Two Thirds Of Medical Professionals Are Subject To Insults And Threats, Spanish Study Finds

Until a few years ago the only knowledge regarding aggressive activities in hospitals concerned extreme cases.  The study entitled “Analysis of Violence”, undertaken in 2005, provided the first results a year later.  Now, this article deals with differences according to the type of centre, area and profession and informs us about the real incidence of this problem in Spain.

“The reality is that there is a less serious, insidious and continued violence of physical aggression, threatening behaviour and verbal abuse that is not reported as this is considered less important, but this type of violence can damage the health of the professionals and the quality of healthcare”, explains Santiago Gascón to SINC, who is the principal author of the study.  The study has been undertaken together with Begoña Martínez-Jarreta and other researchers from the University of Zaragoza (UNIZAR).

The results, which are published in the latest number of the International Journal of Occupational and Environmental Health, shown that 11% of the professionals have been the victim of physical aggression and 5% have been subjected to this on more than one occasion, whereas 64% have been subjected to threatening behaviour, coercion and insults.  34,4% have suffered threats and coercion on at least one occasion and 23.8% on numerous occasions.  Similarly, 36.6% have been subjected to insults on one occasion, at least.

The work, which was undertaken during 2005 in three hospitals and 22 primary care centres in rural and urban areas in Aragón and  Castilla-La Mancha, analyses the experiences and identifies the variables implicated, their distribution according to service, profession, age and gender, as well as the possible association between the number and severity of incidents and psychological health problems.

Among 1,845 participants in the research, 64,2% were women and 35,8% were men, and the mean age was 42.8 years.  According to profession the proportion was as follows: 33.5% were doctors, 47.5% were nursing professionals, 7.9% were administrative personnel, 1.7% were from management, 2.8% were porters and 6.6.% were technical personnel and other professionals.

The figures are higher in the large hospitals compared to the small centres and reach very high values in services such as Accident and Emergency and Psychiatry.  According to Gascón, “the data show the true dimension of under-reported violence”.

Violence due to waiting time

The study shows, moreover, that 85% of cases of aggression are perpetrated by the patients themselves (this percentage is lower in the Accident and Emergency Service where 27.3% of the aggressors turn out to be the people accompanying the patient).  21% of the aggressors are affected by a psychiatric disorder and cognitive deterioration and 5.7% are under the influence of alcohol or drugs.

The most frequent reason for aggression is related to waiting time (58%), followed by disagreements over the issuing of a doctor’s certificate (15%) or the prescription of medication (10%).

But the data contrast with the fact that only eight professionals in this study actually reported the aggression (all were serious physical injuries) whereas there were no reports for episodes of threats of insults.

“Taking into account that the proportion of women in the healthcare environment usually exceeds 60%, no relationship was observed between physical aggression and the fact that the victim was a man or a woman; but this did occur in the threats variable, with a clear prevalence of male victims and who were higher up in the hierarchy”, the researcher from Zaragoza points out to SINC.

Both physical and psychological violence show an identical negative impact in terms of burnout (work dissatisfaction). The perceived support is a variable which protects against the psychological effect of aggression, in such a way that those who do not feel supported by the administration show a worse prognosis following a violent episode.

“Professionals complain about the fact that the legislation in the different  communities does not give the same attention to the rights of the professional as they do to the rights of the patient and that, among the responsibilities and duties of the patient, it states that they must show respect to the equipment and property in the centres, but not one single line mentions observing respect for the dignity of the person who is caring for them”, concludes Gascón.