title: Workplace Violence and Self-reported Psychological Health: Coping with Post-traumatic Stress, Mental Distress, and Burnout among Physicians Working in the Emergency Departments Compared to Other Specialties in Pakistan.
abstract: BACKGROUND
  Little is known about the mental health impact of workplace violence (WPV) among emergency physicians (EPs) working in emergency departments (EDs) in Pakistan and whether this impact varies across specialties.
  
  
  OBJECTIVE
  Our aim was to measure the prevalence of WPV among EPs in 4 of the largest hospitals in Karachi, Pakistan; to measure the association between the experience of WPV and self-report of post-traumatic stress disorder (PTSD), depression, anxiety, and burnout; to compare the same factors across medical specialties; and to explore the coping strategies used by physicians in dealing with job-related stressors.
  
  
  METHODS
  A cross-sectional survey was conducted among 179 physicians from 5 specialties (response rate, 92.2%) using standard questionnaires for WPV, PTSD, burnout, current mental distress, and methods of coping.
  
  
  RESULTS
  One in 6 physicians reported experiencing a physical attack and 3 in 5 verbal abuse on the job in the previous 12 months. Pathologists were less likely to report any form of WPV compared to all other specialties. There was, however, no difference in experience of WPV between EPs and internists, surgeons, or pediatricians. One in 6 physicians screened positive for PTSD, and 2 in 5 for current anxiety and depression. There was significant comorbidity of mental distress with PTSD. Those who reported experiencing physical attack were 6.7 times more likely to report PTSD symptoms. We also found high rates of burnout (42.4% emotional exhaustion; 72.9% depersonalization) among physicians.
  
  
  CONCLUSIONS
  Experience of WPV was not uniform across specialties but was generally high among Pakistani physicians. Prevention of WPV should be a high priority for health care policy makers.
authors.affiliation: Department of Emergency Medicine, Aga Khan University, Karachi, Pakistan.
authors.forename: Waleed
authors.initials: W
authors.lastname: Zafar
authors.affiliation: Department of Emergency Medicine, Aga Khan University, Karachi, Pakistan.
authors.forename: Uzma R
authors.initials: UR
authors.lastname: Khan
authors.affiliation: Department of Emergency Medicine, Aga Khan University, Karachi, Pakistan.
authors.forename: Shakeel A
authors.initials: SA
authors.lastname: Siddiqui
authors.affiliation: Jinnah Postgraduate Medical Centre, Karachi, Pakistan.
authors.forename: Seemin
authors.initials: S
authors.lastname: Jamali
authors.affiliation: Department of Emergency Medicine, Aga Khan University, Karachi, Pakistan.
authors.forename: Junaid A
authors.initials: JA
authors.lastname: Razzak
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D002055:Burnout, Professional / Q000453:epidemiology* / Q000209:etiology / Q000523:psychology; D003430:Cross-Sectional Studies; D003866:Depressive Disorder / Q000453:epidemiology / Q000209:etiology; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010154:Pakistan / Q000453:epidemiology; D010820:Physicians / Q000523:psychology*; D015995:Prevalence; D013313:Stress Disorders, Post-Traumatic / Q000453:epidemiology* / Q000209:etiology / Q000523:psychology; D013315:Stress, Psychological / Q000453:epidemiology* / Q000209:etiology; D064450:Workplace Violence / Q000706:statistics & numerical data*
keywords: Karachi; Pakistan; anxiety; burnout; coping; depression; emergency department; emergency physician; mental health; post-traumatic stress disorder; workplace violence