaux Hôtel Dieu AP-HP de Paris, Paris, France
2 Maastricht School of Management, Maastricht, the Netherlands
3 Open University of the Netherlands, Heerlen, the Netherlands
4 University of Twente, Enschede, the Netherlands
5 Department of Occupational Health, University of Milan, Milan, Italy
6 Fondazione IRCCS Ospedale Maggiore Policlinico, Mangiagalli e Regina Elena, Milan, Italy
7 Department of Safety Engineering, University of Wüppertal, Wüppertal, Germany
Background Recent research suggests that violence in health care is increasing and that it strongly influences the recruitment and retention of nurses as well as sick leave and burnout levels.
Aims To identify the prevalence of violence in nursing and to provide a basis for appropriate interventions.
Methods Nurses from 10 European countries answered to a questionnaire and to a follow-up assessment. Stepwise adjusted multiple logistic regression was used to assess the association between frequency of violence, factors related to teamwork and other work-related factors and outcomes, such as burnout, intention to leave nursing and intention to change institution.
Results A total of 39 894 nurses responded to the baseline questionnaire (51% response rate). After adjustment for age, gender and other risk factors, quality of teamwork appeared to be a major factor with odds ratio (OR) 1.35 (1.24–1.48) for medium quality and 1.52 (1.33–1.74) for low quality. Uncertainty regarding patients‘ treatments was linked with violence, with a clear gradient (OR 1.59, 1.47–1.72 for medium uncertainty and 2.13, 1.88–2.41 for high uncertainty). Working only night shift was at high risk (OR 2.17, 1.76–2.67). High levels of time pressure and physical load were associated with violence OR 1.45 (1.24–1.69) and 1.84 (1.66–2.04), respectively. High and medium frequency of violence was associated with higher levels of burnout, intent to leave nursing and intent to change institution. A 1-year follow-up assessment indicated stability in the relationships between outcomes.
Conclusion This study supports efforts aimed at improving teamwork-related factors as they are associated with a decrease in violence against nurses.
Keywords Burnout; Europe; health care workers; social support; teamwork; turnover; violence
Correspondence to: Madeleine Estryn-Behar, Service Central de Médecine du Travail, Hôpital Hôtel-Dieu, Parvis Notre Dame, 75004 Paris, France. Tel:+33 1 42 34 88 17; Fax:+33 1 42 34 85 20; e-mail: madeleine.estryn-behar{at}sap.aphp-paris.fr