Violence toward staff in the inpatient psychiatric setting: Nurses' perspectives: A qualitative study.

BACKGROUND: Workplace violence is a universal phenomenon faced by employees in all industries but more so by employees working in sectors that require interpersonal contact, especially with individuals who may be violent, distressed, or vulnerable. Globally, healthcare professionals working in the emergency and psychiatric sectors are at the highest risk of workplace violence. In fact, healthcare professionals in the psychiatric setting have a higher risk rate of facing workplace violence opposed to other healthcare settings. Workplace violence can lead to adverse physical and psychological outcomes and impact the quality of care provided to patients. OBJECTIVE: This study aims to explore nurses' experiences with workplace violence and the impact of violence on nurses. Whereas the objectives of this study are to explore and analyze mental health nurses' experiences with workplace violence in Brunei Darussalam, identify and explore the impact of violence on mental health nurses, and discuss nurses' coping mechanisms following a workplace violence experience. DESIGN: Qualitative explorative study. SETTING(S): Mental Health Unit Kiarong of Raja Isteri Pengiran Anak Saleha Hospital, Brunei Darussalam. PARTICIPANTS: Nurses (n = 12). METHODS: Data was collected by conducting individual via online platforms. The interviews were carried out in English and/or Malay, the verbatim transcripts produced were transcribed in their source languages and only relevant excerpts were translated into English for the write-up. The data were analyzed utilizing thematic analysis by the researcher independently. RESULTS: This study identified three themes: Violence as a norm in the psychiatric setting, perceived impact of workplace violence, and "Talk, Report and Accept" as Coping mechanisms. CONCLUSIONS: In conclusion, it is apparent that globally workplace violence is normalized in the nursing industry, especially in the psychiatric setting. Workplace violence yields a plethora of negative long-term and short-term impacts on nurses. Despite this, workplace violence often goes unreported for numerous reasons but mainly due to the lack of changes after reporting. Nurses should be encouraged to report all instances of workplace violence by demonstrating effective changes and providing hazard pay. The management should actively attempt to reduce the risk of workplace violence by preemptively equipping nurses with the necessary training including identification of potential risks of workplace violence, effective de-escalation methods, and proper control and restraint methods.

Patient-reported outcome measures among breast cancer survivors: A cross-sectional comparison between Malaysia and high-income countries.

OBJECTIVES: Patient-reported outcomes (PROs) in high-income countries (HICs) suggest that physical, emotional, and psychological needs are important in cancer care. To date, there have been few inconsistent descriptions of PROs in low-income and middle-income Asian countries. Using a standard questionnaire developed by the International Consortium for Health Outcomes Measurement (ICHOM), we compared the perceived importance of PROs between patients in Malaysia and those in HICs and between clusters of Malaysian women. METHODS: Breast cancer patients were recruited from three Malaysian hospitals between June and November 2017. We compared the proportion of patients who rated PROs as very important (scored 7-9 on a 9-point Likert scale) between Malaysian patients and data collected from patients in HICs via the ICHOM questionnaire development process, using logistic regression. A two-step cluster analysis explored differences in PROs among Malaysian patients. RESULTS: The most important PROs for both cohorts were survival, overall well-being, and physical functioning. Compared with HIC patients (n = 1177), Malaysian patients (n = 969) were less likely to rate emotional (78% vs 90%), cognitive (76% vs 84%), social (72% vs 81%), and sexual (30% vs 56%) functioning as very important outcomes (P < 0.001). Cluster analysis suggests that older, parous, Malaysian women, who were less likely to have received breast reconstructive surgery, were more likely to rate body image and satisfaction with the breast as very important outcomes. CONCLUSION: Taking into account the differences in PROs by cultural and socioeconomic settings could improve patient expectation of services and refine the assessment of cancer care outcomes.