Encouraging employees to report verbal violence in primary health care in Serbia: A cross-sectional study.

INTRODUCTION: Workplace violence is a serious and multidimensional problem that adversely affects professional and personal lives of employees. The aim of this study was to assess the prevalence and characteristics of verbal violence as a part of psychological violence among employees in primary health care in Belgrade, and to identify contributing factors of verbal violence in the workplace. METHODS: In this cross-sectional study, the final analysis included 1526 employees, using multi-stage sampling. Data were collected using the questionnaire Workplace Violence in the Health Sector Country Case Studies Research, developed by ILO/ICN/WHO/PSI. Descriptive statistics and logistic regression analysis were used to analyse the data. The general response rate was 86.8% (1526/1757). RESULTS: It was found that 47.8% of the participants were subjected to verbal violence. The main source of verbal violence was patient/client, 55.6% of employees did not report the incident. Among those who did not report the incident, 74.9% believed that reporting violence was useless. The interaction with patients (OR, 1.45; 95% CI, 1.02-2.06) and work between 6pm and 7am (OR, 1.27; 95% CI, 1.01-1.60) were significant contributing factors of verbal violence. CONCLUSION: The results are indicative of a high prevalence of verbal violence against employees in primary health centres, which could have undesirable consequences. Conducting a better organizational measure and encouraging employees to report workplace violence could reduce the prevalence of verbal violence.

Does workplace violence exist in primary health care? Evidence from Serbia.

BACKGROUND: Violence in the workplace is a serious social and public health problem. The objective of this study was to estimate the prevalence of workplace violence and to identify potential predictors of workplace violence at Serbian Primary Health Care (PHC) centres. METHODS: A cross-sectional study was conducted between October 2012 and July 2013. The sample consisted of medical and non-medical staff employed at PHC centres in Belgrade, Serbia. Among 1757 currently presented at work, 1526 returned the questionnaires. The data were collected by questionnaire Workplace Violence in the Health Sector-Country Case Studies, developed by the ILO/ICN/WHO/PSI. Binary logistic regression was conducted to assess the association between exposure to workplace violence and sociodemographic and work-related characteristics. RESULTS: The prevalence of workplace violence, was 803 (52.6%), with 147 (18.3%), exposed to physical violence. Multiple logistic regression models indicated that the following work-related characteristics were positive associated of workplace violence with working between 18:00 and 07:00 h [odds ratio (OR): 1.37, 95% confidence interval (CI): 1.08-1.73], nurses as a professional group (OR: 1.91, 95% CI: 1.16-3.17), working with preschool children (OR: 0.56, 95% CI: 0.34-0.91). There was negative association of workplace violence with encouragement to report violence (OR: 0.61, 95% CI: 0.49-0.76) and the number of staff in the same work setting (OR: 0.73, 95% CI: 0.56-0.96). CONCLUSIONS: More than half of employees in Belgrade PHC centres were exposed to different types of workplace violence. There is a need for interventions to protect health workers and provide safer workplace environments.

First- and fifth-year medical students' intention for emigration and practice abroad: a case study of Serbia.

Health worker migration is causing profound health, safety, social, economic and political challenges to countries without special policies for health professionals' mobility. This study describes the prevalence of migration intentions among medical undergraduates, identifies underlying factors related to migration intention and describes subsequent actions in Serbia. Data were captured by survey of 938 medical students from Belgrade University (94% response rate), representing two thirds of matching students in Serbia stated their intentions, reasons and obstacles regarding work abroad. Statistical analyses included descriptive statistics and a sequential multivariate logistic regression. Based on descriptive and inferential statistics we were able to predict the profile of first and fifth year medical students who intend or have plans to work abroad. This study contributes to our understanding of the causes and correlates of intent to migrate and could serve to raise awareness and point to the valuable policy options to manage migration.

Competencies gap of management teams in primary health care.

BACKGROUND: Health workforce competencies are considered crucial for attaining high-quality health care in the current market principles approach to the provision of health services. This study explored the competencies and the perceived competence gap of management personnel in public primary healthcare. METHODS: During 2007 and 2008, 14 management teams of Belgrade primary health-care centres were questioned before and after management training in six competency categories. Competency mean differences (95% confidence interval) by gender, educational level, experience and position were analysed by Leven, Snedecor or Welch statistics, and Student's t-test for comparison of two independent samples. Mixed Model Analysis clarified possible interactions of the managers' baseline characteristics and competency task ratings. Differences between team ratings were analysed by analysis of variance (ANOVA) or the Kruskal-Wallis test. The General Linear Model Repeated Measures Analysis determined interactions and competency gap changes. Differences were statistically significant at P ≤ 0.05. RESULTS: Female managers developed higher competency levels after training in communication skills and problem solving. Top managers rated assessing performance of higher importance, while chief nurses emphasized the importance of leading. Before training, the estimated competency gap was generally the highest in assessing performance (6.29), followed by team building (5.81) and planning and priority setting (5.70). Five months after training, the highest gap remained in assessing performance, although it was reduced considerably to 3.18 (P < 0.0005). CONCLUSIONS: Managers rated core competencies as highly important. The reduction in competency gaps can be significant through training. However, assessing performance remained a relatively high weakness among managers.