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Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
[Workplace violence at the Heim Pál National Institute of Pediatrics]
Gergely Fliegauf1,2,3, Dóra Eszter Várnai2,3, Tünde Guti2
11 Nemzeti Közszolgálati Egyetem, Rendészettudományi Doktori Iskola Budapest Magyarország.
Insights
Healthcare workers in children's hospitals experience significant workplace violence, primarily verbal aggression from patients and relatives. Registered nurses and those in emergency care face the highest risk, highlighting the need for targeted interventions.
Area of Science:
- Healthcare Management
- Occupational Health
- Pediatric Care
Background:
- Workplace violence impacts hospital quality and service effectiveness.
- Studies on violence in pediatric settings are less common than in general hospitals.
- Aggression perception is complex, especially with sick children involved.
Purpose of the Study:
- Examine the relationship between healthcare worker demographics and perceived workplace violence.
- Explore staff assessments of their work environment and emergency care specifics.
- Identify risk factors for workplace aggression in a pediatric hospital.
Main Methods:
- Exploratory cross-sectional study of 266 healthcare workers.
- Online questionnaire including demographic, work-related, and aggression scale items.
- Adaptation of the Open Aggression Scale for pediatric hospital context.
Main Results:
- Verbal aggression is the most common form of violence from patients (60.1%), relatives (78.7%), and colleagues (53.8%).
- Registered nurses, those on day/alternating shifts, and multilingual staff showed higher risk.
- 100% of emergency care workers reported verbal aggression from relatives.
Conclusions:
- Lower-ranking healthcare workers face higher risks of workplace violence.
- Perceptions of violence are linked to stress, work organization, and environment.
- Understanding communication dynamics and implementing de-escalation techniques are crucial.
Abstract:
Introduction: Violence against healthcare workers is a frequently researched topic because of its impact on hospital quality. However, studies focusing specifically on children’s hospitals are rarer. Workplace violence reduces the effectiveness of hospital services and the perception of aggression is a social psychological process that becomes particularly complex when a sick child is involved in the interaction. In addition to the behavioral patterns exhibited by patients and their relatives, workplace aggression is also present among healthcare workers in the form of harassment. Objective: Beyond detailed descriptive statistics, our study examines the relationship between demographic characteristics of healthcare workers and perceived workplace violence. We also explore staff’s assessments of their work environment and the specific characteristics of emergency care. Method: Our exploratory cross-sectional study involved 266 healthcare workers (81.2% female, mean age: 42 years). Our research team designed an online questionnaire that included demographic and work-related questions, as well as items from the Open Aggression Scale, which has been used previously in Hungary. The questionnaire was adapted to the specific circumstances of the centrally located children’s hospital where the study was conducted. It also included the findings of a previous study on workplace violence conducted in the same hospital. Prior to the survey, orientation meetings were held in all 32 departments of the hospital. Results: In line with international research, we found that the most common type of hospital violence was 60.1% by patients, 78.7% by relatives and 53.8% by colleagues over a one-year period. In all three categories, verbal aggression was the most common form. The four most frequently perceived aggressive behaviors – shouting, insulting, swearing and derogatory threats – occurred in all three groups of respondents. The highest-risk profile was among registered healthcare professionals with nursing qualifications, working permanent day shifts or alternating day and night shifts, caring mainly for inpatients, working second jobs and speaking English beyond their mother tongue. In terms of job evaluation, 23% of the 149 respondents perceived a worsening trend, 70% saw no change and 7% saw an improvement in the six months prior to the survey. 100% of emergency care workers reported experiencing some form of verbal aggression from relatives, a higher proportion than those working in other departments (82%). Discussion: A study conducted at the Heim Pál National Institute of Pediatrics found an association between perceptions of workplace violence among healthcare workers and demographic variables. Particular attention should be paid to understanding the unique communication dynamics between children, their relatives and healthcare providers. Conclusion: In general, lower-ranking healthcare workers are more likely to interact with patients and relatives in situations where workplace violence may occur. The perception of such interactions is associated with several factors, including stress, work organization, the work environment, interpretation of aggressive behavior, post-event debriefing, the existence of anti-bullying protocols, and knowledge of de-escalation techniques. Orv Hetil. 2025; 166(24): 930–941.
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