Psychosocial pattern of interprofessional violence in Peruvian healthcare work: A mixed Delphi consensus study

Studies on psychological violence in health care facilities have focused on the analysis of incidences in specific contexts. Nevertheless, consensus studies on the psychosocial factors of interprofessional violence related to interpersonal conflict and motivational demands are scarce. The aim of this study is to determine by Delphi consensus the psychosocial pattern of interprofessional violence in healthcare work for Peru and its geographical regions.

A mixed Delphi consensus method was applied, bringing together professionals with experience and knowledge of psychological violence. The study was conducted in three stages and three rounds of Delphi consultation between May 2023 and June 2024. The integration of consensus at regional and national levels was carried out through Graph Network Analysis.

Up to the third stage of the study, 444 experts in 32 focus groups from 81 health care institutions participated. 70.5% of the participants were women and 27.6% worked in nursing and emergency departments. After the Delphi consensus analysis, we obtained a ranked list of six psychosocial factors of interprofessional violence for Peru and nine for the regions.

According to the consensus, two of the main psychosocial factors of interprofessional violence in health establishments in the Costa and Forest regions are the devaluation of work and harassment by superiors towards subordinates that induce them to change jobs or resign. Excessive control by colleagues was the first hierarchy for the Sierra region. The differences between geographical regions in Peru and between studies in other countries reflect that the phenomenon of interprofessional violence is very specific and contextual; in the case of Peru the differences between regions may be due to health care facilities with different characteristics (e.g., rural vs. urban facilities).