The Top News Stories of 2021: The Hidden Toll of COVID-19.

Workplace violence, domestic abuse, and firearm-related deaths are on the rise.

Impact of the COVID-19 pandemic on workplace violence at an academic emergency department.

STUDY OBJECTIVES: COVID-19 brought unique challenges; however, it remains unclear what effect the pandemic had on violence in healthcare. The objective of this study was to identify the impact of the pandemic on workplace violence at an academic emergency department (ED). METHODS: This mixed-methods study involved a prospective descriptive survey study and electronic medical record review. Within our hospital referral region (HRR), the first COVID-19 case was documented on 3/11/2020 and cases peaked in mid-November 2020. We compared the monthly HRR COVID-19 case rate per 100,000 people to the rate of violent incidents per 1000 ED visits. Multidisciplinary ED staff were surveyed both pre/early-pandemic (April 2020) and mid/late-pandemic (December 2020) regarding workplace violence experienced over the prior 6-months. The study was deemed exempt by the Mayo Clinic Institutional Review Board. RESULTS: There was a positive association between the monthly HRR COVID-19 case rate and rate of violent ED incidents (r = 0.24). Violent incidents increased overall during the pandemic (2.53 incidents per 1000 visits) compared to the 3 months prior (1.13 incidents per 1000 visits, p < .001), as well as compared to the previous year (1.24 incidents per 1000 patient visits, p < .001). Survey respondents indicated a higher incidence of assault during the pandemic, compared to before (p = .019). DISCUSSION: Incidents of workplace violence at our ED increased during the pandemic and there was a positive association of these incidents with the COVID-19 case rate. Our findings indicate health systems should prioritize employee safety during future pandemics.

Construção e validação de instrumento de identificação de violência no trabalho de enfermagem no ambiente hospitalar e estratégias de prevenção no contexto de pandemia / Construction and validation of an instrument to identify violence in nursing work in the hospital environment and prevention strategies in the context of a pandemic

O contexto da pandemia nas instituições de saúde está envolto a fatores estressantes devido as mudanças organizacionais, de tratamento e fluxos de atendimento da grande demanda de pessoas que necessitam de cuidados. Essa situação tem levado profissionais de enfermagem a serem vítimas de atos de violência ocupacional, os quais tem ocasionado absenteísmo e adoecimento desses profissionais pela Síndrome de Burnout. Objetivo: construir e validar de um instrumento para identificação dos tipos e formas da violência no trabalho de enfermagem e as estratégias de prevenção adotadas em situação de pandemia. Método: estudo desenvolvido em duas fases procedimentais: na primeira fase foi realizado um estudo de revisão integrativa da literatura com a finalidade de sumarizar os tipos e formas de violência ocupacional do ambiente hospitalar e as estratégias utilizadas pelos profissionais de enfermagem para preveni-las. A busca de evidências científicas foi realizada a artigos primários publicados em revistas indexadas nas bases Web of Science (WOS/ISI), SCOPUS, Medical Literature Analysis and Retrieval Online (MEDLINE/PuBMed), The Cumulative Index to Nursing and Allied Health Literature (CINAHL) e Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS) e Scientific Electronic Library Online (Coleção SciELO) e em servidores de Preprints bioRxiv e SciELO Preprints. Os descritores utilizados foram: "Violência no Trabalho", "Equipe de Enfermagem", "Enfermagem", "Infecções por Coronavirus " e os termos em inglês " Workplace Violence", "Nursing Time", " Nursing" e "Coronavirus Infections" publicados no período de 2015 a 2021. Na segunda fase foi realizado um estudo metodológico de elaboração e a validação de conteúdo e com validação com emprego da Técnica Delphi realizada por um comitê de especialistas em Junho/2021 e validação semântica realizada com 30 profissionais de enfermagem atuantes durante a crise sanitária prestando cuidados diretos ou indiretos a pacientes com COVID-19. O questionário foi construído a partir de evidências da literatura sumarizadas na primeira fase da pesquisa e com base no relatório mundial sobre violência da Organização Mundial de Saúde e nas Diretrizes Marco para Afrontar a Violência Laboral no setor Saúde. Os dados da segunda fase do estudo foram analisados por meio de estatística descritiva e foi aplicado o cálculo do Índice de Validade de Conteúdo (IVC) no processo de avaliação de conteúdo do questionário. Resultados: no estudo de revisão, 35 artigos científicos foram selecionados a partir dos critérios adotados e analisados quanto os tipos de violência no trabalho ambiente hospitalar praticados antes da pandemia e durante a pandemia. Os profissionais de enfermagem no ambiente hospitalar sofreram: agressão física, abuso verbal, assédio sexual, assédio moral, discriminação entre outros. O questionário construído e validado para identificar a violência ocupacional no ambiente hospitalar possui 64 questões, sendo 25 sociodemográficas e 39 relacionadas a violência. O questionário foi validado pelo comitê de especialistas com concordância de 68,7% dos membros na 1ª etapa e 100% de concordância na 2ª etapa. Na aplicação do questionário na amostra de profissionais de enfermagem durante a pandemia o IVC apresentado para todos os itens foi de 1.0. Conclusão: O "Questionário de identificação de violência no trabalho de Enfermagem no ambiente hospitalar no contexto de pandemia" foi validado e pode ser utilizado para identificar os tipos de violência no trabalho de enfermagem no ambiente hospitalar para oferecer subsídios para planejamento de ações de combate, controle e prevenção de violência no trabalho de enfermagem

The context of the pandemic in health institutions is surrounded by stressors due to organizational changes, treatment and care flows of the great demand of people in need of care. This situation has led nursing professionals to be victims of acts of occupational violence, which have caused absenteeism and illness in these professionals due to Burnout Syndrome. Objective: to constructo and validate na instrument for identifying the types and forms of violence in nursing work and strategies for adopted in a pandemic situation. Method: a study developed in two procedural phases: the first phase was an integrative review of the literature with the purpose of stumarizing the types and forms of occupational violence in the hospital environment and the strategies used by nursing professional to prevent them. The search for scientific evidence was performed in primary articles, review of the literature published in journals indexed in the Web of Science (WOS/ISI), SCOPUS. Medical Literature Analysis and Retrieval Online (MEDLINE/PuBMed), The Cumulative Index to Nursing and Allied Health Literature (CINAHL) and Latin American and Caribbean Literature on Health Sciences (LILACS) and Scientific Electronic Library Online (SCIELO collection) and on Preprints servers bioRxiv and SciELO preprints. The descriptors used were: "Violence at Work", "Nursing Team", "Nursing" and "Coronavirus Infections" and the English terms "Workplace Violence", "Nursing Time", "Nursing" and "Coronavirus Infections", published from 2015 to 2021. In the second phase, a methodological study was carried out for the elaboration and validation of content and with validation using the Delphi Technique carried out by a committee of experts in June/2021 and semantic validation carried out with 30 nursing professionals working during the health crisis providing direct care or indirect to patients with COVID-19. The questionnaire was built from evidence from the literature summarized in the first phase of the research and based on the World Health Organization's World Report on Violence and the Framework Guidelines for Addressing Violence at Work in the Health Sector. Data from the second phase of the study were analyzed using descriptive statistics and the calculation of the Content Validity Index (CVI) was applied in the questionnaire content evaluation process. Results: in the review study, 35 scientific articles were selected based on the criteria adopted and analyzed regarding the types of violence at work in the hospital environment practiced before the pandemic and during the pandemic. Nursing professionals in the hospital environment suffered: physical aggression, verbal abuse, sexual harassment, moral harassment, discrimination among others. The questionnaire constructed and validated to identify occupational violence in the hospital environment has 64 questions, 25 of which are sociodemographic and 39 are related to violence. The questionnaire was validated by the expert committee with agreement of 68.7% of the members in the 1st stage and 100% of agreement in the 2nd stage. When applying the questionnaire to the sample of nursing professionals during the pandemic, the CVI presented for all items was 1.0. Conclusion: The "Questionnaire for the identification of violence in nursing work in the hospital environment in the context of a pandemic" was validated and can be used to identify the types of violence in nursing work in the hospital environment to provide subsidies for planning actions to combat, control and prevention of violence in nursing work

Health problems and violence experiences of nurses working in acute care hospitals, long-term care facilities, and home-based long-term care in Germany: A systematic review.

BACKGROUND: Working in the nursing sector is accompanied by great physical and mental health burdens. Consequently, it is necessary to develop target-oriented, sustainable profession-specific support and health promotion measures for nurses. OBJECTIVES: The present review aims to give an overview of existing major health problems and violence experiences of nurses in different settings (acute care hospitals, long-term care facilities, and home-based long-term care) in Germany. METHODS: A systematic literature search was conducted in PubMed and PubPsych and completed by a manual search upon included studies' references and health insurance reports. Articles were included if they had been published after 2010 and provided data on health problems or violence experiences of nurses in at least one care setting. RESULTS: A total of 29 studies providing data on nurses health problems and/or violence experience were included. Of these, five studies allowed for direct comparison of nurses in the settings. In addition, 14 studies provided data on nursing working in acute care hospitals, ten on nurses working in long-term care facilities, and four studies on home-based long-term care. The studies either conducted a setting-specific approach or provided subgroup data from setting-unspecific studies. The remaining studies did not allow setting-related differentiation of the results. The available results indicate that mental health problems are the highest for nurses in acute care hospitals. Regarding violence experience, nurses working in long-term care facilities appear to be most frequently affected. CONCLUSION: The state of research on setting-specific differences of nurses' health problems and violence experiences is insufficient. Setting-specific data are necessesary to develop target-group specific and feasible interventions to support the nurses' health and prevention of violence, as well as dealing with violence experiences of nurses.

Trends in Workplace Violence Involving Health Care Professionals in China from 2000 to 2020: A Review.

The safety of health care workers in China has received an increasing amount of attention owing to numerous incidents of hospital-based violence against medical professionals. When pictures and videos of violent injuries are posted on the internet with real-time data, such as gender or location, researchers can access the information to learn about the incident, its causes, and/or threats to survival. We examined the causes and risk factors for workplace violence by analyzing relevant data retrieved from reports by Chinese internet media for all incidents from 2000 to 2020. We present frequency data on hospital-based violence against medical professionals. A total of 345 incidents occurred in health care settings. The person who committed the violent act was a patient or sick person in the workplace or a co-worker in 95.4% of the incidents; 54 of the incidents resulted in the victim's murder. We provide the characteristics and risk factors of violent criminals. We describe China's past and current clinical practices and health care policies, and we discuss the challenges faced by medical professionals who are victims of hospital-based violence from the perspectives of patients, physicians, hospital leaders, and the government. We conclude by making recommendations for preventing violence in hospital settings. It is urgent for the public to understand that the occupational safety of health care workers must be protected, and treatment should be provided to patients in a harmonious and safe environment. This review aims to describe the trends in workplace violence involving health care professionals in China from 2000 to 2020 and to discuss possible strategies for improving working conditions in hospitals and other health care settings.

Violencia institucional en salud, instituciones, profesionales y usuarios / Institutional violence in health, institutions, professionals and users

El presente ensayo es una reflexión de la violencia en, desde, hacia y entre el personal de salud. Para lograr una aproximación, se consideran distintas fuentes de información, desde reportes periodísticos, estudios empíricos y, por supuesto, postulados conceptuales producidos para otras situaciones y campos de conocimiento. El análisis se realiza en diferentes ejes, el primero con referentes para situar el problema en el marco de propuestas enunciativas y conceptos relevantes; el segundo presenta la perspectiva del paciente o usuario; en el tercero se presentan algunos elementos de los profesionales de la salud. Por último, en último eje se delinean situaciones de las instituciones en salud, como espacio donde se desarrolla y vehiculiza la violencia, en tanto generadora y ámbito donde se ejerce tanto para los profesionales de la salud como para los pacientes usuarios. Finalmente se esbozan unas conclusiones que permiten situar el tema en sus implicaciones y consecuencias. Estos ejes nos permiten sugerir que el estudio de la violencia requiere un abordaje complejo, ya que deja un saldo de víctimas y victimarios siendo las propias instituciones en salud las generadoras de violencia alejando a los actores sociales de actos solidarios y humanizados.

This essay is a reflection about violenceexpressed inside and outside health institutions with an impact on health professionals and patients. We considered different sources of information: journalistic reports, empirical studies and conceptual postulates produced for other situations and fields of knowledge. The analysis is carried out in different axes, first, with references to place the problem within the framework of enunciativeproposals and relevant concepts; the second presents the perspective of the patient; the third presents some elements of health professionals. Finally, in the last axis, situations of health institutions are outlined, as a space where violence is developed and conveyed, as a generator and an area where it is exercised both for health professionals and patients. As conclusions we leave sketches that allow us to place the subject in its implications and consequences. These axes allow us to suggest that the study of violence requires a complex approach, since it leaves a balance of victims and perpetrators, the health institutions themselves being the generators of violence, distancing social actors from acts of solidarity and humanization.

Letter to the Editor.

Thank you for initiating an important conversation regarding NCLEX-RN implementation and experience in Canada. We are three nursing leaders in the province of British Columbia (BC) with continued interest in the governance, regulation and contribution of nursing locally, provincially and nationally. We hold or have held senior policy positions in BC, including in roles responsible for nursing regulation and practice. It is not our intent to replay the past in relation to the exam; rather, our commentary is intended to position the discourse in the broader context of practice regulation and the roles/responsibilities of regulators in our country.

Implementation of a Preparedness Program to Address Violent Situations in Healthcare.

Workplace violence is one of the most complex and dangerous occupational hazards facing hospital healthcare workers today. The United States Occupational Safety and Health Administration recommends that all hospitals have a violence prevention program. The purpose of this article is to describe the development and implementation of a preparedness program to address violent situations in healthcare as an essential component of workplace safety. The foundational program elements are leadership involvement, policy development, organization assessment, response personnel deployment, education, data repository and culture shift. A triad leadership from patient safety, security and nursing led the program. Key implementation lessons involved coordination of change within and across multiple sites.

Quality improvement in forensic mental health: the East London forensic violence reduction collaborative.

Ward-based violence is the most significant cause of reported safety incidents at East London NHS Foundation Trust (ELFT). It impacts on patient and staff safety, well-being, clinical care and the broader hospital community in various direct and indirect ways. The contributing factors are varied and complex. Several factors differentiate the forensic setting, which has been identified as a particularly stressful work environment. Staff must constantly balance addressing therapeutic needs with robust risk management in a complex patient cohort. ELFT identified reducing inpatient physical violence on mental health wards as a major quality improvement (QI) priority. The aim was to use a QI methodology to reduce incidents of inpatient violence and aggression across two secure hospital sites by at least 30% between July 2016 and March 2018. Collaborative learning was central to this project. It sought to foster a culture of openness within the organisation around violence and to support service users and staff to work together to understand and address it. A QI methodology was applied in medium and low secure inpatient settings. A change bundle was tested for effectiveness, which included: safety huddles, safety crosses and weekly community safety discussions. Operational definitions for non-physical violence, physical violence and sexual harassment were developed and used. Reductions of 8% and 16.6% in rates of physical and non-physical violent incidents, respectively, were achieved and sustained. Compared with baseline, this equated to one less incident of physical and 17 less of non-physical violence per week averaged across seven wards. Three wards achieved at least a 30% reduction in incidents of physical violence per week. Five wards achieved at least a 30% reduction in incidents of non-physical violence per week. This collaborative brought significant improvements and a cultural shift towards openness around inpatient violence.

Violence against Emergency Department nurses; Can we identify the perpetrators?

INTRODUCTION: Violence against health care workers is a major issue in health care organisations and is estimated to affect 95% of workers, presenting an enormous risk for workers and employers. Current interventions generally aim at managing rather than preventing or minimising violent incidents. To create better-targeted interventions, it has been suggested to shift attention to the perpetrators of violence. The aim of this study was to identify and discuss the perceptions, held by Emergency Department nurses, about perpetrators of occupational violence and aggression. METHODS: Two focus groups were conducted with Emergency Department nurses at a major metropolitan hospital in Australia. In the focus groups, the nurses' perceptions about perpetrators of violence against health care workers were identified and discussed. The results were analysed using descriptive analysis. RESULTS: This study confirmed that violence is a major issue for Emergency Department nurses and has a considerable impact on them. Participants acknowledged that violence at work had become an intrinsic part of their job and they tend to focus on coping mechanisms. The nurses identified six overlapping groups of perpetrators and described their approach to dealing with these perpetrators. The results highlighted additional factors that impact on the occurrence and management of violence, such as the presence of security, wait times, and the triage system. CONCLUSIONS: Based on the focus groups with Emergency Department nurses we conclude that violence at work is an everyday danger for Emergency Department nurses, who feel vulnerable and recognise that it is not within their power to solve this issue given the societal component. Our conclusion is that attention needs to shift from equipping workers with tools to manage violence to the perpetrator and the development of interventions to reduce violence from targeted perpetrator groups.

The theme of violence in nursing theses from the view of technological toolboxes.

OBJECTIVE: To characterize the data gathering technological tools used in nursing theses on violence from the view of "technological toolboxes". METHOD: It is a descriptive and documental study, with a qualitative approach, based on Thesis available in the last ten volumes of the Catalogue of Theses and Dissertations of the Center of Nursing Studies and Research (CEPEn). Documents presenting technological tools during the data gathering of its studies were selected, and then classified using "technological toolboxes" according to Merhy. RESULTS: 30 theses were selected, data gathering tools were classified in "technological toolboxes" as lightweight, light-hard, and hard technologies, with uniformity in most researches (23; 76.6%). CONCLUSION: Given it is a multifaced phenomenon, violence demands a deeper view, using the most diverse tools for its proper understanding and classification.

The theme of violence in nursing theses from the view of technological toolboxes / La temática de la violencia en las tesis de enfermería bajo la perspectiva de las cajas de herramientas tecnológicas / A temática da violência nas teses de enfermagem na perspectiva das caixas de ferramentas tecnológicas

ABSTRACT Objective: To characterize the data gathering technological tools used in nursing theses on violence from the view of "technological toolboxes". Method: It is a descriptive and documental study, with a qualitative approach, based on Thesis available in the last ten volumes of the Catalogue of Theses and Dissertations of the Center of Nursing Studies and Research (CEPEn). Documents presenting technological tools during the data gathering of its studies were selected, and then classified using "technological toolboxes" according to Merhy. Results: 30 theses were selected, data gathering tools were classified in "technological toolboxes" as lightweight, light-hard, and hard technologies, with uniformity in most researches (23; 76.6%). Conclusion: Given it is a multifaced phenomenon, violence demands a deeper view, using the most diverse tools for its proper understanding and classification.

RESUMEN Objetivo: Caracterizar los instrumentos tecnológicos de recolección de datos utilizados en tesis de enfermería sobre violencia desde la perspectiva de "cajas de herramientas tecnológicas". Método: Estudio descriptivo, documental, con abordaje cuantitativo, a partir de tesis disponibles en los últimos diez volúmenes del Catálogo de Tesis y Disertaciones del Centro de Estudios e Investigaciones en Enfermería (CEPEn). Se seleccionaron documentos que habían presentado instrumentos tecnológicos durante la recolección de datos de sus respectivos estudios, que fueron clasificados utilizando las "cajas de herramientas tecnológicas" según lo plantea Merhy. Resultados: Se seleccionaron 30 tesis, la clasificación de los instrumentos de recolección de datos en las "cajas de herramientas tecnológicas" fueron leve, leve-duras y dura, y hubo uniformidad en la mayoría de las encuestas (23; 76,6%). Conclusión: Por ser un fenómeno de múltiples facetas, se deberá profundizar en el tema de la violencia desde la utilización de los más diversos instrumentos para su adecuada comprensión y clasificación.

RESUMO Objetivo: Caracterizar os instrumentos tecnológicos de coleta de dados utilizados em teses de enfermagem sobre violência na perspectiva de "caixas de ferramentas tecnológicas". Método: Estudo descritivo, documental, com abordagem quantitativa baseado em Teses disponíveis nos últimos dez volumes do Catálogo de Teses e Dissertações do Centro de Estudos e Pesquisas em Enfermagem (CEPEn). Foram selecionados documentos que apresentaram instrumentos tecnológicos durante a coleta de dados de seus respectivos estudos, estes foram classificados utilizando as "caixas de ferramentas tecnológicas" segundo Merhy. Resultados: Foram selecionadas 30 teses, a classificação dos instrumentos de coleta de dados nas "caixas de ferramentas tecnológicas" em leve, leve-duras e dura, havendo uniformidade na maioria das pesquisas (23; 76,6%). Conclusão: Por tratar-se de um fenômeno multifacetado a violência exige um olhar mais aprofundado, a partir da utilização dos mais diversos instrumentos para sua adequada compreensão e classificação.

Workplace violence and risk for psychiatric morbidity among health workers in a tertiary health care setting in Nigeria: Prevalence and correlates.

The objectives were to evaluate the workplace violence and risk for psychiatric morbidity, as well as their correlates, among health workers in a tertiary healthcare setting in Nigeria. A stratified random sampling technique was used to recruit the health workers. Each participant was administered a socio-demographic questionnaire, the ILO/ICN/WHO/PSI Workplace Violence Questionnaire and the 12- item General Health Questionnaire. A total of 380 health workers were recruited, with a mean age of 36.4 (±7.64) years. The prevalence rates of workplace violence and risk of psychiatric morbidity were 39.9% and 38.5%. Factors with independent associations with workplace violence included young age, female sex and worry about workplace violence while a widowed, separated or divorced marital status and being victim of workplace violence independently increased risk for developing psychiatric morbidity. This study therefore showed that workplace violence is common in the health care setting, and significant proportion of workers are at risk for developing psychiatric morbidity. These observations suggest need for the regular mental health screening of health workers, as well as the need for programmes aimed at preventing workplace violence in this setting.

The association between workplace violence and physicians' and nurses' job satisfaction in Macau.

BACKGROUND: This paper describes the association between workplace violence and job satisfaction among physicians and nurses in Macau. Convenience sampling was sourced from six health centers under the Macau Health Bureau. METHODS: This study uses a cross-sectional self-administrative survey. The study used case studies research instruments for workplace violence in the health sector by country (from the ILO, ICN, WHO, PSI), the Minnesota Satisfaction Questionnaire and Perceived Stress Scale. The data collection period spanned from August to December, 2014. DATA ANALYSIS: Multiple logistic regression examines levels of intrinsic and extrinsic satisfaction in physicians and nurses and significant correlates affecting their job satisfaction. RESULTS: A total of 720 (14.9% physicians) participants were recruited. 57.2% of participants reported physical and psychological workplace violence in the preceding year. The most common forms of workplace violence were verbal abuse (53.4%), physical assault (16.1%), bullying / harassment (14.2%), sexual harassment (4.6%) and racial harassment (2.6%). Nurses were at a significantly higher risk of physical assault and verbal abuse compared to physicians. Patients, patients' relatives, and colleagues were the main perpetrators. Worry about WPV, on-call duty and shift work, experience of bullying and verbal abuse and employment sector emerged as significant correlates affecting the intrinsic and extrinsic job satisfaction of physicians and nurses. Frontline staff, aged 30 and 39, coming from an ethnic minority, and perceived stress were significant correlates affecting nurses' job satisfaction. CONCLUSIONS: WPV remains a significant concern in healthcare settings in Macau. Stakeholders should legally enforce a zero-tolerance policy towards WPV within healthcare workplaces. WPV is detrimental to healthcare professionals' mental wellbeing, risking irreversible physical and psychological harm for its victims.

La nueva epidemia: agresión hacia médicos en el ámbito laboral / The new epidemic: aggression against physicians in work places

Objetivos: Describir la prevalencia de eventos de agresión laboral contra médicos en la ciudad de Rosario y alrededores ocurridos en el último año. Determinar las características de los hechos de violencia y analizar la relación entrelos mismos y las características de la población médica.Materiales y Métodos: Estudio observacional, descriptivo y analítico, prospectivo; elaborado a partir de encuestascerradas on-line, realizadas de manera consecutiva a médicos que ejercieran en Rosario, Villa Gobernador Gálvez yGranadero Baigorria; del 18/07/2017 al 24/07/2017. Muestreo de tipo consecutivo, probabilístico, aleatorio simple. Se calculó un tamaño muestra de 350 encuestas.Resultados: Se incluyeron 351 encuestas. Hombres en 33% (n=115) y mujeres en 67% (n=236). El 23,1% (n=81)pertenecía al medio privado; 35% (n=123) al público; 41,6% (n=146) ambos y 0,3% (n=1) NS/NC. El 80,1%(n=281) presentó un episodio de agresión en el último año, de los cuales 86,8% (n=244) fue verbal y 13,2%(n=37) física-verbal. La agresión, pudiendo identificarse más de un agresor, fue realizada por familiar del pacienteen 94%(n=237), paciente 66% (n=166), personal de salud no médico 33% (n=83) y 26% (n=67) por un colega.El sitio de agresión más frecuente fue la guardia externa. Las mujeres padecieron mayor cantidad de eventos deagresión. Las especialidades más agredidas fueron Obstetricia y Pediatría. Se identificaron como factores de riesgo:sexo femenino (p=0,01; OR=2; IC95%=1,1-3,4), ejercicio profesional en guardia externa (p<0,0001; OR=3,2;IC95%=1,8-5,8) y la especialidad pediatría (p=0,016; OR=1,2; IC95%=1,2-1,3)... (AU)

Purposes: Estimation of the prevalence of aggression events against physicians in the workplace in the city of Rosario and environmentsin last year. Description of the violence events and how they are related with the medical population characteristics.Materials and methods: This is an observational, descriptive and analytic, prospective research. Performed withphysicians working in Rosario, Villa Gobernador Gálvez and Granadero Baigorria cities, Santa Fe, Argentina in base ofclosed on line surveys in a consecutive way. The evaluation included the period from July 18th to July 24th, 2017. Thesample was consecutive, probabilistic and simply randomized. The calculated sample size was 350 surveys.Results: 351 surveys were included, 33% males (n=115) and 67% females (n=236). 23% (n=81) from privateinstitutions, 35% (n=236) public ones, 41,6% both (n=146) both and unknown / unanswered 0,3% (n=1). 80%(n=281) presented an episode of aggression in the previous year, of which 86% (n=244) was verbal and 13,2% (n=37)physical and verbal. The aggression was performed by a patient`s relative in 94% (n=237), the patient in 66% (n=166),non-medical health personnel 33% (n=83) and 26% (n=67) by a colleague. The most frequent place of aggression wasemergency room. The women suffered a higher frequency of aggression. Obstetrics and pediatrics were the specialties moreinvolved. The risk factors were: female sex (p=0.01; OR=2; CI95%=1,1-3,4); working in emergency room (p<0,0001;OR=3,2; IC95%=1,8-5,8 and the specialty of pediatrics (p=0,016; OR=1,2; CI95%=1,2-1,3)... (AU)

The pathways between female garment workers' experience of violence and development of depressive symptoms.

BACKGROUND: The prevalence of intimate partner violence (IPV) is high (54%) in Bangladesh. Moreover, female garment workers report higher rates of IPV and are also vulnerable to workplace violence (WPV). Experience of violence puts women at increased risk of developing depressive symptoms, which are related with low self-esteem, lower life satisfaction and lower productivity. To our knowledge, there has been no previous research on depression among female garment workers and its connections to IPV and WPV in Bangladesh. This paper aims to address this gap by studying the relationship of IPV, WPV and depression among female garment workers. METHODS: The data for this paper comes from a cross-sectional survey of female garment workers (n = 800) conducted as baseline survey of a quasi-experimental study known as HERrespect. Survey data were collected during September-December, 2016 among randomly selected female garment workers from eight garment factories in and around Dhaka city. Structural equation modelling was conducted to explore the relationship among IPV, WPV and depression. RESULTS: The findings show high rates of any IPV (69%); WPV (73%, experienced or witnessed) and depressive symptomatology (40%) among female garment workers. The analysis of pathways shows that IPV impacts a woman's experience of WPV and work related stress leading to the development of depression; while WPV had direct and mediated pathways to depression. Experience of controlling by their husband leads to WPV and increased work related stress, and thus leads to depression. It also reveals that a worker's ability to mobilize resources in emergency, however, increased self-esteem and reduced work related stress. CONCLUSION: This study shows the pathways through which experience of IPV and WPV lead to development of depressive symptoms among female garment workers. The link between women's ability to mobilize resources with self-esteem and work related stress indicates the need for socio-economic empowerment of women and may suggest that combined intervention to address IPV and women's empowerment could be successful in dealing with WPV and mental health.