Factors influencing violence at emergency departments: Patients' relatives' perspectives

In hospitals, the places where the highest rate of violence is perpetrated are emergency departments (EDs). Evaluating patient relatives' perceptions of violence and obtaining their views about how to prevent violence incidents are important in terms of uncovering the factors that increase violent behaviors. This study was aimed at determining the factors increasing violence in the emergency department (ED) from the perspectives of patient relatives.

The sample of this study consisted of 520 individuals who brought a relative to the Adult ED of Akdeniz University Hospital in Turkey between April 2017 and June 2017. Data was collected using a two-part questionnaire prepared by the researcher. The first part consists of 15 items questioning the demographic characteristics of the participants. The second part consists of 20 statements asked the participants to rate the reasons urged patients or their relatives to perpetrate violence in the emergency department. Numbers and percentage calculations were used to evaluate the data.

Of the participants, 55.6% were men and 54.7% were married. According to the participants' statements, of the relatives of the 520 patients, 141 (27.1%) witnessed verbal violence against emergency department staff, 76 (14.6%) witnessed physical violence against emergency department staff, 9 (1.7%) witnessed verbal threat against emergency department staff, especially against nurses. According to the participants, the primary factor causing people to perpetrate violence at EDs was that patients or their relatives were not adequately informed about the patient's condition. More than 40% of patients' relatives said that anxiety and nervousness arising from being a patient's relative, and stress and sadness they suffered were among the leading factors causing people to perpetrate violent incidents.

In order to prevent and decrease incidents of violence in the emergency departments, healthcare systems should be reviewed and revised. Our study revealed that informing patients and their relatives about the patient's condition and empathic approaches displayed by healthcare employees towards patients reduced the number of incidents of violence. Unlike other studies, this study addresses the negative experiences of patients' relatives in the emergency department and the factors influencing these experiences. Obtaining the opinions of the patients' relatives about possible solutions to the violent events in the ED makes this study unique.