title: The role of aggressions suffered by healthcare workers as predictors of burnout.
abstract: OBJECTIVE
  To examine the prevalence of aggression against healthcare professionals and to determine the possible impact that violent episodes have on healthcare professionals in terms of loss of enthusiasm and involvement towards work. The objective was to analyse the percentage of occupational assault against professionals' aggression in different types of healthcare services, differentiating between physical and verbal aggression as a possible variable in detecting burnout in doctors and nursing professionals.
  
  
  BACKGROUND
  Leiter and Maslach have explored a double process model of burnout not only based on exhaustion by overload, but also based on personal and organisational value conflicts (community, rewards or values). Moreover, Whittington has obtained conclusive results about the possible relationship between violence and burnout in mental health nurses.
  
  
  METHODS
  A retrospective study was performed in three hospitals and 22 primary care centres in Spain (n = 1·826).
  
  
  METHODS
  Through different questionnaires, we have explored the relationship between aggression suffered by healthcare workers and burnout.
  
  
  RESULTS
  Eleven percent of respondents had been physically assaulted on at least one occasion, whilst 34·4% had suffered threats and intimidation on at least one occasion and 36·6% had been subjected to insults. Both forms of violence, physical and non-physical aggression, showed significant correlations with symptoms of burnout (emotional exhaustion, depersonalisation and inefficacy).
  
  
  CONCLUSIONS
  The survey showed evidence of a double process: (1) by which excess workload helps predict burnout, and (2) by which a mismatch in the congruence of values, or interpersonal conflict, contributes in a meaningful way to each of the dimensions of burnout, adding overhead to the process of exhaustion-cynicism-lack of realisation. Relevance to clinical practice.  Studies indicate that health professionals are some of the most exposed to disorders steaming from psychosocial risks and a high comorbidity: anxiety, depression, etc. There is a clear need for accurate instruments of evaluation to detect not only the burnout but also the areas that cause it. Professional exhaustion caused by aggression or other factors can reflect a deterioration in the healthcare relationship.
authors.affiliation: Authors: Santiago Gascon, PhD, Assistant Professor, Department of Psychology, Zaragoza University, Teruel, Spain; Michael P Leiter, PhD, Professor, Centre for Organisational and Development Research, Acadia University, Wolfville, NS, Canada; Joao P Pereira, PhD, Assistant Professor, Instituto Superior de Maia, Castelo da Maia; María J Cunha, PhD, Assistant Professor, Instituto Superior de Maia, Castelo da Maia, Portugal; Agustín Albesa, PhD Student, Psychologist and Lawyer, Department of Psychology, Zaragoza University, Zaragoza; Jesus Montero-Marín, PhD, Assistant Professor, Zaragoza University, Zaragoza; Javier García-Campayo, PhD, Professor, Department of Psychiatry Zaragoza University, Zaragoza, Spain.
authors.forename: Santiago
authors.initials: S
authors.lastname: Gascon
authors.forename: Michael P
authors.initials: MP
authors.lastname: Leiter
authors.forename: Eva
authors.initials: E
authors.lastname: Andrés
authors.forename: Miguel A
authors.initials: MA
authors.lastname: Santed
authors.forename: Joao P
authors.initials: JP
authors.lastname: Pereira
authors.forename: María J
authors.initials: MJ
authors.lastname: Cunha
authors.forename: Agustín
authors.initials: A
authors.lastname: Albesa
authors.forename: Jesus
authors.initials: J
authors.lastname: Montero-Marín
authors.forename: Javier
authors.initials: J
authors.lastname: García-Campayo
authors.forename: Begoña
authors.initials: B
authors.lastname: Martínez-Jarreta
mesh_terms: D000374:Aggression; D002055:Burnout, Professional / Q000523:psychology*; D006282:Health Personnel / Q000523:psychology*; D006801:Humans; D024382:Professional Role; D012189:Retrospective Studies