User violence in public mental health services. Comparative analysis of psychiatrists and clinical psychologists.

BACKGROUND: User violence toward health workers is a growing problem. Several studies report that it is increasing and there is also an increase in the number of complaints by these professionals. Within the health system, Mental Health services have been identified as a collective at special risk. AIMS: This study aims to examine in greater depth the differences in perceived user violence against health professionals, as well as its consequences, comparing two large groups: psychiatrists and clinical psychologists. METHODS: Using a cross-sectional design, self-reported questionnaires were applied to a sample of 138 professionals from all the public centers in the Region of Murcia (southwest of Spain) that have a Mental Health Unit. RESULTS: The results show that psychiatrists are significantly more exposed to user violence, both verbal and physical, revealing a relationship with job dissatisfaction, emotional exhaustion, professional effectiveness, and cynicism. CONCLUSIONS: The present study provides evidence on the differences in the perception of violence of users towards psychologists and psychiatrists, being those who show that they claim to be more exposed. Furthermore, this violence is associated with burnout, job dissatisfaction, somatic symptoms, anxiety, or depression, among other consequences.

Classification accuracy and resistance to coaching of the Spanish version of the Inventory of Problems-29 and the Inventory of Problems-Memory: A simulation study with mTBI patients.

Objective: The present study aims to evaluate the classification accuracy and resistance to coaching of the Inventory of Problems-29 (IOP-29) and the IOP-Memory (IOP-M) with a Spanish sample of patients diagnosed with mild traumatic brain injury (mTBI) and healthy participants instructed to feign. Method: Using a simulation design, 37 outpatients with mTBI (clinical control group) and 213 non-clinical instructed feigners under several coaching conditions completed the Spanish versions of the IOP-29, IOP-M, Structured Inventory of Malingered Symptomatology, and Rivermead Post Concussion Symptoms Questionnaire. Results: The IOP-29 discriminated well between clinical patients and instructed feigners, with an excellent classification accuracy for the recommended cutoff score (FDS ≥ .50; sensitivity = 87.10% for coached group and 89.09% for uncoached; specificity = 95.12%). The IOP-M also showed an excellent classification accuracy (cutoff ≤ 29; sensitivity = 87.27% for coached group and 93.55% for uncoached; specificity = 97.56%). Both instruments proved to be resistant to symptom information coaching and performance warnings. Conclusions: The results confirm that both of the IOP measures offer a similarly valid but different perspective compared to SIMS when assessing the credibility of symptoms of mTBI. The encouraging findings indicate that both tests are a valuable addition to the symptom validity practices of forensic professionals. Additional research in multiple contexts and with diverse conditions is warranted.

Patients' aggressive behaviours towards nurses: development and psychometric properties of the hospital aggressive behaviour scale- users.

AIM: This article is to report the development and psychometric testing of the Hospital Aggressive Behaviour Scale - Users. BACKGROUND: Workplace violence is present in many work spheres, but in the healthcare sector, nurses in particular are at more risk due to the close contact they maintain with users and clients and the special characteristics of this relationship. DESIGN: Using qualitative and quantitative methodology, an instrument was applied to a sample of 1,489 nurses from 11 public hospitals. Data collection was carried out in 2010 and 2011. RESULTS: Exploratory factor analysis yielded a 10-item instrument distributed in two factors (non-physical violence and physical violence), which was validated by means of confirmatory factor analysis. Both the resulting questionnaire and the factors identified present high internal consistency and adequate external validity, analysed by means of statistically significant correlations between the Hospital Aggressive Behaviour Scale and job satisfaction, burnout components, and psychological well-being. CONCLUSIONS: The results indicate that, in nursing personnel, higher exposure to user violence leads to lower job satisfaction, more emotional exhaustion and more cynicism, and to a lower level of psychological well-being. The instrument developed in this study may be very useful in the sphere of assessment and prevention of psychosocial risks for the early detection of the problem of user violence in its two facets.

Workplace violence in hospital emergency departments and consequences for health care professionals and support staff: a cluster analysis. / Violencia laboral de usuarios y sus consecuencias sobre profesionales sanitarios y no sanitarios de los servicios de urgencias hospitalarios: análisis de clúster.

OBJECTIVES: Workplace violence of any type is influenced by multiple factors and leads to physiological, psychological, social, and organizational change. Emergency and other urgent care settings have assault rates up to 5-fold higher than other health care settings. This study aimed to analyze the consequences of physical and nonphysical violence on health care and support personnel in hospital emergency departments. MATERIAL AND METHODS: Cross-sectional descriptive analysis of responses to a 121-item survey of 584 health care and support workers in 12 Spanish hospital emergency departments. We analyzed the magnitude of the problem with a two-step self-clustering method and then assessed the associations between variables and workplace violence. RESULTS: Two groups were identified. The first consisted of 298 cases with high mean (SD) scores for nonphysical assaults (51.5 [7.9]) and low scores for physical violence (4.8 [2.9]). The second group consisted of 285 cases with intermediate scores for nonphysical assaults (27.1 [8.4]) and low scores for physical violence (3.4 [1.3]). CONCLUSION: Emergency departments have incidents of nonphysical workplace violence more often than physical violence. Emergency personnel with high exposure to workplace violence, particularly nonphysical assaults, experience physiological, psychosocial, and organizational changes.

OBJETIVO: La violencia laboral en cualquiera de sus modalidades se halla influenciada por múltiples factores, dando lugar a cambios fisiológicos, psicológicos, sociales y organizacionales, y los entornos de urgencias y emergencias presentan una incidencia de hasta cinco veces más con respecto al resto de servicios sanitarios. El objetivo de este estudio es analizar las características que desarrollan los profesionales sanitarios y no sanitarios de los servicios de urgencias hospitalarios (SUH) que sufren violencia laboral física y no física. METODO: Es un diseño trasversal, descriptivo-analítico mediante la aplicación de un formulario de 121 ítems a una muestra de 584 profesionales sanitarios y no sanitarios de 12 hospitales españoles con SUHS, se aplicó análisis estadístico para magnitud del evento y análisis de clúster mediante método stepwise con solución de autoclustering y posterior relación de variables del estudio con violencia laboral. RESULTADOS: Tras la aplicación inicial del método descrito, se conformaron 2 grupos, el primero de ellos incluye a 298 casos y se caracteriza por puntuaciones altas en violencia no física (media: 51,5, desviación estándar: 7,9) y bajas en física (4,8, 2,9). Por otro lado, el segundo grupo está compuesto por 285 casos y se caracteriza por puntuaciones intermedias en violencia no física (27,1, 8,4) y bajas en física (3,4, 1,3). CONCLUSIONES: En los SUH existen manifestaciones de violencia laboral no física que presentan una mayor incidencia que las manifestaciones de violencia física. Aquellos profesionales con elevada exposición a violencia laboral, y en concreto a violencia no física, presentan alteraciones biopsicosociales y organizacionales.

Personality traits and sick leave in workers diagnosed with nonorganic neck pain.

Previous research has suggested that personality can influence the perception and reporting of physical symptoms, such as pain. To assess the relationship between the course of nonorganic neck pain and the individual's personality, we studied the association between two indicators of neck pain prognosis, such as the duration of sick leave associated with neck pain and sick leave recurrence, and 15 personality traits in a sample of 64 workers suffering from disabling neck pain without any signs of physical abnormalities in the neck area. The TEA Personality Test (TPT), a self-report instrument designed to evaluate personality traits related to organizational behaviors, was used. Compared to the normative data, the study sample obtained high scores in the Depression, Anxiety and Emotional Instability scales, thus suggesting a personality profile primarily characterized by high neuroticism-related scores. Controlling for age, gender, and any rehabilitation undergone, we found a positive relationship between Depression and the duration of sick leave (in weeks). Moreover, lower scores on the TPT personality trait Dynamism and activeness were associated with higher likelihood of sick leave recurrence. These findings highlight the need for further research into the role played by personality at the onset and in the maintenance of nonorganic neck pain. Furthermore, they suggest that a complementary psychological approach may be useful to nonorganic neck pain management.

Mental Health and Healthy Habits in University Students: A Comparative Associative Study.

There is evidence of increased psychopathology in university students and its relationship with unhealthy lifestyle habits. The objective of this work is to examine the prevalence and differences in psychopathological symptoms and lifestyle in a sample of university students according to educational levels and area of knowledge. A comparative associative study was conducted with 1405 university students. The results indicated significant differences in psychopathology and habits in the different groups. The prevalence of psychopathology found was high, especially depressive and anxious pathologies. This incidence tends to be higher in undergraduates and/or Arts and Humanities, coinciding with those who tend to have poorer lifestyle habits. The promising contributions from this study facilitate the early detection of university students with a risk profile for the appearance or exacerbation of psychopathology, as well as the design of psychological intervention programs aimed at the psychological well-being of this population.

Attitudes Towards School Violence: A Qualitative Study With Spanish Children.

School violence is a social issue of particular interest both for intervention and research. Attitudes towards violence have been reported in the literature as relevant variables for evaluation, prevention, and intervention in this field. This study aims to examine in-depth attitudes toward school violence. The sample consists of 96 participants from Spanish Elementary Education and Compulsory Secondary Education schools. A qualitative study was conducted through focus groups and thematic analysis of the data. The results identify a habitual set of attitudes towards violence in children. These are related to violence as a way to feel better or increase self-esteem, as leisure or fun, perceived as legitimate, when violence is exercised against those who are different, when it has no consequences, to resolve conflicts, to socialize, and to attract the attention of peers. These results could serve as a basis for the creation of evaluation tools, as well as the design of prevention and intervention plans based on attitude modification.

Association between attitudes toward violence and violent behavior in the school context: A systematic review and correlational meta-analysis.

BACKGROUND/OBJECTIVE: Both theoretical proposals and empirical work point to a common concurrence between attitudes toward school violence and violent behavior. Studies often address this issue superficially or within intervention programs. Our objective is to describe the results of a systematic review and to conduct a meta-analysis exploring these associations. METHOD: A systematic review was conducted in the main databases. Effect sizes were calculated and synthesized using random-effects meta-analysis to estimate the relationship between attitudes toward violence and school violence. A meta-regression was performed for the moderator analysis of sex and age. RESULTS: The literature search strategy produced 12,293 articles. The review process produced a final result of 23 studies. Our results estimate a significant positive relationship (r =.368 p < .001; 95% CI [.323, .412]) between attitudes toward violence and school violence in children and adolescents. CONCLUSIONS: This study allows us to quantify with an adequate degree of specificity the attitude-behavior relationship in the school context. These results may facilitate future researchers to design programs that address this specificity in order to improve school climate. More research is needed using validated instruments to further specify the type of attitudes that have the greatest influence on the manifestation of school violence.

ANTECEDENTES/OBJETIVO: Las propuestas teóricas y trabajos empíricos apuntan una concurrencia entre las actitudes y la conducta violenta en el contexto escolar. Los estudios suelen abordar esta cuestión superficialmente o dentro de programas de intervención donde se trabajan múltiples variables, existiendo diferencias en la magnitud de esta relación. El objetivo del estudio es describir los resultados de una revisión sistemática y realizar un meta análisis que explore estas asociaciones. MÉTODO: Se realizó una revisión sistemática en las principales bases de datos. Se calcularon los tamaños del efecto y fueron sintetizados mediante un meta análisis de efecto aleatorio para la relación entre actitudes hacia la violencia y violencia escolar. Se realizó una meta regresión para el análisis moderador del sexo y edad. RESULTADOS: La estrategia de búsqueda produjo 12.293 artículos. El proceso de revisión estructurado produjo un resultado final de 23 estudios. Nuestros resultados estiman una relación positiva y significativa (r = 0,368 p < 0,001; 95% CI = [0,323, 0,412]) entre actitudes y violencia escolar en menores. CONCLUSIONES: Este estudio permite cuantificar con un adecuado grado de especificidad la relación actitud conducta en el contexto escolar. Estos resultados facilitarían a futuros investigadores plantear programas que aborden esta especificidad para mejorar el clima escolar.

Sources of Conflict and Prevention Proposals in User Violence Toward Primary Care Staff: A Qualitative Study of the Perception of Professionals.

Background: Some studies indicate that at least one in four cases of workplace violence occurs in the health sector, with a higher incidence in Emergency Departments, Mental Health Services or Primary Care. Unlike other professional groups, healthcare workers perceive this type of behavior mainly from users or patients. This is the reason why both the detection of conflict between users and professionals and the ways to face and reduce these conflicts has been and is one of the main fields of study in this population. The aim of this study was to delve into the sources of conflict between users and professionals in Primary Care from the perspective of the professionals themselves. In addition, the aim was to explore the proposals for intervention/prevention of this conflict that the professionals perceived as necessary to improve the work environment. Methods: This study uses qualitative methodology conducting 8 focus groups with professionals related to Primary Health Care. The final sample was composed of 44 workers who were part of the regional management, labor unions, area coordinators, center coordinators and representatives of the professional groups of these centers (medicine, nursing and administration). Thematic analysis was used to extract topics and subtopics. Results: The results are divided into areas of conflict and intervention proposals. The professionals detect a lack of training or education in themselves, absence of functional multidisciplinary teams or competencies to improve the patient-professional relationship, among others. To address these shortcomings, they propose the creation of protocols for action in the face of aggression, the formation of spaces and channels of communication both among the center's own workers and between them and other organizations (e.g., hospitals), fostering a positive relationship with the user community and ongoing training in various topics such as self-safety, management of emotions, empathy or interpersonal communication. Conclusions: This study allows to highlight specific areas of user-professional conflict in Primary Care. Furthermore, the inclusion of intervention proposals by the professionals allows to propose starting points for the development of complete plans.

Assessment of Non-physical User Violence and Burnout in Primary Health Care Professionals. The Modulating Role of Job Satisfaction.

INTRODUCTION: Growing concern about workplace violence shows the need for an evaluation in specific contexts in order to identify the particularities of each professional group. The health sector consists of a group of professionals with high exposure to violence, specially from users. There are differences depending on the professional category or unit in which the professional works. In this regard, Primary Health Care (PHC) is characterized by a personalized and continuous patient treatment over time, which is not exempt from cases of violence. Among the commonly studied consequences of these situations are decreases in job satisfaction and burnout. OBJECTIVE: The main objective of this study is to analyze the modulating role of job satisfaction in the relationship between non-physical user violence and the onset of burnout. METHODS: Cross-sectional comparative descriptive design. The sample consisted of 574 professionals from 39 PHC centers of the Murcian Health Service. Data were collected using two-stage cluster sampling. For data analysis, descriptive analysis, correlations and stepwise hierarchical regression were used to analyze the interaction between the variables. RESULTS: Regression analysis draws a model where non-physical violence and low intrinsic and extrinsic job satisfaction act as modulators of non-physical violence, cynicism and emotional exhaustion. CONCLUSIONS: This study provides evidence of the psychological consequences of the perception of user violence in the PHC staff. Furthermore, it is evident that the emergence of burnout syndrome in these professionals is related to exposure to verbal or non-physical violence together with low job satisfaction. In this sense, a circular and bidirectional relationship between the variables studied is proposed as a possible explanatory model.

(Un)Broken: Lateral violence among hospital nurses, user violence, burnout, and general health: A structural equation modeling analysis.

Introduction: Workplace violence is a social problem yet to be solved. Although it is present in virtually all work environments, its prevalence in healthcare settings stands out, being perceived as something inherent to the job. Most studies in this context have focused on user violence against professionals. However, it has been observed that violence among colleagues in these types of jobs is a risk factor for the health of workers and has rarely been studied as a whole. Among the main consequences of exposure to violence reported in the literature, burnout syndrome, depression, anxiety, or somatic problems have been among the most studied. On the one hand, some authors claim that being exposed to workplace violence can increase the associated physical and psychological pathology and lead to a picture congruent with burnout. On the other hand, it has been hypothesized that violence is associated with burnout, which can trigger physical and psychological symptoms. Taking into account this background, the aim of this study is to explore workplace violence in health personnel, symptomatology, and burnout syndrome through mediation models that allow us to know the interrelationships between the variables. Methods: A cross-sectional design with a double descriptive-associative strategy was used. The sample was composed of 950 nursing professionals from public hospitals. The scales of physical and non-physical violence from users to professionals HABS-U, personal, social, and occupational violence among co-workers using the Health Aggressive Behavior Scale - Co-workers and Superiors (HABS-CS) scale, the burnout scale Maslach Burnout Inventory - General Survey (MBI-GS) which evaluates professional exhaustion, efficacy and cynicism, and the factors referring to depression, anxiety, somatization, and dysfunction of the GHQ-28 scale were applied. In order to calculate the models, workplace violence was used as a predictor of symptomatology, using the burnout variables as mediators. Regression coefficients with and without mediation model, direct and standardized estimates were obtained. For statistical power, Bootstrap analysis was used to calculate direct mediation effects. Results: After controlling the mediation effects of burnout and cynicism, physical and non-physical user violence toward healthcare personnel were significant predictors of the GHQ-28 scores. These same results were obtained when assessing the relationship between social, occupational, and personal violence among co-workers and GHQ-28 scores. Conclusion: Our results contribute to increase the evidence about the effects of violence on the health of professionals and to advance in the characterization of the possible consequent psychological damage. Regardless of the type of violence experienced, exposure to violence can lead to anxious, depressive or somatization symptoms, among others. Violence is also a predictor of burnout syndrome, which in turn accentuates the rest of the consequences studied. Despite the limitations of the proposed model, these results serve to highlight the complexity of the situation experienced by healthcare professionals. Moreover, it serves as a basis for proposing intervention/prevention programs to raise awareness and protect professionals from these risks. To this end, self-care tools should be proposed with which professionals take care of their own health through the management of violent situations and/or the improvement of occupational health.

Profiles of lateral violence in nursing personnel of the Spanish public health system.

BACKGROUND: Workplace violence in healthcare settings has long been studied in scientific literature, particularly in the nursing profession. Research has explored mostly user violence probably for its high prevalence and impact on health and job satisfaction. Yet this focus may overshadow another dangerous type of workplace violence: coworker violence. Exerted by co-workers with similar status, lateral violence differs from that yielded by a co-worker with a higher rank, known as vertical. This study aims to deepen the knowledge about lateral violence perceived by nurses and its interaction with other variables commonly associated with workplace violence in healthcare: burnout, job satisfaction, and self-perceived health. METHOD: A random block sampling was performed, prompting a total sample of 925 nursing professionals from 13 public hospitals located in the southeast of Spain. The sample distribution (mean and standard deviation) and the response percentages according to the study variables of the ad-hoc questionnaire were analyzed and classified with cluster analysis. RESULTS: Through the cluster analysis, two subgroups were obtained: Cluster 1, composed of 779 participants, with low scores in the variables used for the classification, high levels of both extrinsic and intrinsic satisfaction, low levels of emotional exhaustion and cynicism, and low rates of somatization, anxiety, social dysfunction and depression; and Cluster 2, composed of 115 participants and characterized by moderate-high scores in the variables used for the classification, moderate extrinsic satisfaction, and low intrinsic satisfaction, high emotional exhaustion and cynicism and lower somatization, anxiety, social dysfunction, and depression scores. Excluded cases amounted to 31. CONCLUSION: Nursing professionals who experience lateral violence reveal a lower intrinsic satisfaction, feeling less self-accomplished in their job, and less positive work experience. Emotional exhaustion rises as a concerning progressive and long-term outcome of experiencing this type of violence.

Relationship between Job Satisfaction and Workload of Nurses in Adult Inpatient Units.

Among Nursing and Psychology professionals, the job satisfaction of those in Adult Inpatient Units is analyzed, with a new scale to measure nursing workloads validated. Objective: The objective of this study was to relate nursing workloads to professional job satisfaction. Methods: This is an observational, analytical, descriptive, concurrent and quantitative study, which used the Overall Job Satisfaction scale and subscales therein, to identify global satisfaction-intrinsic or related to motivational factors and extrinsic or associated with hygienic factors-in nursing professionals (n = 104) from eight Inpatient Units of Internal Medicine and Surgery, in four hospital centers, to describe job satisfaction in the professionals studied and to find statistically significant associations between job satisfaction and workload (measured with the scale MIDENF®) in the inpatient units where they work. Results: There were higher levels of satisfaction in the variables "relationship with immediate boss" and "relationship with fellow workers", and lower levels in "relationship with senior management" and "organizational system of the unit". In the inferential analysis, the scores were 75.63 for overall satisfaction, 35.28 for intrinsic satisfaction, and 40.36 for extrinsic satisfaction. Conclusions: There is a close relationship between workload and job satisfaction, showing more dissatisfaction regarding organizational aspects and professional recognition.

Acculturative stress in Latin-American immigrants: an assessment proposal.

The aim of this paper was to develop an instrument to assess levels of stress experienced by Latin-American immigrants in their acculturative process in Spain. A sample of 692 immigrants from Latin America, aged 20 to 63 years, took part on this study (54.9% males and 45.1% females). A 24-item questionnaire with high reliability (.92) was elaborated. Six factors related to acculturative stress were found: 1) discrimination and rejection; 2) differences with the out-group (native Spaniards); 3) citizenship problems and legality; 4) problems concerning social relationships with other immigrants; 5) nostalgia and longing; and 6) family break-up. Our findings show that participants have a high level of stress related to nostalgia and longing, family break-up, and the perception of discrimination and rejection by natives. The usefulness of the instrument and its applications and restrictions are discussed.

Cues for feigning screening in whiplash associated disorders.

The objective of this work is to evaluate the ability of a series of possible feigning indicators, extracted from relevant literature in the field, to discriminate between clinical patients with genuine symptomatology and instructed malingerers. A sample of 273 participants divided into two groups was used for this study: 153 whiplash associated disorder patients who were evaluated at a multidisciplinary medical center in the region of Murcia (Spain), between December 2017 and March 2019 and 120 healthy controls with malingering instructions, students of the Faculty of Medicine of the University of Murcia. In order for researchers to evaluate the indicators included in the study, a 22-step checklist (CDS) was developed, consisting of 22 criteria divided into 5 dimensions. Our results show that 18 of 22 indicators could discriminate between groups. Dimension 2 "Attitude toward the situation of illness" presented the greatest capacity for discrimination. In general terms, malingerers express a much more negative experience of the condition than the clinical patients.

Whiplash-Associated Disorders. Biopsychosocial Profiles of Pain Perception in Forensic Cases of Victims of Motor Vehicle Accidents.

In order to make a complete diagnosis of all the factors influencing whiplash associated disorders (WAD), the evidence suggests that the condition evaluation should follow an integrated biopsychosocial model. This perspective would offer a fuller view of it, recognizing the interplay between the medical, biomechanical, social, and psychological factors. Despite the progress made in the subject, evidence of which psychosocial factors influence the experience of pain in litigant WAD patients is limited. A cross-sectional design and a cluster analysis was used to study the experience of pain and the psychosocial factors included therein in 249 patients with WAD assessed after suffering a motor vehicle accident. Three clusters were obtained: C1, with low scores of pain and a slight-moderate alteration of the Health-Related Quality of Life (HRQoL); C2, with medium scores of pain, alteration of HRQoL and a perception of moderate disability; and C3, with medium-high scores of pain, alteration of the HQoL, perception of moderate disability, presence of anxious-depressive symptomatology, poorer comprehension of the condition suffered, and the belief that it will extend over a long period of time. The results show a heterogeneous experience of pain in WAD, compatible with the biopsychosocial model of disease and the multidimensional approach to pain. The role of the psychologist in the evaluation of the condition could be useful to obtain a complete view of the condition, thus ensuring that the treatment is adapted to the needs of the patient.

Attitudes toward School Violence against LGBTQIA+. A Qualitative Study.

School climate is one of the main concerns in terms of research and intervention worldwide. Although it can be directed toward any student, some groups seem to be more vulnerable, as is the case of the LGBTQIA+ (lesbian, gay, bisexual, transgender, queer and intersex +) students, among others. Attitudes toward violence are a construct of particular importance for action plans focused on improving school coexistence. The aim of this study is to examine attitudes toward school violence against LGBTQIA+ students and their relationship with violent behaviors. For this purpose, 96 Spanish students of Spanish elementary education (PE) and compulsory secondary education (CSE) participated in this qualitative study through focus groups for its subsequent thematic analysis. The results identify four types of attitudes toward violence, such as the use of violence as a form of fun, to feel better, when it is perceived as legitimate, and as a way of relating to the LGBTQIA+ community. In addition, a greater number of negative attitudes and violent behaviors toward homosexual boys and transgender minors are observed.

[Violence of users towards health and non-health professionals in Hospital Emergency Services: descriptive-comparative cross-sectional study.] / Violencia de usuarios hacia profesionales sanitarios y no sanitarios en Servicios de Urgencias Hospitalarias. Estudio transversal descriptivo-comparativo.

OBJECTIVE: Workplace violence is a public health problem that affects professionals in the hospital emergency services, being this environment where there is an intense interaction with users and / or relatives who require critical and / or special care. Given this, the aim of this study was to evaluate the exposure to user violence perceived by different health and non-health professionals in Emergency Services belonging to eleven Spanish hospitals. METHODS: The design was an associative, descriptive-comparative cross-sectional strategy developed in 2019 with a sample of 584 healthcare and non-healthcare professionals from eleven Spanish hospital emergency services in eight Spanish autonomous communities. Non-parametric statistics were used for between-group comparisons, post-hoc analysis and the calculation of the effect size. RESULTS: 100% of respondents acknowledged having suffered workplace violence at least once in the last year. Specifically, at least eight out of every ten professionals were exposed to non-physical violence (range 85.1%-100%). The group that most perceived this violence was administration, followed by nursing, medicine and auxiliary nursing care technician (T.C.A.E) (H=28.881; p=0.001). While the manifestations of physical violence affected approximately three out of ten professionals (range 22.6%-29.5%), it is more present in the Auxiliary Nursing Care Technicians (T.C.A.E), followed by medical and nursing health professionals, as well as non-health professionals, orderlies and administration (H=9.800; p=0.05). CONCLUSIONS: Our study shows the high prevalence of a medium or low intensity violent behavior in spanish Emergency Services. In addition, it allows to deepen in the different manifestations of violence received by the main professional groups of these services.

OBJETIVO: La violencia laboral es un problema de Salud Pública que afecta a profesionales de los Servicios de Urgencias Hospitalarias, siendo este entorno donde existe una intensa interacción con los pacientes usuarios y/o familiares que precisan cuidados críticos y/o especiales. Con ello, el objetivo de este trabajo fue evaluar la exposición a la violencia de los usuarios percibida por los distintos profesionales sanitarios y no sanitarios de los Servicios de Urgencias pertenecientes a once hospitales españoles. METODOS: El diseño fue una estrategia asociativa, de corte transversal, resultando un estudio descriptivo-comparativo, desarrollado en 2019, con una muestra de 584 profesionales sanitarios y no sanitarios de once servicios españoles de Urgencias Hospitalarias de ocho comunidades autónomas españolas. Se utilizaron estadísticos no paramétricos para las comparaciones entre grupo, análisis post-hoc y el cálculo de la magnitud del efecto. RESULTADOS: El 100% de los encuestados reconocieron haber sufrido violencia laboral al menos una vez en el último año. Específicamente, en cuanto a violencia no física, al menos ocho de cada diez profesionales estuvieron expuestos (rango 85,1%-100%). El grupo que más percibió esta violencia fue administración, seguidos de los profesionales sanitarios de enfermería y medicina, así como de los técnicos de cuidados auxiliares de enfermería (T.C.A.E) (H=28,881; p=0,001). Por otro lado, las manifestaciones de violencia física afectaron aproximadamente a tres de cada diez profesionales (rango 22,6%-29,5%), estando más presente en T.C.A.E y seguidos de los profesionales sanitarios de medicina y enfermería, así como de los profesionales no sanitarios, celadores y administración (H=9,800; p=0,05). CONCLUSIONES: Nuestro estudio evidencia la alta prevalencia de conductas violentas de media o baja intensidad en los servicios de Urgencias y Emergencias españoles. Además, permite profundizar en las distintas manifestaciones de violencia recibidas por los principales grupos profesionales de estos servicios.

Tough Love Lessons: Lateral Violence among Hospital Nurses.

BACKGROUND: Workplace violence is a growing social problem among many professions, but it particularly affects the health sector. Studies have mainly focused on evaluating user violence toward health professionals, with less attention being paid to other sources of conflict, such as co-workers themselves. There are different manifestations of this violence in what has been called a context of tolerated or normalized violence among co-workers. However, its effects are far from being tolerable, as they have an impact on general health and job satisfaction and contribute to burnout among professionals. Based on this idea, and following the line of the previous literature, nursing staff are a population at high risk of exposure to workplace violence. For this reason, the present study aims to evaluate exposure to lateral violence or violence among co-workers in nursing staff in public health services and the relationship of this exposure with some of the most studied consequences. (2) Methods: A cross-sectional associative study was carried out in which scales of workplace violence (HABS-CS), burnout (MBI-GS), job satisfaction (OJS), and general health (GHQ-28) were applied to a sample of 950 nursing staff from 13 public hospitals located in the southeast of Spain. (3) Results: The results show that nursing staff have a high exposure to violence from their co-workers, which is more common in male nurses. Greater exposure is observed in professionals with between 6 and 10 years of experience in the profession, and it is not characteristic of our sample to receive greater violence when they have less experience or are younger. A positive correlation is observed with high levels of burnout and a negative correlation with general health and job satisfaction. (4) Conclusions: The results of this work contribute to increasing the scientific evidence of the consequences of a type of workplace violence frequent among nursing staff and to which less attention has been paid in relative terms to other types of prevalent violence. Organizations should be aware of the importance of this type of workplace violence, its frequency and impact, and implement appropriate prevention policies that include the promotion of a culture that does not reward violence or minimize reporting. A change of mentality in the academic environment is also recommended in order to promote a more adequate training of nursing staff in this field.

Users' Perception of Violence and Conflicts With Professionals in Primary Care Centers Before and During COVID-19. A Qualitative Study.

Background: Workplace violence is a social problem of special interest in both intervention and research. Among the sectors that most perceive this type of violence, health care professionals stand out. The most common type of violence for this professional group is the one perpetrated by the users or patients themselves. It has been reported that one out of every four acts of violence in the workplace occurs in the healthcare setting. Within the health sector, the Mental Health, Emergency and Primary Care services have been widely reported as being among the most vulnerable, with Primary Care being the least addressed of the three. Although the available literature is extensive, there are hardly any studies that explore from a qualitative perspective what are the sources of conflict in this sector from the perspective of the users, the most common being to work with professionals. Objective: The aim of this study is to examine those aspects derived from the organization, the professionals or the users of Primary Care that, from the users' point of view, cause violent situations and how they think these could be avoided. Method: The sample consisted of 80 users of the Primary Care services of the Health Service of Murcia. For data collection, a qualitative study was conducted through 10 focus groups and a subsequent thematic analysis of the data. Results: The results have allowed us to identify that, from an organizational point of view, the uncertainty in waiting times, the need to adapt the telematic or telephone appointment to the different types of users, or the management of emergencies in Primary Care are the aspects that cause most conflicts between users and professionals. In this sense, suggested improvements are aimed at providing information in the mobile application updated on the opening hours or maintaining the telephone appointment for those who need or request it, among many others. As for the professionals, users point out that the medical staff is perceived as distant and sometimes does not provide enough information on the health status of users. Another professional group widely addressed in the focus groups was the administrative staff, being described as lacking in communication skills, assertiveness, or empathy. Users recognize the existence of a demanding/aggressive profile among users, who makes instrumental use of violence to achieve privileges over users in general. We have also identified the profile of the user who makes use of Primary Care as a way of socializing or managing conflicts of a socioemotional nature. As proposals for this thematic block, users suggest group therapies, the use of audiovisual material complementary to the information provided by professionals or community interventions in psychoeducation. Conclusion: This study allows to explore conflicts between users and professionals from the Primary Care patients' perspective. Our results are complementary to the available evidence that has used the professional's approach to study the phenomenon of workplace violence. The identification of sources of conflict and the assessment and contribution of users on possible ways of improvement can serve as a basis for the design of prevention and intervention plans to improve the work environment in Primary Care centers.