Dimensions of violence against healthcare workers in emergency departments: a cross-sectional comparative study

Violence against health workers in hospital emergency departments is a global concern. The aim of this comparative study is to assess the differences in the patterns, magnitude, effects and underlying reasons for violence against health workers in the emergency departments of Palestine and Türkiye.

A cross-sectional study was conducted in 14 emergency departments in the West Bank and 3 in Isparta Province in Türkiye. A convenience sample of 377 health workers (227 in Palestine and 150 in Türkiye), consisting of 97 physicians, 198 nurses, and 82 other workers, including administrative and support health personnel, participated in the study. A self-administered survey was used to collect data between June and November 2024. Data was analyzed using SPSS with a significance level set at < 0.05. Statistical methods included, frequencies and percentages of the study variables, as well as Chi-square tests (χ2) and Fisher's exact tests used to assess the differences between the two countries in relation to violence prevalence and related factors.

A total of 68.7% of the participants reported exposure to workplace violence during the past year, which was significantly greater among Palestinian participants (84.6%) than among Türkiye participants. The prevalence rates of physical violence were 28.1%, 35.7% and 16.7% in Palestine and Türkiye, respectively; the prevalence rates of nonphysical violence were 65.3%, 81.1% and 41.1%, respectively (p < 0.05). Among the participants, physicians were the most affected by violence. The perpetrators were mainly (79.0%) patient families/companions and the patients themselves. A long waiting time to receive services, unmet expectations of patients and families and a lack of violence prevention measures were the top reported reasons. Approximately 80.0% of the events were not reported (62.1% in Türkiye, 86.3% in Palestine, p < 0.05), mainly because of a lack of follow-up and actions taken against aggressors or because the events were considered trivial/part of the job or feared consequences of reporting. The impacts of violence include significant negative psychological effects, such as hopelessness, disappointment, fear, and anxiety, in addition to effects on the delivery of care, e.g., minimizing communication and time spent with patients and companions. Violence was also associated with the intention of health care workers to leave their job in emergency services (p < 0.05).

Contextual differences are evident in the patterns and levels of violence in the countries studied; however, concerns are clearly common regarding and underlying reasons and impacts. The findings show that both settings suffer from considerable levels of workplace violence and negative consequences for healthcare workers and health care services with insufficient measures to combat them, which would require immediate attention. A collaborative approach among key stakeholders for developing and implementing evidence-based policies and strategies to mitigate the risks of this arduous public health problem is crucial.