Aggression towards health care staff in a UK general hospital: variation among professions and departments.
BACKGROUND
Aggression towards health care staff is an increasing problem and although many studies have examined psychiatric settings, few have considered general hospitals and in particular, variation among professions and locations. In addition, studies often fail to include all forms of aggression such as threatening behaviour and verbal aggression.


METHODS
This study extends existing research by evaluating physical assault, threatening behaviour and verbal aggression from patients/visitors towards general hospital staff in the context of different professions and departments.


CONCLUSIONS
The survey of staff showed that aggression is widespread. Within the preceding year, 27% of the respondents were assaulted, 23% experienced threatening behaviour from patients and 15.5% experienced threatening behaviour from visitors. Over 68% reported verbal aggression, 25.7% experiencing it more regularly than monthly. By departments, over 42% of the medical department staff, 36% of the surgical staff and over 30% of the Accident and Emergency staff were assaulted. By profession, staff nurses and enrolled nurses reported the most assaults (43.4%) and doctors, the fewest (13.8%). Other nursing grades and health care professions all reported levels of physical assault in excess of 20%. Correspondingly high levels of threatening behaviour and verbal aggression were also reported although the patterns of victimization differed according to the various professions and departments. Independently, significant levels of assault, threatening behaviour and verbal aggression were reported. When aggregated they demonstrate the higher levels of victimization that general hospital staff experienced on a regular basis.


CONCLUSIONS
Institutional averages actually obscure the much higher levels of aggression experienced by the particular professions in particular departments. This study helps to localize the problem and identify those at most risk, but more research is needed into the aetiology of the aggression and of vulnerability factors associated with victimization.
Winstanley
Sue
S
Faculty of Health and Applied Social Sciences, Psychology and Speech & Language Therapy, De Montfort University, Leicester, UK. swinstan@dmu.ac.uk
Whittington
Richard
R
D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D000374:Aggression / Q000523:psychology; D001291:Attitude of Health Personnel; D004739:England; D005260:Female; D006769:Hospitals, General; D006801:Humans; D008297:Male; D008875:Middle Aged; D020380:Needs Assessment; D016273:Occupational Exposure / Q000009:adverse effects / Q000517:prevention & control / Q000706:statistics & numerical data*; D010564:Personnel, Hospital / Q000523:psychology*; D011369:Professional-Patient Relations; D012189:Retrospective Studies; D012307:Risk Factors; D012637:Security Measures; D012919:Social Behavior; D011795:Surveys and Questionnaires; D014705:Verbal Behavior; D014754:Violence / Q000517:prevention & control / Q000523:psychology / Q000706:statistics & numerical data*; D014789:Visitors to Patients / Q000523:psychology; D017132:Workplace / Q000523:psychology / Q000706:statistics & numerical data