Workplace violence, occupational burnout, and post-traumatic stress among healthcare workers in Armenia

Workplace violence is a significant occupational hazard in healthcare systems worldwide and may have serious psychological consequences for healthcare workers. Exposure to violence can contribute to the development of occupational burnout and post-traumatic stress disorder (PTSD), negatively affecting both staff well-being and the quality of healthcare services.

To analyze the types of workplace violence, associated risk factors, and the relationship between exposure to violence, occupational burnout, and post-traumatic stress disorder among healthcare workers.

A quantitative cross-sectional non-experimental study was conducted among 432 healthcare workers from Yerevan and the regions of Armenia. Workplace violence was assessed using the collaboratively developed and internationally validated questionnaire within ICREATE project. Burnout was evaluated using the Maslach Burnout Inventory, while PTSD symptoms were assessed using the DSM-5 PCL-5 questionnaire among participants who reported exposure to violence (n = 305). Statistical analyses included Chi-square tests, Cramer's V coefficient, independent samples t-tests, one-way ANOVA, and logistic regression.

Verbal violence was reported by 333 participants, physical violence by 184, sexual harassment by 77 and sexual violence by 10 healthcare workers. High or very high levels of occupational burnout were observed in the majority of respondents. Statistical analysis revealed significant associations between physical and verbal violence and higher levels of emotional exhaustion, depersonalization, and overall burnout (p < 0.05). Ordinal logistic regression analysis indicated that healthcare workers exposed to physical violence had approximately three times higher odds of experiencing higher levels of burnout (OR≈3.02; 95% CI: 1.98-4.63). Among participants exposed to violence, 64.9% reached the threshold score for probable PTSD. Physical violence was significantly associated with PTSD (χ² = 30.130, p = 0.000), and logistic regression analysis showed that exposure to physical violence increased the likelihood of PTSD by approximately 3.4 times.

Workplace violence is strongly associated with occupational burnout and PTSD among healthcare workers. Physical and verbal violence represent key predictors of adverse psychological outcomes.