(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.

Prosecutorial decision-making regarding offenders' social reintegration programs in intimate partner violence cases. A Portuguese study.

Intimate partner violence is one of the most challenging and demanding problems that the criminal justice system has to face. Given the severe consequences of intimate partner violence, it is imperative that intervention from the criminal justice system, regarding perpetrators, be effective to prevent further victimization and recurrences. In Portugal, it is up to the state prosecutor to decide which cases will be subject to a social reintegration program as a pretrial diversion program. This study aims to explore the variables that might influence the state prosecutor's decision-making process. We have examined 283 intimate partner violence cases in which provisional suspension of criminal proceedings was applied. The decision as to whether defendants should be referred for social reintegration program attendance (G1) or not (G2) was made by the state prosecutor. Differences between G1 and G2 were identified: the victim's age, couple living in a current relationship, drug-addicted defendant, intimate partner violence child exposure. However, defendants' unemployment and drug abuse were the only two variables identified as a determinant for state prosecutor decisions. We believe that the effectiveness of state prosecution decision-making would benefit from: (a) systematically taking into account all intimate partner violence risk factors; (b) an index or checklist detailing what science reveals useful in intimate partner violence offenders' social reintegration; (c) rehabilitation solutions based on the needs of each offender instead of a "one-size-fits-all" approach.

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.

Intimate partner violence against women. Does violence decrease after the entry of the alleged offender into the criminal justice system?

Intimate partner violence (IPV) is simultaneously assumed as a serious crime and a major public health issue, having recurrences as one of its main characteristics and, consequently, re-entries of some alleged offenders in the criminal justice system (CJS). The main goal of this study is to assess if in cases of female victims of IPV, violence decreases after the first entry of the alleged offender in the CJS. A retrospective study was performed based on the analysis of police reports of alleged cases of IPV during a 4-year period. The final sample (n = 1 488) was divided into two groups according to the number of entries in the CJS (single or multiple) followed by a comparative approach. Results suggest that violence decreases after the first entry of alleged offenders in the CJS. Re-entries were found in only 15.5% of the cases but they were accountable for 3.3 times more crimes on average. Besides, victims of recidivism presented more injuries and required more medical care. Thus, a small group of alleged offenders seems to be more violent and accountable for most of the IPV crimes registered in the CJS suggesting that regardless of legal sanctions aiming to deter violence, these measures may not be enough for a certain group of offenders. This study sustains the need for a predictive model to quantify the risk of repeated IPV cases within the Portuguese population.

Suspension of Criminal Proceedings for Perpetrators of Intimate Partner Violence Against Women: Impact on Re-Entries.

Intimate partner violence (IPV) is one of the most prevalent crimes in our society, but the legal mechanisms to oppose it are recent. The Portuguese Provisional Suspension of Criminal Proceedings (PSCP) as a criminal justice system (CJS) response proposes an integrated consensual solution with the involved parties, to reduce offenders' recidivism. This article analyses the effect of PSCP on re-entries into the CJS. We examined 1,662 IPV police reports, exploring cases that underwent PSCP and re-entries of the same offender in the CJS. Results show that PSCP is applied in 17% of the cases. From all analyzed determinants, with a possible relation to the PSCP implementation, it was found that social violence and the age of both victims and defendants emerge as significantly associated with the request or acceptance of this legal mechanism. No variables tested moderated the relationship between PSCP and re-entry over 96months following the first police report. The article also examined variables that might moderate the decision to request this legal mechanism among victims and defendants.

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.

When Problems Only Get Bigger: The Impact of Adverse Childhood Experience on Adult Health.

Introduction: Previous studies have shown that adverse childhood experiences negatively impact child development, with consequences throughout the lifespan. Some of these consequences include the exacerbation or onset of several pathologies and risk behaviors. Materials and Methods: A convenience sample of 398 individuals aged 20 years or older from the Porto metropolitan area, with quotas, was collected. The evaluation was conducted using an anonymous questionnaire that included sociodemographic questions about exposure to adverse childhood experiences, a list of current health conditions, questions about risk behaviors, the AUDIT-C test, the Fagerström test and the Childhood Trauma Questionnaire-brief form. Variables were quantified to measure adverse childhood experiences, pathologies, and risk behaviors in adult individuals for comparison purposes. Results: Individuals with different forms of adverse childhood experiences present higher rates of smoking dependence, self-harm behaviors, victimization of/aggression toward intimate partners, early onset of sexual life, sexually transmitted infections, multiple sexual partners, abortions, anxiety, depression, diabetes, arthritis, high cholesterol, hypertension, and stroke. Different associations are analyzed and presented. Discussion and Conclusions: The results show that individuals with adverse childhood experiences have higher total scores for more risk behaviors and health conditions than individuals without traumatic backgrounds. These results are relevant for health purposes and indicate the need for further research to promote preventive and protective measures.