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Determinants of workplace violence against nurses and mitigation strategies in hospitals in developing countries: a
Fatemeh Mahmoudi1, Mahnaz Ashoorkhani2, Nadia Saniee3
1Department of Health Education and Promotion, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
Background:
Violence against nurses has become a serious concern, especially in developing countries. Given the critical role that nurses play in healthcare, it is essential to implement interventions aimed at reducing this violence. The objective of this study was to identify the causes of violence against nurses in hospitals in developing countries and to propose mitigation strategies.
Methods:
This scoping review was conducted in accordance with Arksey and O'Malley framework and reported based on PRISMA-ScR guideline in 2024. A comprehensive search was carried out across international databases including PubMed, Scopus, PsycInfo, and Web of Science. The search strategy involved a combination of keywords related to "nurses" and "violence," covering studies published between 2003 and 2024. Data extraction was performed using a structured form developed in Microsoft Word 2016. Thematic content analysis was employed to synthesize the findings.
Results:
During the search, 2658 records were identified, with 414 duplicates removed. Ultimately, 160 full texts were reviewed, and 74 records were deemed eligible for inclusion in the study. The main causes of violence against nurses in developing countries categorized by patients and companions' causes (e.g., unmet expectations of the patient and their companion), nurses' causes (e.g., stress due to workload pressure), organizational causes (e.g., crowded work environment and excessive noise), social causes (e.g., low level of public awareness), and political causes (e.g., political issues). The most important interventions for reducing violence against nurses were categorized into three levels: before the occurrence of violence (e.g., restriction of patient- companions' mobility), during the occurrence of violence (e.g., calling security personnel to the scene of violence), and after the occurrence of violence (e.g., reporting incidents of violence).
Conclusion:
The results revealed that violence against nurses in developing countries is a complex, multifactorial issue rooted in individual, organizational, social, and political domains. A holistic and context-sensitive strategy is required to address workplace violence against nurses effectively. Interventions must go beyond individual behavior and encompass organizational reforms, public awareness, and policy development. Future research should prioritize evaluating interventions during and after violence, assessing long-term impacts, and exploring the role of leadership and organizational culture.
Clinical Trial Number:
Not applicable.
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