Health care personnel and workplace violence in the emergency departments of a volatile metropolis: Results from Karachi, Pakistan

Waleed Zafar, Emaduddin Siddiqui, Kiran Ejaz, Muhammad Umer Shehzad, Uzma Rahim Khan, Seemin Jamali, Junaid Razzak

Research output: Contribution to journalArticle

Abstract

Background Workplace violence (WPV) is an important challenge faced by health care personnel in the emergency department (ED). Study Objectives To determine the prevalence and nature of WPV reported by physicians and nurses working in the EDs of four of the largest tertiary care hospitals in Karachi, Pakistan and to understand the mental health impact of experiencing WPV. Methods This cross-sectional survey was conducted between September and November 2008 using a widely used questionnaire developed by the World Health Organization. Overall, 266 (86% response rate) questionnaires were included in this study. Results A total of 44 (16.5%) physicians and nurses said they had been physically attacked, and 193 (72.5%) said that they had experienced verbal abuse in the last 12 months. Among those who reported physical attack, 29.6% reported that the last incident involved a weapon, and in 64% of cases the attacker was a patient's relative. Eighty-six percent thought that the last attack could have been prevented, and 64% said that no action was taken against the attacker. After adjusting for covariates, physicians were less likely than nurses to report physical attack (odds ratio [OR] 0.46; 95% confidence interval [CI] 0.2-1.0), and personnel with greater work experience (OR 4.8; 95% CI 2.0-11.7) and those who said that there were procedures to report WPV in their workplace (OR 3.2; 95% CI 1.6-6.5) were more likely to report verbal abuse. WPV was associated with mental health effects in the form of bothersome memories, super-alertness, and feelings of avoidance and futility. Conclusion WPV is an important challenge in the EDs of large hospitals in Karachi. A majority of respondents feel that WPV is preventable, but only a minority of attackers face consequences.

Original languageEnglish (US)
Pages (from-to)761-772
Number of pages12
JournalJournal of Emergency Medicine
Volume45
Issue number5
DOIs
StatePublished - Nov 2013
Externally publishedYes

Fingerprint

Workplace Violence
Pakistan
Health Personnel
Hospital Emergency Service
Delivery of Health Care
Odds Ratio
Nurses
Confidence Intervals
Physicians
Mental Health
Medical Futility
Weapons
Tertiary Healthcare
Tertiary Care Centers
Workplace
Emotions
Cross-Sectional Studies

Keywords

  • emergency department
  • Karachi
  • mental health
  • Pakistan
  • workplace violence

ASJC Scopus subject areas

  • Emergency Medicine

Cite this

Health care personnel and workplace violence in the emergency departments of a volatile metropolis : Results from Karachi, Pakistan. / Zafar, Waleed; Siddiqui, Emaduddin; Ejaz, Kiran; Shehzad, Muhammad Umer; Khan, Uzma Rahim; Jamali, Seemin; Razzak, Junaid.

In: Journal of Emergency Medicine, Vol. 45, No. 5, 11.2013, p. 761-772.

Research output: Contribution to journalArticle

Zafar, Waleed ; Siddiqui, Emaduddin ; Ejaz, Kiran ; Shehzad, Muhammad Umer ; Khan, Uzma Rahim ; Jamali, Seemin ; Razzak, Junaid. / Health care personnel and workplace violence in the emergency departments of a volatile metropolis : Results from Karachi, Pakistan. In: Journal of Emergency Medicine. 2013 ; Vol. 45, No. 5. pp. 761-772.
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abstract = "Background Workplace violence (WPV) is an important challenge faced by health care personnel in the emergency department (ED). Study Objectives To determine the prevalence and nature of WPV reported by physicians and nurses working in the EDs of four of the largest tertiary care hospitals in Karachi, Pakistan and to understand the mental health impact of experiencing WPV. Methods This cross-sectional survey was conducted between September and November 2008 using a widely used questionnaire developed by the World Health Organization. Overall, 266 (86{\%} response rate) questionnaires were included in this study. Results A total of 44 (16.5{\%}) physicians and nurses said they had been physically attacked, and 193 (72.5{\%}) said that they had experienced verbal abuse in the last 12 months. Among those who reported physical attack, 29.6{\%} reported that the last incident involved a weapon, and in 64{\%} of cases the attacker was a patient's relative. Eighty-six percent thought that the last attack could have been prevented, and 64{\%} said that no action was taken against the attacker. After adjusting for covariates, physicians were less likely than nurses to report physical attack (odds ratio [OR] 0.46; 95{\%} confidence interval [CI] 0.2-1.0), and personnel with greater work experience (OR 4.8; 95{\%} CI 2.0-11.7) and those who said that there were procedures to report WPV in their workplace (OR 3.2; 95{\%} CI 1.6-6.5) were more likely to report verbal abuse. WPV was associated with mental health effects in the form of bothersome memories, super-alertness, and feelings of avoidance and futility. Conclusion WPV is an important challenge in the EDs of large hospitals in Karachi. A majority of respondents feel that WPV is preventable, but only a minority of attackers face consequences.",
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AU - Khan, Uzma Rahim

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N2 - Background Workplace violence (WPV) is an important challenge faced by health care personnel in the emergency department (ED). Study Objectives To determine the prevalence and nature of WPV reported by physicians and nurses working in the EDs of four of the largest tertiary care hospitals in Karachi, Pakistan and to understand the mental health impact of experiencing WPV. Methods This cross-sectional survey was conducted between September and November 2008 using a widely used questionnaire developed by the World Health Organization. Overall, 266 (86% response rate) questionnaires were included in this study. Results A total of 44 (16.5%) physicians and nurses said they had been physically attacked, and 193 (72.5%) said that they had experienced verbal abuse in the last 12 months. Among those who reported physical attack, 29.6% reported that the last incident involved a weapon, and in 64% of cases the attacker was a patient's relative. Eighty-six percent thought that the last attack could have been prevented, and 64% said that no action was taken against the attacker. After adjusting for covariates, physicians were less likely than nurses to report physical attack (odds ratio [OR] 0.46; 95% confidence interval [CI] 0.2-1.0), and personnel with greater work experience (OR 4.8; 95% CI 2.0-11.7) and those who said that there were procedures to report WPV in their workplace (OR 3.2; 95% CI 1.6-6.5) were more likely to report verbal abuse. WPV was associated with mental health effects in the form of bothersome memories, super-alertness, and feelings of avoidance and futility. Conclusion WPV is an important challenge in the EDs of large hospitals in Karachi. A majority of respondents feel that WPV is preventable, but only a minority of attackers face consequences.

AB - Background Workplace violence (WPV) is an important challenge faced by health care personnel in the emergency department (ED). Study Objectives To determine the prevalence and nature of WPV reported by physicians and nurses working in the EDs of four of the largest tertiary care hospitals in Karachi, Pakistan and to understand the mental health impact of experiencing WPV. Methods This cross-sectional survey was conducted between September and November 2008 using a widely used questionnaire developed by the World Health Organization. Overall, 266 (86% response rate) questionnaires were included in this study. Results A total of 44 (16.5%) physicians and nurses said they had been physically attacked, and 193 (72.5%) said that they had experienced verbal abuse in the last 12 months. Among those who reported physical attack, 29.6% reported that the last incident involved a weapon, and in 64% of cases the attacker was a patient's relative. Eighty-six percent thought that the last attack could have been prevented, and 64% said that no action was taken against the attacker. After adjusting for covariates, physicians were less likely than nurses to report physical attack (odds ratio [OR] 0.46; 95% confidence interval [CI] 0.2-1.0), and personnel with greater work experience (OR 4.8; 95% CI 2.0-11.7) and those who said that there were procedures to report WPV in their workplace (OR 3.2; 95% CI 1.6-6.5) were more likely to report verbal abuse. WPV was associated with mental health effects in the form of bothersome memories, super-alertness, and feelings of avoidance and futility. Conclusion WPV is an important challenge in the EDs of large hospitals in Karachi. A majority of respondents feel that WPV is preventable, but only a minority of attackers face consequences.

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