Violence at work and its relationship with burnout, depression and anxiety in healthcare professionals of the emergency services

Gloria M. Roldán, Isabel C. Salazar, Laura Garrido, Juan M. Ramos

“La Caleta” Healthcare Center, Granada, Spain.
“Virgen de las Nieves” University Hospital, Granada, Spain.
University of Granada, Granada, Spain.

DOI: 10.4236/health.2013.52027                

Abstract

The aim of this study was to examine the possible relationship between physical and psychological aggression suffered in the workplace and professional burnout, depression and anxiety suffered by healthcare professionals of the emergency services. Methods: 315 physicians, nurses, orderlies and ambulance drivers of Critical Care and Emergency Devices (CCED) in the Andalusian Public Health System, in the province of Granada (Spain) participated. They were interviewed about the exposure to violence at work and answered a battery of questions that measured burnout, depression and anxiety. Results: Physical aggression was significantly related to emotional exhaustion, personal accomplishment at work, depression and anxiety. Psychological aggression was associated with personal accomplishment. Logistic regression showed that the CCED professionals who have suffered physical aggression were 4.2 and 2.6 times more likely to have suffered anxiety and reduced personal accomplishment, respectively, than those who did not suffer physical aggression. On the other hand, feelings of anxiety and reduced personal accomplishment increase the professionals’ risk (3.4 and 2.1 times more likely, respectively) of suffering from physical aggression. Conclusion: The results suggest that exposure to violence is related to the other psychological problems tested: emotional exhaustion and personal accomplishment (two components of burnout), depression and anxiety. In addition, physical violence is a risk factor for anxiety and diminished personal accomplishment of the CCED professionals.

Keywords

Workplace Violence; Aggression; Burnout; Depression; Anxiety; Health Professionals; Emergency Services

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1]	World Health Organization (2012) New research shows workplace violence threatens health services. http://www.who.int/mediacentre/news/releases/release37/en/index.html
[2]	International Labour Organisation (2003) Code of prac tice on workplace violence in services sectors and measures to combat this phenomenon. http://www.ilo.org/safework/info/standards-and-instruments/codes/WCMS_107705/lang--en/index.htm
[3]	Alameddine, M., Kazzi, A., El-Jardali, F., Dimassi, H. and Maalouf, S. (2011) Occupational violence at Lebanese emergency departments: prevalence, characteristics and associated factors. Journal of Occupational Health, 53, 455-464. doi:10.1539/joh.11-0102-OA
[4]	Estryn-Behar, M., vander Heijden, B., Camerino, D., Fry, C., Le Nezet, O., Conway, P.M., Hasselhorn, H.M. and NEXT Study Group (2008) Violence risks in nursing —Results from the European NEXT Study. Occupational Medicine, 58, 107-117. doi:10.1093/occmed/kqm142
[5]	Colegio Oficial de Médicos de Barcelona (2004) Guide to preventing and managing violence against physicians in the workplace [Guía para prevenir y gestionar la vio lencia en el lugar de trabajo contra los médicos]. Cua dernos de la Buena Praxis, 17, 6. http://issuu.com/comb/docs/praxi17?mode=embed&layout=http%3A//skin.issuu.com/v/light/layout.xml&showFlipBtn=true
[6]	Moreno Jiménez, M.A., Vico Ramírez, F., Zerolo Andrey, F.J., López Rodríguez, A., Herrera Serena, P. and Mateios Salidoc, M.J. (2005) Analysis of patients’ violence in primary care [Análisis de la violencia del paciente en atención primaria]. Atención Primaria, 36, 152-158. doi:10.1157/13077484
[7]	Cervantes, G., Blanch, J.M. and Hermoso, D. (2010) Work place violence against healthcare professionals in Catalonia notified online (2007-2009) [Violencia ocupacional contra profesionales sanitarios en Catalu?a notificadapor Internet (2007-2009)]. Archivos de Prevención de Riesgos Laborales, 13, 135-140.
[8]	Martínez-Jarreta, B., Gascón, S., Santed, M.A. and Goicoechea, J. (2007) Medical-legal analysis of aggression towards health professionals. An approach to a silent reality and its consequences on health [Análisis médico legal de las agresiones a profesionales sanitarios. Apro ximación a una realidad silenciosa y a sus consecuencias para la salud]. Medicina Clínica, 128, 307-310. doi:10.1157/13099583
[9]	Martínez-León, M., Queipo-Burón, D., Irurtia-Mu?iz, M.J. and Martínez-León, C. (2012) Análisis médico-legal de las agresiones a los profesionales sanitarios en Castilla y León (Espa?a) [Medico-legal analysis of the assaults on healthcare workers in Castilla y León (Spain)]. Revista Espa?ola de Medicina Legal, 38, 5-10. doi:10.1016/j.reml.2011.10.001
[10]	Roldán, G.M., Garrido, L., Salazar, I.C. and Ramos, J.M. (2012) The violence suffered by healthcare professionals of the emergency services [La violencia sufrida por los profesionales sanitarios de los servicios de urgencias]. Unpublished document.
[11]	Gerberich, S.G., Church, T.R., McGovern, P.M., Hansen, H.E., Nachreiner, N.M., Geisser, M.S., Ryan, A.D., Mongin, S.J. and Watt, G.D. (2004) An epidemiological study of the magnitude and consequences of work related violence: The Minnesota nurses’ study. Occupational and Envi ronmental Medicine, 61, 495-503. doi: 10.1136/oem.2003.007294
[12]	Maslach, C. and Jackson, S.E. (1982) Burnout in health professions: A social psychological analysis. In: Sanders, G.S. and Suls, J., Eds., Social Psychology of Health and Illness, Erlbanm, Hillsdale, 227-251.
[13]	Sabbah, I., Sabbah, H., Sabbah, S., Akoum, H. and Droubi, N. (2012) Burnout among Lebanese nurses: Psychometric properties of the Maslach Burnout Inventory-Human Services Survey (MBI-HSS). Health, 4, 644-652. doi:10.4236/health.2012.49101
[14]	Roldán, G.M., Salazar, I.C., Garrido, L. and Ramos, J.M. (2012) Psychological problems and burnout in healthcare professionals of the emergency services [Problemas psi cológicos y desgaste profesional en los profesionales sa nitarios de los servicios de urgencias]. Unpublished do cument.
[15]	Mandiracioglu, A. and Cam, O. (2006) Violence exposure and burn-out among Turkish nursing home staff. Occupational Medicine, 56, 501-503. doi:10.1093/occmed/kql073
[16]	Whittington, R. (2002) Attitudes toward patient aggression amongst mental health nurses in the “zero tolerance” era: Associations with burnout and length of experience. Journal of Clinical Nursing, 11, 819-825. doi:10.1046/j.1365-2702.2002.00659.x