Association of school neighbourhood socioeconomic disadvantage and teaching staff's risk of violence at work.

AIM: The aim of this study was to determine the association between neighbourhood socioeconomic disadvantage and teaching staff's risk of workplace violence and whether workplace psychosocial resources can act as effect modifiers. METHODS: Primary school teaching staff in the six largest cities in Finland responded to a survey in 2018 and were linked to information on school neighbourhood disadvantage obtained from the national grid database (n = 3984). RESULTS: After adjustment for confounders, staff working in schools located in the most disadvantaged neighbourhoods had a 1.2-fold (95% confidence interval 1.07-1.35) risk of encountering violence or threat of violence compared with staff working in the most advantaged neighbourhoods. The association was less marked in schools with strong support from colleagues (risk ratio 1.14, 95% confidence interval (95% CI) 0.98-1.32 for high support versus 1.23, 95% CI 1.07-1.43 for low/intermediate support), a strong culture of collaboration (1.08, 95% CI 0.93-1.26 versus 1.31, 95% CI 1.12-1.53), high leadership quality (1.12, 95% CI 0.96-1.31 versus 1.29, 95% CI 1.08-1.54), and high organizational justice (1.09, 95% CI 0.91-1.32 versus 1.29, 95% CI 1.09-1.52). CONCLUSIONS: The association between school neighbourhood and teaching staff's risk of violence was weaker in schools with high workplace psychosocial resources, suggesting that targeting these factors might help in minimizing violence at schools, but future intervention studies are needed to confirm or refute this hypothesis.

Using body-worn cameras in emergency departments: a pilot project.

Nurses and other emergency department (ED) staff often experience verbal and physical abuse as part of their everyday work. Body-worn cameras are one tool that ED staff can use to try to reduce workplace violence and abuse and have been shown to be effective in other healthcare environments, such as mental health units. This article describes a pilot service evaluation which used a survey to assess the effectiveness of using body-worn cameras for staff in the author's ED. Findings suggest that nurses believed the cameras provided support when they were confronted by abusive or aggressive patients or relatives and in some instances diffused potentially violent situations.

Consensus on relevant psychosocial interventions applied in health institutions to prevent psychological violence at work: Delphi method.

OBJECTIVE: Studies on psychological violence in the workplace (PVW) in Latin America have focused on incidence values. In contrast, studies on preventive interventions (PIs) in the health sector are very limited. Our objective was to determine to what extent there is consensus on the most relevant characteristics of the psychosocial interventions applied in the prevention of PVW in health institutions in Peru. To that end, health professionals with knowledge and experience in PVW at the national level were recruited, and the Delphi consensus technique was applied. RESULTS: The consensus study was developed in four stages that included three phases of Delphi consultation. In the third consultation phase, 428 experts participated in 25 analysis groups from 66 health institutions in the country. A total of 70.3% of the participants were women, and 27.6% of the participants worked in nursing and emergency services. After the Delphi consensus analysis, we obtained a list of 10 hierarchical psychosocial interventions to prevent PVW in the country. Most notable were interventions based on the prior resolution of interprofessional conflicts, on the visibility of incidents to generate an inverse effect and on experiential training to improve assertive and empathic communication skills.

Magnitude and Impact of Workplace Violence Against Obstetric Healthcare Personnel: A Multicentre Cross-Sectional Study.

Background: Workplace violence is defined by the World Health Organization (WHO) as incidents where staff is abused, threatened or assaulted in work settings. In emergency predominated branch like obstetrics, there is a need to study the magnitude and impact of violence against healthcare workers (HCW). Materials and Methodology: This cross-sectional study was conducted in the Department of Obstetrics at 2 centres in Lucknow district, for a period of 6 months. The study population included trainee residents, senior residents, nursing staff and consultants. Standard definitions from the WHO were used to define the types of violence. The validated questionnaire was designed in English with 25 questions to understand the incidence of workplace violence, prevention policy, reporting and follow-ups of incidents and impact of violence. Results: With a response rate of 90%, 274 HCW participated in the study. In total, 172 HCW (62.7%) either faced physical or verbal assault. In 70% of incidents, patient, their relatives or public were perpetrators of violence, and the rest 30% incidents were by colleagues or management. Majority of the incidents were in emergency areas. Only 22% of the abused reported to the concerned authorities. At least 123 (71.5%) HCW were extremely dissatisfied with the action taken. Action was taken against only 9.8% of the perpetrators. None of the respondents received any training to handle workplace violence. Conclusion: There is an alarming high prevalence of workplace violence by patients and colleagues. Adequate training to handle these incidents, improvement of working environment and unconditional support from management will bring a positive work experience. Supplementary Information: The online version contains supplementary material available at 10.1007/s13224-023-01809-0.

[Violence at work and work engagement against nursing professionals in Spain: a cross-sectional study.] / Violencia en el trabajo y compromiso laboral en los profesionales de enfermería en España: un estudio transversal.

OBJECTIVE: Nurses are one of the groups most exposed to violence in the workplace. The objective of this study was to analyze the relationship between violence at work and engagement in a sample of nurses in Spain. METHODS: A descriptive cross-sectional study was carried out in a national sample of Spanish nurses. A questionnaire was administered that collected the sociodemographic variables, the Utrecht Work Engagement Scale (UWES-9) and an ad hoc scale on violence at work. The Mann-Whitney U test was performed as the statistical test with Bonferroni correction and the CHAID algorithm. RESULTS: The sample consisted of a total of 1,648 active nurses. It was observed that 42.17% of them had personally suffered some type of aggression or violence in the workplace, verbal aggression being the most frequent. The results indicated that there was a negative association between work engagement and exposure to situations of violence at work. CONCLUSIONS: There is a relationship between having suffered attacks and the degree of work engagement against nurses, hence the need to establish effective preventive and intervention policies to promote an adequate work environment, and therefore stop episodes of violence in their initial stages.

OBJETIVO: Los profesionales de la enfermería son uno de los colectivos más expuestos a la violencia en los lugares de trabajo. El objetivo de este estudio fue analizar la relación existente entre la violencia en el trabajo y el compromiso laboral (Engagement) en una muestra de profesionales de enfermería en España. METODOS: Se realizó un estudio descriptivo de corte transversal en una muestra de enfermeras españolas a nivel nacional. Se administró un cuestionario que recogía las variables sociodemográficas, el Utrecht Work Engagement Scale (UWES-9) y una escala sobre violencia en el trabajo elaborada ad hoc. Se realizaron como pruebas estadísticas la prueba de U de Mann-Whitney, con corrección de Bonferroni y el algoritmo CHAID. RESULTADOS: La muestra estuvo compuesta por un total de 1.648 profesionales de enfermería en activo. Se observó que el 42,17% había sufrido personalmente algún tipo de agresión o violencia en el lugar de trabajo, siendo la agresión verbal la más frecuente. Los resultados indican que existía una asociación negativa entre el compromiso laboral y la exposición a situaciones de violencia en el trabajo. CONCLUSIONES: Existe una relación entre haber sufrido agresiones y el grado de compromiso laboral de los profesionales de enfermería, de ahí la necesidad de establecer políticas preventivas y de intervención eficaces para fomentar un adecuado clima laboral, y para atajar episodios de violencia en sus etapas iniciales.

Violencia en el trabajo y compromiso laboral en los profesionales de enfermería en España: un estudio transversal / Violence at work and work engagement against nursing professionals in Spain: a cross-sectional study

FUNDAMENTOS: Los profesionales de la enfermería son uno de los colectivos más expuestos a la violencia en los lugares de trabajo. El objetivo de este estudio fue analizar la relación existente entre la violencia en el trabajo y el compromiso laboral (Engagement) en una muestra de profesionales de enfermería en España. MÉTODOS: Se realizó un estudio descriptivo de corte transversal en una muestra de enfermeras españolas a nivel nacional. Se administró un cuestionario que recogía las variables sociodemográficas, el Utrecht Work Engagement Scale (UWES-9) y una escala sobre violencia en el trabajo elaborada ad hoc. Se realizaron como pruebas estadísticas la prueba de U de Mann-Whitney, con corrección de Bonferroni y el algoritmo CHAID. RESULTADOS: La muestra estuvo compuesta por un total de 1.648 profesionales de enfermería en activo. Se observó que el 42,17% había sufrido personalmente algún tipo de agresión o violencia en el lugar de trabajo, siendo la agresión verbal la más frecuente. Los resultados indican que existía una asociación negativa entre el compromiso laboral y la exposición a situaciones de violencia en el trabajo. CONCLUSIONES: Existe una relación entre haber sufrido agresiones y el grado de compromiso laboral de los profesionales de enfermería, de ahí la necesidad de establecer políticas preventivas y de intervención eficaces para fomentar un adecuado clima laboral, y para atajar episodios de violencia en sus etapas iniciales.(AU)

BACKGROUND: Nurses are one of the groups most exposed to violence in the workplace. The objective of this study was to analyze the relationship between violence at work and engagement in a sample of nurses in Spain. METHODS: A descriptive cross-sectional study was carried out in a national sample of Spanish nurses. A questionnaire was administered that collected the sociodemographic variables, the Utrecht Work Engagement Scale (UWES-9) and an ad hoc scale on violence at work. The Mann-Whitney U test was performed as the statistical test with Bonferroni correction and the CHAID algorithm. RESULTS: The sample consisted of a total of 1,648 active nurses. It was observed that 42.17% of them had personally suffered some type of aggression or violence in the workplace, verbal aggression being the most frequent. The results indicated that there was a negative association between work engagement and exposure to situations of violence at work. CONCLUSIONS: There is a relationship between having suffered attacks and the degree of work engagement against nurses, hence the need to establish effective preventive and intervention policies to promote an adequate work environment, and therefore stop episodes of violence in their initial stages.(AU)

As múltiplas violências vivenciadas por farmacêuticas no ambiente laboral / The multiple violences experienced by pharmacist women in the workplace / Las múltiples violencias experimentadas por las farmacéuticas en el entorno laboral

Resumo A divisão sexual do trabalho ocasiona iniquidade entre gêneros, bem como situações de violência direcionadas às mulheres no ambiente laboral. Na área farmacêutica, a maioria feminina e a inserção em múltiplos cenários, que envolvem contato com público e parcerias profissionais diferenciadas, potencializam a exposição à violência. Assim, o objetivo deste estudo foi analisar situações de violência vivenciadas por farmacêuticas no ambiente laboral. Para tal, utilizou-se método qualitativo, com análise de conteúdo, realizada no software NVivo®, de uma survey on line, respondida por farmacêuticas (n=381) registradas no Conselho Regional de Farmácia de Minas Gerais, Brasil. Como resultado, identificou-se quatro categorias: 'Convivendo com o desrespeito, ameaças e vulnerabilidade', 'O sexismo e o machismo estrutural que cala, diminui e atordoa', 'A discriminação contra a mulher como obstáculo à equidade' e 'Assédio sexual e objetificação da mulher'. Emergiram diversas expressões de violências no ambiente laboral provenientes de múltiplos agressores. Farmacêuticas reconheceram prejuízo profissional e pouco reconhecimento pela capacidade técnica. Conclui-se que os relatos expuseram a falta de proteção da integridade farmacêutica no ambiente de trabalho. Espera-se que esses resultados tragam à luz a desigualdade de gênero no trabalho farmacêutico, com destaque para situações de violência, ampliando a discussão e proporcionando evolução dessa profissão majoritariamente feminina.

Abstract The sexual division of labor causes inequality between genders, as well as situations of violence directed to women in the workplace. In the pharmaceutical area, the majority of women and insertion in multiple scenarios, involving contact with public and differentiated professional partnerships, enhance exposure to violence. Thus, the objective of this study was to analyze situations of violence experienced by pharmacists in the workplace. For this, a qualitative method was used, with content analysis, performed in the NVivo® software, of an online survey, answered by pharmacists (n=381) registered in the Regional Pharmacy Council of Minas Gerais, Brazil. As a result, four categories were identified: 'Living with disrespect, threats and vulnerability,' 'Sexism and structural chauvinism that shuts down, diminishes and torments,' 'Discrimination against women as an obstacle to equity' and 'Sexual harassment and objectification of women.' Several expressions of violence in the labor environment emerged from multiple aggressors. Pharmacists recognized professional impairment and little recognition for technical capacity. We concluded that the reports exposed the lack of protection of pharmaceutical integrity in the workplace. It is expected that these results bring to light the gender inequality in pharmaceutical work, with emphasis on situations of violence, expanding the discussion and providing evolution of this mostly female profession.

Resumen La división sexual del trabajo ocasiona iniquidad entre los géneros, así como situaciones de violencia dirigidas a las mujeres en el entorno laboral. En el ámbito farmacéutico, la mayoría de las mujeres y la inserción en múltiples escenarios, que implican contacto con el público y asociaciones profesionales diferenciadas, potencian la exposición a la violencia. Por lo tanto, el objetivo de este estudio fue analizar las situaciones de violencia experimentadas por las farmacéuticas en el entorno laboral. Para esto, se utilizó un método cualitativo, con análisis de contenido, realizado en el software NVivo®, de una encuesta en línea, respondida por farmacéuticas (n=381) registradas en el Consejo Regional de Farmacia de Minas Gerais, Brasil. A consecuencia, se identificaron cuatro categorías: 'Conviviendo con falta de respeto, amenazas y vulnerabilidad', 'el sexismo y el machismo estructural que cala, disminuye y atormentó', 'la discriminación contra la mujer como obstáculo a la equidad' y 'el acoso sexual y la objeción de la mujer'. Han surgido varias expresiones de violencia en el entorno laboral procedentes de múltiples agresores. Los productos farmacéuticos han reconocido el daño profesional y el escaso reconocimiento de la capacidad técnica. Se concluye que los informes haciendo hincapié de manifiesto la falta de protección de la integridad farmacéutica en el entorno laboral. Se espera que estos resultados traigan a la luz la desigualdad de género en el trabajo farmacéutico, haciendo hincapié en las situaciones de violencia, ampliando el debate y dando lugar a la evolución de esa profesión principalmente femenina.

Violência no trabalho: dimensões estruturais e interseccionais / Violence at work: structural and intersectional dimensions

Resumo Introdução: a violência é um fenômeno histórico e sociocultural que acompanha a humanidade desde sua origem. Nos contextos de trabalho, a violência tem sido objeto de renovada atenção nas últimas décadas, em razão da incidência de sérios problemas que assolam os trabalhadores, tais como: os suicídios, a criminalidade e os transtornos mentais e comportamentais. Objetivo: discutir as dimensões estruturais e interseccionais da violência relacionada ao trabalho (VRT). Métodos: foi realizada reflexão teórica assentada na literatura científica. Resultados: os debates sobre a interseccionalidade permitem compreender os riscos psicossociais como resultados das interações dos trabalhadores com os imbricados processos sociais, que remetem às estruturas de poder, notadamente às relações transversais de classe, "raça" e gênero, sem prejuízo à incorporação de outros eixos de diferenciação social que importem para os sujeitos e para a análise do trabalho. Conclusão: conclui-se que a VRT não pode ser adequadamente compreendida e enfrentada sem o entendimento das suas distintas dimensões, bem como das articulações entre elas, das suas manifestações plurais e interseccionais, além de seu caráter sistêmico no modo de produção capitalista.

Abstract Introduction: violence is a historical and sociocultural phenomenon that accompanies humanity since its origin. In work contexts, violence has been the object of renewed attention in recent decades due to the incidence of serious problems affecting workers, such as suicides, criminality, and mental and behavioral disorders. Objective: to discuss the structural and intersectional dimensions of work-related violence (WRV). Methods: a theoretical reflection based on scientific literature was carried out. Results: debates on intersectionality enable us to understand psychosocial risks as a result of workers' interactions with intertwined social processes that refer to power structures, notably cross-cutting relations of class, "race," and gender, without prejudice to the incorporation of other axes of social differentiation that matter to subjects and to the analysis of work. Conclusion: WRV cannot be properly understood and faced without the evaluation of its different dimensions, the articulations between them, its plural and intersectional manifestations, and its systemic character in the capitalist mode of production.

Situações de violência física produzidas pelos bloqueios injustos no trabalho de entrega de comida por aplicativos / Situations of physical violence produced by unfair blockades in the work of food delivery by apps / Situaciones de violencia física producidas por los bloqueos injustos en el trabajo de entrega de comida por aplicaciones

O objetivo principal deste artigo é apresentar e compreender o risco de violência física envolvendo entregadores via aplicativos e clientes, cujos fatores imediatos são os chamados bloqueios indevidos. Por meio de etnografia digital que consistiu no acompanhamento de grupos de WhatsApp e de vídeos produzidos por motoboys, deparamos com esse risco emergente relacionado ao trabalho e levantamos elementos que ajudam a compreender o fenômeno. O medo de ser excluído da plataforma devido à reclamação de um cliente aparece como fator de risco dessa violência. Fatores políticos e socioeconômicos também podem estar relacionados a essas situações de violência entre entregadores e clientes, como, por exemplo, a dependência econômica que esses trabalhadores têm de plataformas digitais e o ambiente de permissividade regulatória.

The main objective of this article is to present and understand the risk of physical violence involving deliv-erers by app and customers, whose immediate factors are the so-called unfair blockades. Through digital ethnography that consisted in monitoring WhatsApp groups and videos produced by food deliverers, we found out this emerging occupational risk and raised elements that help to understand the phenomenon. The fear of being excluded from the platform due to a customer's complaint appears as a risk factor for that violence. Political and socio-economic factors can also be related to these situations of violence between deliverers and customers, such as, for example, the economic dependence of these workers on digital plat-forms and the environment of regulatory permissiveness.

El objetivo principal de este artículo es presentar y comprender el riesgo de violencia física que envuelve repartidores de comida mediante aplicaciones y clientes, cuyos factores inmediatos son los llamados bloqueos indebidos. A través de la etnografía digital, que consistió en monitorizar grupos de WhatsApp y videos producidos por repartidores de comida, encontramos este riesgo emergente relacionado con el trabajo y levantamos elementos que ayudan a comprender el fenómeno. El miedo de ser excluido de la plataforma debido a alguna reclamación de un cliente aparece como un factor de riesgo para esa violencia. Factores políticos y socioeconómicos también pueden estar relacionados con estas situaciones de violencia entre repartidores y clientes, como, por ejemplo, la dependencia económica que estos trabajadores tienen de las plataformas digitales y el ambiente de permisividad regulatoria.

Violence against healthcare workers br Hungarian experiences / Egészségügyi dolgozók ellen elkövetett eroszakos cselekedetek

Introduction: Violence against healthcare workers damages not only the health and dignity of employees but also the safety and productivity of institutions. Violence in healthcare also poses a threat to patient safety and the quality of patient care. Objective: The aim of the research is to get an idea of whether healthcare workers in Hungarian healthcare institu-tions, if they get involved in violent conflict, have someone to turn to at their workplace. It aims to explore whether communication, simulation and self-defense trainings are held in institutions, and to examine the relationship be-tween these prevention and treatment trainings with confidence. Method: Cross-sectional quantitative research has been conducted with an online questionnaire involving 720 health professionals. Results: It can be stated that when an atrocity hits a healthcare worker, he or she turns to his or her colleague during the violence and, after atrocity, asks the head nurse or a psychologist for help in processing the problem. 52% of verbal violence and 45% of physical violence were not reported by employees. A very high percentage (39%) of work-ers do not even know who to turn to if they are subjected to violent atrocity. The data show that communication training alone is not enough to make healthcare workers confident. However, participation in this training does not significantly reduce the average number of atrocities experienced in a year. Conclusion: The results obtained may also signal the need for communication training, but it is not enough in itself, it should be followed by simulation practice as well as self-defense education and practice. Participating in other communication or violence prevention training increases the confidence of healthcare workers, but communication training alone does not. There is no reporting obligation in the institutions so a lot of atrocities remain hidden.

Determinants and consequences of workplace violence against hospital-based nurses: a rapid review and synthesis of international evidence.

Workplace violence against nurses is an international public health issue with likely detrimental consequences for individuals, systems and societies. To effectively address workplace violence against nurses, its root causes must be understood and its effect on nurse outcomes quantified. In line with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, the authors rapidly reviewed the international literature to identify determinants of workplace violence against hospital-based nurses and the effects of workplace violence on nurse outcomes. Twenty-one studies (22 articles) formed the final sample - 16 quantitative, three qualitative and two mixed-methods studies. Supervisors, other nurses and physicians were the major perpetrators of workplace violence against nurses. Perpetrators of workplace violence were other nurses or physicians, the workplace, patients, and organisational management. Workplace violence was linked to deficits in nurses' health, job satisfaction and intention to stay in their role. To address workplace violence, evidence-based zero-tolerance policies, preventive interventions and appropriate disciplinary actions must be implemented at organisational and national level.

Construção e validação de instrumento de identificação de violência no trabalho de enfermagem no ambiente hospitalar e estratégias de prevenção no contexto de pandemia / Construction and validation of an instrument to identify violence in nursing work in the hospital environment and prevention strategies in the context of a pandemic

O contexto da pandemia nas instituições de saúde está envolto a fatores estressantes devido as mudanças organizacionais, de tratamento e fluxos de atendimento da grande demanda de pessoas que necessitam de cuidados. Essa situação tem levado profissionais de enfermagem a serem vítimas de atos de violência ocupacional, os quais tem ocasionado absenteísmo e adoecimento desses profissionais pela Síndrome de Burnout. Objetivo: construir e validar de um instrumento para identificação dos tipos e formas da violência no trabalho de enfermagem e as estratégias de prevenção adotadas em situação de pandemia. Método: estudo desenvolvido em duas fases procedimentais: na primeira fase foi realizado um estudo de revisão integrativa da literatura com a finalidade de sumarizar os tipos e formas de violência ocupacional do ambiente hospitalar e as estratégias utilizadas pelos profissionais de enfermagem para preveni-las. A busca de evidências científicas foi realizada a artigos primários publicados em revistas indexadas nas bases Web of Science (WOS/ISI), SCOPUS, Medical Literature Analysis and Retrieval Online (MEDLINE/PuBMed), The Cumulative Index to Nursing and Allied Health Literature (CINAHL) e Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS) e Scientific Electronic Library Online (Coleção SciELO) e em servidores de Preprints bioRxiv e SciELO Preprints. Os descritores utilizados foram: "Violência no Trabalho", "Equipe de Enfermagem", "Enfermagem", "Infecções por Coronavirus " e os termos em inglês " Workplace Violence", "Nursing Time", " Nursing" e "Coronavirus Infections" publicados no período de 2015 a 2021. Na segunda fase foi realizado um estudo metodológico de elaboração e a validação de conteúdo e com validação com emprego da Técnica Delphi realizada por um comitê de especialistas em Junho/2021 e validação semântica realizada com 30 profissionais de enfermagem atuantes durante a crise sanitária prestando cuidados diretos ou indiretos a pacientes com COVID-19. O questionário foi construído a partir de evidências da literatura sumarizadas na primeira fase da pesquisa e com base no relatório mundial sobre violência da Organização Mundial de Saúde e nas Diretrizes Marco para Afrontar a Violência Laboral no setor Saúde. Os dados da segunda fase do estudo foram analisados por meio de estatística descritiva e foi aplicado o cálculo do Índice de Validade de Conteúdo (IVC) no processo de avaliação de conteúdo do questionário. Resultados: no estudo de revisão, 35 artigos científicos foram selecionados a partir dos critérios adotados e analisados quanto os tipos de violência no trabalho ambiente hospitalar praticados antes da pandemia e durante a pandemia. Os profissionais de enfermagem no ambiente hospitalar sofreram: agressão física, abuso verbal, assédio sexual, assédio moral, discriminação entre outros. O questionário construído e validado para identificar a violência ocupacional no ambiente hospitalar possui 64 questões, sendo 25 sociodemográficas e 39 relacionadas a violência. O questionário foi validado pelo comitê de especialistas com concordância de 68,7% dos membros na 1ª etapa e 100% de concordância na 2ª etapa. Na aplicação do questionário na amostra de profissionais de enfermagem durante a pandemia o IVC apresentado para todos os itens foi de 1.0. Conclusão: O "Questionário de identificação de violência no trabalho de Enfermagem no ambiente hospitalar no contexto de pandemia" foi validado e pode ser utilizado para identificar os tipos de violência no trabalho de enfermagem no ambiente hospitalar para oferecer subsídios para planejamento de ações de combate, controle e prevenção de violência no trabalho de enfermagem

The context of the pandemic in health institutions is surrounded by stressors due to organizational changes, treatment and care flows of the great demand of people in need of care. This situation has led nursing professionals to be victims of acts of occupational violence, which have caused absenteeism and illness in these professionals due to Burnout Syndrome. Objective: to constructo and validate na instrument for identifying the types and forms of violence in nursing work and strategies for adopted in a pandemic situation. Method: a study developed in two procedural phases: the first phase was an integrative review of the literature with the purpose of stumarizing the types and forms of occupational violence in the hospital environment and the strategies used by nursing professional to prevent them. The search for scientific evidence was performed in primary articles, review of the literature published in journals indexed in the Web of Science (WOS/ISI), SCOPUS. Medical Literature Analysis and Retrieval Online (MEDLINE/PuBMed), The Cumulative Index to Nursing and Allied Health Literature (CINAHL) and Latin American and Caribbean Literature on Health Sciences (LILACS) and Scientific Electronic Library Online (SCIELO collection) and on Preprints servers bioRxiv and SciELO preprints. The descriptors used were: "Violence at Work", "Nursing Team", "Nursing" and "Coronavirus Infections" and the English terms "Workplace Violence", "Nursing Time", "Nursing" and "Coronavirus Infections", published from 2015 to 2021. In the second phase, a methodological study was carried out for the elaboration and validation of content and with validation using the Delphi Technique carried out by a committee of experts in June/2021 and semantic validation carried out with 30 nursing professionals working during the health crisis providing direct care or indirect to patients with COVID-19. The questionnaire was built from evidence from the literature summarized in the first phase of the research and based on the World Health Organization's World Report on Violence and the Framework Guidelines for Addressing Violence at Work in the Health Sector. Data from the second phase of the study were analyzed using descriptive statistics and the calculation of the Content Validity Index (CVI) was applied in the questionnaire content evaluation process. Results: in the review study, 35 scientific articles were selected based on the criteria adopted and analyzed regarding the types of violence at work in the hospital environment practiced before the pandemic and during the pandemic. Nursing professionals in the hospital environment suffered: physical aggression, verbal abuse, sexual harassment, moral harassment, discrimination among others. The questionnaire constructed and validated to identify occupational violence in the hospital environment has 64 questions, 25 of which are sociodemographic and 39 are related to violence. The questionnaire was validated by the expert committee with agreement of 68.7% of the members in the 1st stage and 100% of agreement in the 2nd stage. When applying the questionnaire to the sample of nursing professionals during the pandemic, the CVI presented for all items was 1.0. Conclusion: The "Questionnaire for the identification of violence in nursing work in the hospital environment in the context of a pandemic" was validated and can be used to identify the types of violence in nursing work in the hospital environment to provide subsidies for planning actions to combat, control and prevention of violence in nursing work

Agressão verbal contra profissionais de saúde da atenção primária e terciária: estudo de métodos mistos / Verbal aggression against health professionals in primary and tertiary care: a mixed methods study / Agresión verbal contra profesionales de la salud en atención primaria y terciaria: un estudio de métodos mixtos

Objetivo: analisar a ocorrência da agressão verbal e fatores associados ao fenômeno contra trabalhadores de saúde. Método: estudo misto, explanatório sequencial, desenvolvido de 2016 a 2019, com 647 trabalhadores de serviços de saúde das regiões Oeste e Extremo Oeste de Santa Catarina. Utilizaram-se o Survey Questionnaire Workplace Violence in the Health Sector e entrevistas semiestruturadas. Realizaram-se as análises estatística inferencial e temática, respectivamente. Resultados: dos participantes, 307 (47,4%) relataram terem sofrido ao menos um episódio de agressão verbal. Esse evento foi associado à função do trabalhador, ao contato físico com paciente, ao reconhecimento no trabalho e à preocupação com a violência no trabalho. Os depoimentos apontam os impactos na saúde dos trabalhadores e a fragilidade das condutas após os episódios. Conclusão: a agressão verbal é uma violência típica dos serviços públicos de saúde, com vítimas que possuem um perfil comum e instituições com dificuldade de manejo deste problema.

Objective: to analyze the occurrence of verbal aggression and factors associated with the phenomenon against health workers. Method: mixed study, sequential explanatory, developed from 2016 to 2019, with 647 health service workers from the West and Far West regions of Santa Catarina. The Survey Questionnaire Workplace Violence in the Health Sector and semi-structured interviews were used. Inferential and thematic statistical analyzes were carried out, respectively. Results: of the participants, 307 (47.4%) reported having suffered at least one episode of verbal aggression. This event was associated with the role of the worker, physical contact with the patient, recognition at work, and concern about violence at work. The testimonies point out the impacts on the health of workers and the fragility of the conducts after the episodes. Conclusion: verbal aggression is a typical violence of public health services, with victims who have a common profile and institutions with difficulty in managing this problem.

Objetivo: analizar la ocurrencia de agresiones verbales y factores asociados al fenómeno contra trabajadores de la salud. Método: estudio explicativo mixto, secuencial, desarrollado entre 2016 y 2019, con 647 trabajadores de los servicios de salud de las regiones Oeste y Lejano Oeste de Santa Catarina. Se utilizó el Survey Questionnaire Workplace Violence in the Health Sector y entrevistas semiestructuradas. Se realizaron análisis estadísticos inferenciales y temáticos, respectivamente. Resultados: de los participantes, 307 (47,4%) relataron haber al menos un episodio de agresión verbal. Este evento se asoció con el rol del trabajador, el contacto físico con el paciente, el reconocimiento en el trabajo y la preocupación por la violencia en el trabajo. Los testimonios apuntan los impactos en la salud de los trabajadores y la fragilidad de los comportamientos tras los episodios. Conclusión: la agresión verbal es una violencia típica de los servicios públicos de salud, con víctimas que tienen un perfil común e instituciones con dificultad en el manejo de este problema.

The Frequency and Form of Controls by HIIS over Primary Health Care Physicians in Slovenia.

OBJECTIVE: The aim of this study was to evaluate the pattern of controls and sanctions by the Health Insurance Institute (HIIS) over primary healthcare practitioners (PHCPs) in Slovenia, the reasons for sanctions and the violence against PHCPs if they followed the HIIS rules. MATERIALS AND METHODS: We performed analyses using survey data from a cross-sectional study, across public health centres and individual contractors in which 1,458 PHCPs were invited to answer a questionnaire anonymously via an online system used to collect data for the Slovenian Medical Chamber and the Association of General Practice/Family Medicine of South-East Europe. Quantitative data were presented by descriptive statistics and analysed using Pearson's chisquared test. RESULTS: Responses were obtained from 462 female and 138 male PHCPs. Of the total number of 600 participants, 430 were family medicine specialists. 263 (43.8%) responded that they have been sanctioned for various reasons. PHCPs that are more likely to be sanctioned include family medicine specialists and individual contractors. PHCPs working in areas smaller than 20 000 inhabitants were sanctioned in a bigger proportion than their counterparts. Monetary penalties levied against those working at health centres were usually covered by the health centre. Family medicine specialists, more often than other PHCPs experienced violence from patients or patients' relatives if they followed HIIS rules. CONCLUSION: Family medicine specialists are sanctioned more frequently than other PHCPs, individual contractors are sanctioned more frequently than public healthcare PHCPs and PHCPs in working area with a population less than 20.000 are more frequently sanctioned than those working in an area with a bigger population count.

Violências relacionadas ao trabalho e variáveis associadas em profissionais de enfermagem que atuam em oncologia / Work-related violences and associated variables in oncology nursing professionals

Resumo A violência ocupacional é um agravo ao qual os profissionais de saúde estão cotidianamente expostos. O objetivo deste artigo é identificar a prevalência de violência no trabalho (verbal/física) e as variáveis relacionadas em profissionais de enfermagem atuantes em oncologia. Estudo transversal, em que a agressão física ou verbal foi avaliada por meio do autorrelato. Analisou-se a relação entre as variáveis sociodemográficas, psicoemocionais e relacionadas ao trabalho violência (verbal/física) por meio dos testes Qui-Quadrado, exato de Fisher, Test T Student e Mann-Whitney. A amostra do estudo foi composta por 231 profissionais de enfermagem. A prevalência de agressão física ou verbal referida no último ano foi de 61,5%. Maior prevalência de agressão foi evidenciada nos profissionais que afirmaram apresentar-se cansados ao final do plantão e com concentração diminuída durante este turno. Destaca-se que os trabalhadores que sofreram violência apresentaram Burnout em alto nível em todas as subescalas, maior escore médio na escala de estresse no trabalho e pior qualidade do sono. Os achados do presente estudo apontam para necessidade de medidas institucionais para prevenção e controle da violência ocupacional.

Abstract Occupational violence is a problem that health professionals are exposed to daily. This cross-sectional study aimed at identifying the prevalence of violence at work (verbal/physical) and the variables related to it in nursing professionals working in oncology. Physical or verbal aggression was assessed through self-report. The relationship between sociodemographic, psycho-emotional and work-related violence (verbal/physical) variables was analyzed using the Chi-Square, Fisher's Exact, Student T and Mann-Whitney tests. The study sample consisted of 231 nursing professionals. The prevalence of physical or verbal aggression reported in the last year was 61.5%. A higher prevalence of aggression was evidenced in professionals who stated that they were tired at the end of the shift and presented reduced concentration during the shift. It is noteworthy that workers who suffered violence presented high levels of burnout in all subscales, a higher Mean score on the work stress scale and a lower Mean with regards to sleep quality. The findings of this study point to the need for institutional measures to prevent and control occupational violence.

Managing violence and aggression in the emergency department.

Half of all reported violent incidents in healthcare settings occur in the emergency department (ED), so ED nurses are disproportionately affected by violence and aggression. Violence and aggression can cause physical injury, psychological harm, delays to patient care, eroded staff morale, increased sick leave and low staff retention. This article explores potential causes and risk factors for violent or aggressive behaviour from patients and visitors in the ED. It discusses risk assessment tools, management approaches and risk reduction strategies that can be used in the ED to tackle violence and aggression. The article also features a case study describing a successful small-scale trial of body-worn cameras at an East London ED.

Cross-sectional and longitudinal relationships between psychological violence and teacher burnout.

OBJECTIVE: This study aimed to identify cross-sectional and longitudinal relationships between psychological violence (PV) and burnout after two years of follow-up. METHODS: This is a longitudinal study involving 430 public school teachers from a city in southern Brazil. PV was defined as insults by students, humiliation or embarrassment by colleagues or superiors or threats by any member of the school. Burnout was measured using the emotional exhaustion (EE) and depersonalization (DP) subscales of the Maslach Burnout Inventory-Human Services Survey. Analyses were performed using structural equation models in R. RESULTS: Younger age (ß = - .167) and poor/fair relationship with students (ß = .275) had a direct effect on PV. Temporary employment (ß = - .111) and poor/fair perception of the number of students in the classroom (ß = .124) had a direct effect on EE. Cross-sectionally, PV showed a direct effect at both T0 and T1 on EE (T0: ß = .435; T1: ß = .334) and on DP (T0: ß = .332; T1: ß = .325). Longitudinally, PV at T0 did not have a significant direct effect on burnout at T1. However, indirect effects of PV on EE (ß = .459) and DP (ß = .428) at T1 were observed. CONCLUSIONS: The effect of PV on burnout occurs in a short period of time. However, the long-term effect should be considered because there is a cumulative burden of exposure to violence over time.

Managing behaviour that challenges in people with dementia in the emergency department.

Dementia symptoms can manifest in a variety of ways, such as anxiety, agitation and an inability to communicate unmet needs. In emergency departments (EDs), these symptoms, as well as various environmental factors, can lead to behaviour that challenges in people with dementia. Therefore, ED staff must be skilled in screening, assessing and managing this patient group effectively. This article details a literature review that was conducted to explore the evidence on managing behaviour that challenges in people with dementia in the ED and what de-escalation strategies may be useful. A literature search of eight databases was undertaken, resulting in 11 articles that were included in this literature review. Four main themes were identified: violence and aggression towards staff; manual and chemical restraint in the ED; identifying delirium and dementia; and environment and person-centred care. Strategies identified to de-escalate and reduce the risk of behaviour that challenges include: making environmental modifications to the ED; providing person-centred care; excluding or evaluating pain and unmet needs; using various tools and strategies to improve communication; and using distraction techniques.

Recurrence of Violence Against Teachers: Two-Year Follow-Up Study.

The objective of this study was to analyze whether the experience of violence by teachers in the school environment increases the risk of teachers suffering violence again within a 2-year period. This longitudinal study included 430 primary and secondary public school teachers from a city in the south of Brazil, with data collected at two time points: T1 (2012-2013) and T2 (2014-2015). The data were obtained via face-to-face interviews and the completion of a questionnaire. The forms of violence investigated included reports of insults from students, humiliation or embarrassment by colleagues or superiors, and threats and physical violence from any member of the school occurring in the 12 months prior to the study. McNemar's test and the Poisson regression with robust error variance were used in the analyses, and the relative risk (RR) and 95% confidence interval (95% CI) were calculated. After 2 years, there was a reduction in violence reported by the teachers from 65.4% (T1) to 56.9% (T2) (p = .003). Teachers who suffered a certain form of violence had three times the risk of suffering that type of violence again. Those who reported three or four forms of violence at T1 had an RR of 2.23 of suffering any form of violence at T2 (95% CI [1.70, 2.93]) compared with those who did not report violence at T1. Psychological violence at T1 was not associated with physical violence at T2, nor was physical violence at T1 associated with psychological violence at T2. Despite the reduction in violence against teachers reported at T2, some forms of violence remained stable after 2 years. Suffering more forms of violence increases the risk of suffering any future violence.