Workplace Violence in Tertiary Hospitals: Unraveling Its Detrimental Effects on Healthcare Workers’ Job Engagement
Main Article Content
Keywords
workplace violence, Healthcare Worker, Safety, Commitment, Management
Abstract
Background: Workplace (WPW) violence is a significant issue among healthcare workers (HCWs) in hospitals and negatively impacts the healthcare workforce. WPW can have more severe consequences, especially in tertiary hospitals with a concentrated, specialised workforce. In this regard, the study aimed to identify the dynamics of workplace violence exposure among HCWs in a tertiary hospital. It also investigated its impact on job engagement. Methods: The study was designed as a descriptive cross-sectional study conducted between June and September 2023. The study involved 3,526 HCWs at a tertiary hospital in Turkey, all invited, with 390 participating. The study examined healthcare workers' ability to handle WPV. It also examined their exposure to violence, their perception of safety against violence at work, and their engagement in their jobs. Results: Exposure to WPV among HCWs included in the study significantly predicts job engagement, with a negative relationship (β: -0.473). Additionally, as HCWs' skills in managing WPV increase, job engagement also increases (β: -0.279). Among younger and less experienced HCWs, WPV exposure and job engagement scores were significantly lower (p<0.05). Conclusions: WPV, common among health workers, is an essential factor that reduces work engagement. Identifying and controlling the dynamics of WPV is critical to enhancing job engagement among healthcare workers and preventing related adverse outcomes.
References
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29. Calvo JM, Kwatra J, Yansane A, Tokede O, Gorter RC, Kalenderian E. Burnout and work engagement among US dentists. J Patient Saf. 2021;17(5):398-404.
30. Channa S, Khan S, Tunio ZH, Jhatiyal RA, Tunio IA, Umrani KB. Workplace Bullying and Harassment among Health Care Professionals. Age (Years). 2021;20(25):24.
31. Appel-Meulenbroek R, van der Voordt T, Aussems R, Arentze T, Le Blanc P. Impact of activity-based work-places on burnout and engagement dimensions. Journal of Corporate Real Estate. 2020;22(4):279-296.
32. Bakker AB, Demerouti E, Sanz-Vergel AI. Burnout and work engagement: The JD–R approach. Annu Rev Or-gan Psychol Organ Behav. 2014;1(1):389-411.
33. Barab J. Workplace Violence: The Hidden Epidemic Plaguing Health Care Workers. Published online 2022.
34. Magnavita N, Angelillo A, Anniballi A, et al. Workplace violence, early neurological symptoms, and metabolic or psychiatric disorders. Eur J Public Health. 2020;30(Supplement_5):ckaa165-660.
35. Wolf L, Perhats C, Delao A, et al. Violence and its impact on the emergency nurse. J Emerg Nurs. 2020;46(3):354-358.
36. Vento S, Cainelli F, Vallone A. Violence against healthcare workers: a worldwide phenomenon with serious consequences. Front Public Health. 2020;8:570459.
37. Bellman V, Thai D, Chinthalapally A, Russell N, Saleem S. Inpatient violence in a psychiatric hospital in the middle of the pandemic: clinical and community health aspects. AIMS Public Health. 2022;9(2):342.
38. Nithimathachoke A, Wichiennopparat W. High incidence of workplace violence in metropolitan emergency departments of Thailand; a cross sectional study. Arch Acad Emerg Med. 2021;9(1).
39. Al Anazi RB, AlQahtani SM, Mohamad AE, Hammad SM, Khleif H. Violence against health-care workers in governmental health facilities in Arar City, Saudi Arabia. The Scientific World Journal. 2020;2020.
40. Liu J, Zheng J, Liu K, et al. Workplace violence against nurses, job satisfaction, burnout, and patient safety in Chinese hospitals. Nurs Outlook. 2019;67(5):558-566.
41. Tonso MA, Prematunga RK, Norris SJ, Williams L, Sands N, Elsom SJ. Workplace violence in mental health: A Victorian mental health workforce survey. Int J Ment Health Nurs. 2016;25(5):444-451.
42. Li YL, Li RQ, Qiu D, Xiao SY. Prevalence of workplace physical violence against health care professionals by patients and visitors: a systematic review and meta-analysis. Int J Environ Res Public Health. 2020;17(1):299.
43. d’Ettorre G, Mazzotta M, Pellicani V, Vullo A. Preventing and managing workplace violence against healthcare workers in Emergency Departments. Acta Bio Medica: Atenei Parmensis. 2018;89(Suppl 4):28.
44. Ferrinho P, Patrício SR, Craveiro I, Sidat M. Is workplace violence against health care workers in Mozambique gender related? Int J Health Plann Manage. 2023;38(1):265-269.
45. Kouloumberis P. Navigating a Traditionally Male-Dominated Specialty as a Woman. Burnout in Women Phy-sicians: Prevention, Treatment, and Management. Published online 2020:277-302.
46. Dimitriu MCT, Pantea-Stoian A, Smaranda AC, et al. Burnout syndrome in Romanian medical residents in time of the COVID-19 pandemic. Med Hypotheses. 2020;144:109972.
47. Zadow AJ, Dollard MF, Dormann C, Landsbergis P. Predicting new major depression symptoms from long working hours, psychosocial safety climate and work engagement: A population-based cohort study. BMJ Open. 2021;11(6):e044133.
48. Beştaş İ. Doktor İstifaları ve Yurt Dışı Göçü (2020-2022) Medya Yansımaları. Sosyal Bilimlere Çok Yönlü Yaklaşımlar: Tarih, Turizm, Eğitim, Ekonomi, Siyaset ve İletişim. Published online 2023:213.
49. Şen Olgay S, Yurt S. Determination of the Reasons for Migration and Life Satisfaction of Health Workers Who Migrated from Turkey to United Kingdom. Sağlık ve Hemşirelik Yönetimi Dergisi. 2023;10(1):99-107. doi:10.54304/shyd.2023.60565
50. Pasquarella FJ, Lizano EL, Lee S, De La Peza D. An examination of work engagement’s antecedents and con-sequences in a sample of US community mental health providers. Health Soc Care Community. 2022;30(5):e2318-e2329.
2. The National Institute for Occupational Safety and Health (NIOSH). Healthcare Workers and Work Stress.Available online at: https://www.cdc.gov/niosh/topics/healthcare/workstress.html (Accessed Sep-tember 10, 2023).
3. World Health Organization. (2002). First ever global report on violence and health released. Retrieved Sep-tember. 15:2008.
4. Sari H, Yildiz İ, Çağla Baloğlu S, Özel M, Tekalp R. The frequency of workplace violence against healthcare workers and affecting factors. PLoS One. 2023;18(7):e0289363.
5. Converso D, Sottimano I, Balducci C. Violence exposure and burnout in healthcare sector: mediating role of work ability. Med Lav. 2021;112(1):58.
6. Mento C, Silvestri MC, Bruno A, et al. Workplace violence against healthcare professionals: A systematic re-view. Aggress Violent Behav. 2020;51:101381.
7. Havaei F, MacPhee M. Effect of workplace violence and psychological stress responses on medical-surgical nurses’ medication intake. Canadian journal of nursing research. 2021;53(2):134-144.
8. Shahjalal M, Parvez Mosharaf M, Mahumud RA. Effect of workplace violence on health workers injuries and workplace absenteeism in Bangladesh. Glob Health Res Policy. 2023;8(1):33.
9. Pérez-Fuentes M del C, Gázquez JJ, Molero M del M, Oropesa NF, Martos Á. La violencia y la satisfacción labo-ral de los profesionales de enfermería: importancia de la red de apoyo en el ámbito sanitario. The European Journal of Psychology Applied to Legal Context. 2021;13(1):21-28.
10. Szilvassy P, Širok K. Importance of work engagement in primary healthcare. BMC Health Serv Res. 2022;22(1):1044.
11. Kartal N. Evaluating the relationship between work engagement, work alienation and work performance of healthcare professionals. Int J Healthc Manag. 2018;11(3):251-259.
12. Lymberakaki V, Sarafis P, Malliarou M. Communication, work engagement and caring provision differences between nurses and physicians. Int J Caring Sci. 2021;14(1):100.
13. Jung FU, Bodendieck E, Bleckwenn M, Hussenoeder FS, Luppa M, Riedel-Heller SG. Burnout, work engage-ment and work hours–how physicians’ decision to work less is associated with work-related factors. BMC Health Serv Res. 2023;23(1):1-8.
14. Tullar JM, Amick BC, Brewer S, Diamond PM, Kelder SH, Mikhail O. Improve employee engagement to retain your workforce. Health Care Manage Rev. 2016;41(4):316-324.
15. Yasmin R, Mubarak N. The Relationship between Workplace Violence and Turnover Intention with a Medi-ating Role of Work Engagement and Job Satisfaction. Jinnah Business Review. 2021;9(2):112-124. Doi: 10.53369/ZYOY5815
16. Navarro-Abal Y, Climent-Rodríguez JA, Vaca-Acosta RM, Fagundo-Rivera J, Gómez-Salgado J, García-Iglesias JJ. Workplace Violence: Impact on the Commitment and Involvement of Nurses at Work. J Nurs Manag. 2023;2023:1-8. Doi:10.1155/2023/9987092
17. Hu H, Gong H, Ma D, Wu X. Association between workplace psychological violence and work engagement among emergency nurses: The mediating effect of organizational climate. PLoS One. 2022;17(6):e0268939. Doi: 10.1371/journal.pone.0268939
18. Saleem Z, Shenbei Z, Hanif AM. Workplace Violence and Employee Engagement: The Mediating Role of Work Environment and Organizational Culture. Sage Open. 2020;10(2). Doi: 10.1177/2158244020935885
19. Cao Y, Gao L, Fan L, et al. Effects of verbal violence on job satisfaction, work engagement and the mediating role of emotional exhaustion among healthcare workers: a cross-sectional survey conducted in Chinese ter-tiary public hospitals. BMJ Open. 2023;13(3).
20. Koranne R, Williams ES, Poplau S, et al. Reducing burnout and enhancing work engagement among clini-cians: The Minnesota experience. Health Care Manage Rev. 2022;47(1):49-57.
21. Magnavita N, Filon FL, Giorgi G, Meraglia I, Chirico F. Assessing workplace violence: methodological consid-erations. Med Lav. 2024;115(1).
22. Schaufeli WB, Shimazu A, Hakanen J, Salanova M, De Witte H. An ultra-short measure for work engagement. European Journal of Psychological Assessment. Published online 2017.
23. Chen ZH, Wang SY, Lu YC, Jing CX. Analysis on the epidemiological features and risk factors of hospital work-place violence in Guangzhou. Zhonghua Liu Xing Bing Xue Za Zhi. 2004;25(1):3-5.
24. Tutan A. İşyeri Şiddeti Ölçeğinin Türkçeye Uyarlanması. İşletme Araştırmaları Dergisi. Published online 2023.
25. Kowalenko T, Gates D, Gillespie GL, Succop P, Mentzel TK. Prospective study of violence against ED workers. Am J Emerg Med. 2013;31(1):197-205.
26. Şengül H, Bulut A, Özgüleş B. Sağlık profesyonellerinin şiddete karşı güvenlik ve güven ölçeği Türkçe for-munun geçerlik ve güvenirliginin yapısal eşitlik modeli ile sınanması. Uluslararası Sosyal Araştırmalar Dergisi/The Journal of International Social Research. Published online 2019.
27. Tabachnick BG, Fidell LS, Ullman JB. Using Multivariate Statistics. Vol 6. pearson Boston, MA; 2013.
28. Kotera Y, Van Laethem M, Ohshima R. Cross-cultural comparison of mental health between Japanese and Dutch workers: Relationships with mental health shame, self-compassion, work engagement and motivation. Cross Cultural & Strategic Management. 2020;27(3):511-530.
29. Calvo JM, Kwatra J, Yansane A, Tokede O, Gorter RC, Kalenderian E. Burnout and work engagement among US dentists. J Patient Saf. 2021;17(5):398-404.
30. Channa S, Khan S, Tunio ZH, Jhatiyal RA, Tunio IA, Umrani KB. Workplace Bullying and Harassment among Health Care Professionals. Age (Years). 2021;20(25):24.
31. Appel-Meulenbroek R, van der Voordt T, Aussems R, Arentze T, Le Blanc P. Impact of activity-based work-places on burnout and engagement dimensions. Journal of Corporate Real Estate. 2020;22(4):279-296.
32. Bakker AB, Demerouti E, Sanz-Vergel AI. Burnout and work engagement: The JD–R approach. Annu Rev Or-gan Psychol Organ Behav. 2014;1(1):389-411.
33. Barab J. Workplace Violence: The Hidden Epidemic Plaguing Health Care Workers. Published online 2022.
34. Magnavita N, Angelillo A, Anniballi A, et al. Workplace violence, early neurological symptoms, and metabolic or psychiatric disorders. Eur J Public Health. 2020;30(Supplement_5):ckaa165-660.
35. Wolf L, Perhats C, Delao A, et al. Violence and its impact on the emergency nurse. J Emerg Nurs. 2020;46(3):354-358.
36. Vento S, Cainelli F, Vallone A. Violence against healthcare workers: a worldwide phenomenon with serious consequences. Front Public Health. 2020;8:570459.
37. Bellman V, Thai D, Chinthalapally A, Russell N, Saleem S. Inpatient violence in a psychiatric hospital in the middle of the pandemic: clinical and community health aspects. AIMS Public Health. 2022;9(2):342.
38. Nithimathachoke A, Wichiennopparat W. High incidence of workplace violence in metropolitan emergency departments of Thailand; a cross sectional study. Arch Acad Emerg Med. 2021;9(1).
39. Al Anazi RB, AlQahtani SM, Mohamad AE, Hammad SM, Khleif H. Violence against health-care workers in governmental health facilities in Arar City, Saudi Arabia. The Scientific World Journal. 2020;2020.
40. Liu J, Zheng J, Liu K, et al. Workplace violence against nurses, job satisfaction, burnout, and patient safety in Chinese hospitals. Nurs Outlook. 2019;67(5):558-566.
41. Tonso MA, Prematunga RK, Norris SJ, Williams L, Sands N, Elsom SJ. Workplace violence in mental health: A Victorian mental health workforce survey. Int J Ment Health Nurs. 2016;25(5):444-451.
42. Li YL, Li RQ, Qiu D, Xiao SY. Prevalence of workplace physical violence against health care professionals by patients and visitors: a systematic review and meta-analysis. Int J Environ Res Public Health. 2020;17(1):299.
43. d’Ettorre G, Mazzotta M, Pellicani V, Vullo A. Preventing and managing workplace violence against healthcare workers in Emergency Departments. Acta Bio Medica: Atenei Parmensis. 2018;89(Suppl 4):28.
44. Ferrinho P, Patrício SR, Craveiro I, Sidat M. Is workplace violence against health care workers in Mozambique gender related? Int J Health Plann Manage. 2023;38(1):265-269.
45. Kouloumberis P. Navigating a Traditionally Male-Dominated Specialty as a Woman. Burnout in Women Phy-sicians: Prevention, Treatment, and Management. Published online 2020:277-302.
46. Dimitriu MCT, Pantea-Stoian A, Smaranda AC, et al. Burnout syndrome in Romanian medical residents in time of the COVID-19 pandemic. Med Hypotheses. 2020;144:109972.
47. Zadow AJ, Dollard MF, Dormann C, Landsbergis P. Predicting new major depression symptoms from long working hours, psychosocial safety climate and work engagement: A population-based cohort study. BMJ Open. 2021;11(6):e044133.
48. Beştaş İ. Doktor İstifaları ve Yurt Dışı Göçü (2020-2022) Medya Yansımaları. Sosyal Bilimlere Çok Yönlü Yaklaşımlar: Tarih, Turizm, Eğitim, Ekonomi, Siyaset ve İletişim. Published online 2023:213.
49. Şen Olgay S, Yurt S. Determination of the Reasons for Migration and Life Satisfaction of Health Workers Who Migrated from Turkey to United Kingdom. Sağlık ve Hemşirelik Yönetimi Dergisi. 2023;10(1):99-107. doi:10.54304/shyd.2023.60565
50. Pasquarella FJ, Lizano EL, Lee S, De La Peza D. An examination of work engagement’s antecedents and con-sequences in a sample of US community mental health providers. Health Soc Care Community. 2022;30(5):e2318-e2329.
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17-04-2025
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Balsak H, Özel M. Workplace Violence in Tertiary Hospitals: Unraveling Its Detrimental Effects on Healthcare Workers’ Job Engagement. Med Lav [Internet]. 2025 Apr. 17 [cited 2025 Apr. 19];116(2):16271. Available from: https://mail.mattioli1885journals.com/index.php/lamedicinadellavoro/article/view/16271
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How to Cite
1.
Balsak H, Özel M. Workplace Violence in Tertiary Hospitals: Unraveling Its Detrimental Effects on Healthcare Workers’ Job Engagement. Med Lav [Internet]. 2025 Apr. 17 [cited 2025 Apr. 19];116(2):16271. Available from: https://mail.mattioli1885journals.com/index.php/lamedicinadellavoro/article/view/16271
