The frequency of patient-initiated violence and its psychological impact on physicians in China: A cross-sectional study

Jianwei Shi, Sheng Wang, Ping Zhou, Leiyu Shi, Yu Zhang, Fei Bai, Di Xue, Xinkai Zhang

Research output: Contribution to journalArticlepeer-review


Introduction: In China, the severity of medical disputes has greatly increased during the past two decades, which has caused various adverse outcomes for health professionals. Previous research on violence in healthcare settings has primarily examined the occurrence of patient-initiated violence and its effects on physicians, but few studies have focused on the impact of the extent of physicians' exposure to violence. This study examined the different frequency levels of specific types of violence and their relationships to physicians' psychological wellbeing, including emotional exhaustion (EE), job satisfaction (JS), and intention to leave (IL). Methods: Using a stratified random sampling method, the participants were drawn from 123 public hospitals in Shanghai, Hubei Province, and Gansu Province in China, and 1,656 completed questionnaires were collected. Chi-square test, analysis of variance, and mixed linear model were employed in the analysis. Results: The results showed that the rate of exposure to verbal abuse (VA) was the highest (92.75%), followed by threats of assault (TA, 88.10%) and physical assaults (PA, 81.04%). Physicians' reported high-frequency exposure to VA, TA, and PA was 35.14%, 27.72%, and 19.32%, respectively. The results indicated that exposure to violence significantly affected EE, JS, and IL, and the intensity of the harm of high-frequency exposure was several times stronger than that of low-frequency exposure. Interestingly, we found that VA produced a greater adverse impact on physicians' EE and satisfaction with work (JS-1) than did TA or PA. This finding may be attributed to the fact that physicians are more likely to be exposed to a high frequency of VA, and the effect of high-frequency exposure is much stronger. Conclusion: The results indicated that decreasing violent incidents and creating a safer work environment for physicians should be a top priority for both government and society.

Original languageEnglish (US)
Article numbere0128394
JournalPloS one
Issue number6
StatePublished - Jun 1 2015

ASJC Scopus subject areas

  • General


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