Violence against healthcare workers br Hungarian experiences / Egészségügyi dolgozók ellen elkövetett eroszakos cselekedetek

Introduction: Violence against healthcare workers damages not only the health and dignity of employees but also the safety and productivity of institutions. Violence in healthcare also poses a threat to patient safety and the quality of patient care. Objective: The aim of the research is to get an idea of whether healthcare workers in Hungarian healthcare institu-tions, if they get involved in violent conflict, have someone to turn to at their workplace. It aims to explore whether communication, simulation and self-defense trainings are held in institutions, and to examine the relationship be-tween these prevention and treatment trainings with confidence. Method: Cross-sectional quantitative research has been conducted with an online questionnaire involving 720 health professionals. Results: It can be stated that when an atrocity hits a healthcare worker, he or she turns to his or her colleague during the violence and, after atrocity, asks the head nurse or a psychologist for help in processing the problem. 52% of verbal violence and 45% of physical violence were not reported by employees. A very high percentage (39%) of work-ers do not even know who to turn to if they are subjected to violent atrocity. The data show that communication training alone is not enough to make healthcare workers confident. However, participation in this training does not significantly reduce the average number of atrocities experienced in a year. Conclusion: The results obtained may also signal the need for communication training, but it is not enough in itself, it should be followed by simulation practice as well as self-defense education and practice. Participating in other communication or violence prevention training increases the confidence of healthcare workers, but communication training alone does not. There is no reporting obligation in the institutions so a lot of atrocities remain hidden.

Cardiac autonomic functions and the emergence of violence in a highly realistic model of social conflict in humans.

Among the multitude of factors that can transform human social interactions into violent conflicts, biological features received much attention in recent years as correlates of decision making and aggressiveness especially in critical situations. We present here a highly realistic new model of human aggression and violence, where genuine acts of aggression are readily performed and which at the same time allows the parallel recording of biological concomitants. Particularly, we studied police officers trained at the International Training Centre (Budapest, Hungary), who are prepared to perform operations under extreme conditions of stress. We found that aggressive arousal can transform a basically peaceful social encounter into a violent conflict. Autonomic recordings show that this change is accompanied by increased heart rates, which was associated earlier with reduced cognitive complexity of perceptions ("attentional myopia") and promotes a bias toward hostile attributions and aggression. We also observed reduced heart rate variability in violent subjects, which is believed to signal a poor functioning of prefrontal-subcortical inhibitory circuits and reduces self-control. Importantly, these autonomic particularities were observed already at the beginning of social encounters i.e., before aggressive acts were initiated, suggesting that individual characteristics of the stress-response define the way in which social pressure affects social behavior, particularly the way in which this develops into violence. Taken together, these findings suggest that cardiac autonomic functions are valuable external symptoms of internal motivational states and decision making processes, and raise the possibility that behavior under social pressure can be predicted by the individual characteristics of stress responsiveness.