Treating Too Lightly? Radiation Therapists' Experiences of Workplace Violence When Providing Care to Cancer Patients and Their Families.

INTRODUCTION: Workplace violence (WPV) is defined as any act in which a person is abused, threatened, intimidated, or assaulted during their employment. Despite an absence of published evidence, radiation therapists (RTs) are considered a "low-risk" profession for WPV. The aim of this research was to determine the incidence, severity, and impact of WPV on RTs perpetrated by patients and/or their caregivers. MATERIALS AND METHODS: A cross-sectional online questionnaire, based on established components of WPV, was distributed via e-mail to all RTs in a large, urban cancer clinic. The questionnaire was divided into the five categories of WPV and asked about the frequency, severity, perpetrator, location, and impact of WPV. RESULTS: Seventy-eight responses were received from a department of 165 RTs (47% response rate). Fifty-nine RTs reported experiencing at least one verbal abuse event during their career. Twenty-five reported experiencing a verbal threat at least once, 46 reported at least one occasion of harassing behaviour, and 18 experienced a threatening action at least once. Five RTs reported suffering from at least one physical assault. The majority of this WPV took place on the treatment unit, with the patient as the perpetrator, and was not reported by the RT. High numbers of RTs reported suffering from stress (35), frustration (34), and anxiety (29) as a consequence of WPV. CONCLUSIONS: The close, longitudinal relationship between RTs and cancer patients puts RTs at considerable risk of experiencing multiple WPV events during their career. WPV is infrequently reported by RTs, perhaps linked to the belief that excellent patient care requires you to accept and excuse poor behaviour by patients. Prevention programs and de-escalation training are needed for RTs, but short-term measures such as shift or unit changes may prevent multiple WPV exposures which are associated with an increased risk of emotional and psychological sequelae.

Communicating with Emotional Patients: Thoughts, Skills, and Influencing Factors for Ontario Radiation Therapists.

PURPOSE: Patients receiving radiation therapy are subject to high anxiety levels. Radiation Therapists (RTs) are uniquely positioned to support patients as they progress through treatment, but little is known about therapists' ability to perform this important task. This research was designed to describe RTs' ability to communicate with cancer patients during emotional interactions and to determine what intrinsic and extrinsic factors influence that ability. METHODS: Single-centre focus groups were used to develop themes for a questionnaire. That questionnaire was then distributed throughout 13 Ontario cancer centres. Themes evaluated included intrinsic factors (demographics, value, and so forth) and extrinsic factors (work environment, resources, and so forth). A validated clinical vignette was used to evaluate actual respondent communication skill and a validated scale reported various aspects of emotional intelligence. RESULTS: One hundred ninety-nine responses were received from 13 cancer centres distributed across Ontario. Response rate was low (31%), but wave analysis indicated a lack of nonresponse bias. Based on the clinical vignette, RTs showed a high degree of skill when communicating with emotional patients, reporting minimal use of blocking or controlling behaviours. Factors shown to significantly influence the ability to communicate with emotional patients included personal sociability and years of experience, organizational provision of time, private space, and support (P < .05). CONCLUSIONS: RT respondents were particularly skilled at communicating with emotional patients. That skill level was significantly influenced by both personal and organizational factors. The most important of these were experience and time. These findings are consistent with the literature for other professions and are likely generalizable throughout Canada and similar international practice environments.