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Abstract
Aims: To explore hospital staff experiences and perceptions of patient-perpetrated violence.
Design: Descriptive qualitative study.
Methods: Twelve semi-structured interviews (June-August 2022) were held with a diverse sample of hospital nurses, doctors, allied health professionals, security and a non-clinical manager. The framework approach was used to organise and analyse data, using Attribution Theory as a theoretical lens.
Results: Three themes were identified: violence as (un)predictable, violence as (un)preventable, and the cumulative toll of violence. In making sense of why patients become violent, participants described different ‘types’ of aggressive patients and variably attributed behaviours to situation, disposition, or a combination of both. Regardless of perceived causal factors, staff overwhelmingly appeared to view violence as predictable. Participants also reflected on the wider structural problems underpinning violence, frequently alluding to their sense of relative powerlessness to initiate change. The cumulative toll of violence was a common thread, with staff describing their acquisition of ‘resilience’ and reflecting on its role in their responses to escalating situations.
Conclusions: Many hospital staff are resigned to the inevitability of violence. The concept of staff ‘resilience’ following violence is not unproblematic, having the potential to serve as a guise for acceptance and as an additional variable for which staff are held accountable. When designing strategies, organisations should ensure that accountability for violence reduction is distributed across multiple levels. This study makes a novel contribution by exploring the perspectives of multiple staff groups working across diverse hospital settings, and adds to a sparse literature on this subject in the United Kingdom.
Implications for the profession: Efforts to address violence against healthcare staff need to be power-conscious, ensuring that accountability is distributed across multiple levels.
Reporting method: This study is reported in line with the Consolidated Criteria for Reporting Qualitative Studies (COREQ).
Patient or public contribution: No patient or public contribution.
Design: Descriptive qualitative study.
Methods: Twelve semi-structured interviews (June-August 2022) were held with a diverse sample of hospital nurses, doctors, allied health professionals, security and a non-clinical manager. The framework approach was used to organise and analyse data, using Attribution Theory as a theoretical lens.
Results: Three themes were identified: violence as (un)predictable, violence as (un)preventable, and the cumulative toll of violence. In making sense of why patients become violent, participants described different ‘types’ of aggressive patients and variably attributed behaviours to situation, disposition, or a combination of both. Regardless of perceived causal factors, staff overwhelmingly appeared to view violence as predictable. Participants also reflected on the wider structural problems underpinning violence, frequently alluding to their sense of relative powerlessness to initiate change. The cumulative toll of violence was a common thread, with staff describing their acquisition of ‘resilience’ and reflecting on its role in their responses to escalating situations.
Conclusions: Many hospital staff are resigned to the inevitability of violence. The concept of staff ‘resilience’ following violence is not unproblematic, having the potential to serve as a guise for acceptance and as an additional variable for which staff are held accountable. When designing strategies, organisations should ensure that accountability for violence reduction is distributed across multiple levels. This study makes a novel contribution by exploring the perspectives of multiple staff groups working across diverse hospital settings, and adds to a sparse literature on this subject in the United Kingdom.
Implications for the profession: Efforts to address violence against healthcare staff need to be power-conscious, ensuring that accountability is distributed across multiple levels.
Reporting method: This study is reported in line with the Consolidated Criteria for Reporting Qualitative Studies (COREQ).
Patient or public contribution: No patient or public contribution.
| Original language | English |
|---|---|
| Pages (from-to) | (In-Press) |
| Number of pages | 13 |
| Journal | Journal of Clinical Nursing |
| Volume | (In-Press) |
| Early online date | 19 May 2024 |
| DOIs | |
| Publication status | E-pub ahead of print - 19 May 2024 |
Bibliographical note
This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.Funder
The authors are grateful to the Clive Richards Foundation, formerly known as the Clive and Sylvia Richards Charity, Hereford, for funding this work. The funder played no role in the conduct of the research.Funding
The authors are grateful to the Clive Richards Foundation, formerly known as the Clive and Sylvia Richards Charity, Hereford, for funding this work. The funder played no role in the conduct of the research.
| Funders | Funder number |
|---|---|
| Clive Richards Foundation |
Keywords
- exposure to violence
- health personnel
- patient assault
- professional burnout
- qualitative
- verbal abuse
- workplace violence
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Exploring staff experiences and perceptions of patient-perpetrated violence in hospital settings: A qualitative study
Sammut, D., Lees-Deutsch, L. & Hallett, N., 27 Jun 2023, (Accepted/In press).Research output: Contribution to conference › Abstract › peer-review