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This study sought to investigate whether association between customer verbal abuse and depressive symptoms differed by workload. We conducted a cross-sectional survey of 795 cosmetic sales workers at department store in South Korea. Experience of customer verbal abuse over the past one month was measured by using a yes/no question. Depressive symptoms during the preceding week were assessed by using 20 items from the Center for Epidemiologic Studies-Depression scale. Workload during the past week was measured by asking the number of customers a worker dealt with on average in a day and classified into two categories: 1) Low (15 people or less), and 2) High (more than 15 people). Cosmetics sales workers' experience of customer verbal abuse was associated with a higher prevalence of depressive symptoms (PR: 1.37, 95% CI: 1.15-1.63). After being stratified by workload, customer verbal abuse showed a statistically significant association with depressive symptoms among high workload groups (PR: 1.46, 95% CI: 1.19-1.79), whereas the association was not statistically significant among low workload group (PR: 1.23, 95% CI: 0.91-1.65). Our findings suggest that experience of customer verbal abuse could have a negative influence on depressive symptoms among high-workload cosmetics sales workers in South Korea.

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Background and Purpose: Questioning the adverse childhood experiences of adults may facilitate their search for help for their physical, social, and psychological well-being. The aim of this study is to determine the validity and reliability of the Adverse Childhood Experience Questionnaire for Adults in Turkish. Methods: This methodological study was conducted with 290 participants. The data collection tools consisted of a personal information form, the Adverse Childhood Experience Questionnaire for Adults, and the Childhood Trauma Experiences Questionnaire Short Form. Results: The number of items in the original questionnaire was 29 and became 24 in the Turkish adaption, which showed content validity, construct validity, and internal consistency reliability (Cronbach's alpha (α) = 0.928). Conclusions: The Adverse Childhood Experience Questionnaire for Adults was found to be valid and reliable for the Turkish population.

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This study examines domestic violence perpetrated by wives against husbands in Palestine, utilizing structured interviews with 53 married participants. Findings reveal prevalent female-perpetrated domestic violence, often involving mutual conflict initiation. External stressors and power dynamics significantly influence behaviors, reflecting situational pressures and control issues. Verbal abuse and emotional manipulation are widespread, indicating covert and challenging violence dynamics. Responses to violence vary, suggesting barriers to accessing support systems. Effective conflict resolution is crucial to address ongoing relationship challenges. The study underscores the multifaceted nature of domestic violence, emphasizing the need to address underlying psychological factors and promote healthier relationship dynamics. Based on the study's findings, actionable recommendations include educational outreach, customized support services, legal advocacy initiatives, community engagement projects, professional development activities, and sustained research efforts to promote positive societal change.

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This study aims to investigate the forms of verbal abuse by teachers toward students during the teaching and learning process, the prototype of verbal abuse recognized by teachers, and the specific features of verbal abuse of students by teachers. This study used mixed methods that combine qualitative and quantitative methods. The quantitative method focused on investigating the frequency of verbal abuse by teachers using the Korean Verbal Abuse Questionnaire. Meanwhile, the qualitative method examined the prototype of verbal abuse recognized by teachers and the features of verbal abuse that teachers use toward students. This study recruited 204 students from the fourth to the sixth grades of elementary school and 30 teacher representatives from five elementary schools in Indonesia. The data were collected through online surveys and interviews. The data on the frequency of verbal abuse by teachers during the teaching and learning process were analyzed using descriptive statistics. In contrast, the data from the open-ended questionnaire for teachers and the interviews with students and teachers were analyzed using content analysis. This study found that there are four types of verbal abuse by teachers. These are raising their voices, telling students that they are acting stupid or like brats, scolding, and calling names that make students feel inadequate. Teachers tend to define abuse as something that is physically aggressive, suggesting that teachers often categorize abuse within the realm of physical violence. There are four types of verbal abuse features found in teachers' utterances; these are labeling students' cognitive ability, labeling students' behaviors, shaming students' physiques, and raising their voices. The results of this study can be employed to develop communication strategies for teachers to lessen verbal abuse during the teaching and learning process.

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Introduction Domestic violence (DV) in the form of verbal abuse is very common among women, especially pregnant women, posing as a serious public health issue that could lead to complications in pregnancy and threaten maternal and fetal outcomes. Studies have determined that domestic verbal abuse (DVA) in pregnancy was more common in women less than 25 years of age as well as in those with low education levels. This study determined the overall prevalence of verbal abuse in pregnant women, in a semi-urban population and is unique in that the verbal abuse in pregnant women with a previous girl child was also determined. This study helps healthcare providers identify the potential causes of DVA in pregnancy and provide timely interventions in the form of counseling for pregnant women and families. Objective This observational study was carried out to assess the prevalence of DVA among pregnant women, to determine the trimester of occurrence of DVA among pregnant women, and to explore the associations of DVA with age, employment status, parity gestational age, and birth weight.  Materials and methods This was a six-month hospital-based observational study conducted at Dr D. Y. Patil Medical College's in-patient department (IPD) of Obstetrics and Gynecology in Pimpri, Pune. Consent was obtained from 200 pregnant women who received admission for delivery and provided a validated modified copy of a DV assessment screening questionnaire. A statistical analysis was performed using GraphPad Prism 10. A Chi-square test was employed wherever required, and a p-value of less than 0.05 was considered significant. Results The study included 200 pregnant women, who were admitted to the hospital for delivery. The prevalence of DV in the form of verbal abuse was noted to be 74 out of 200 (37%). The working status of the woman showed an influence on DVA. There was also a significant increase in verbal abuse (68%) among the age group between 18 and 23 years. The previous delivery of a female child also had a significant impact on DVA, which turned out to be more prevalent, particularly if two female children were born previously (80%). The study also noted higher rates of preterm deliveries in pregnant women with DVA being 57%. Conclusion The study demonstrates that women, even in modern times, experience DVA during pregnancy, especially among the younger age group. It has also been found that it is more common among women who are financially dependent due to maternal unemployment. As a result, there is a need to routinely screen pregnant women for DVA to avoid potentially detrimental pregnancy outcomes and to prevent ongoing abuse.

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AIMS: To explore hospital staff experiences and perceptions of patient-perpetrated violence. DESIGN: Descriptive qualitative study. METHODS: Twelve semi-structured interviews (June-August 2022) were held with a diverse sample of hospital nurses, doctors, allied health professionals, security and a non-clinical manager. The framework approach was used to organise and analyse data, using Attribution Theory as a theoretical lens. RESULTS: Three themes were identified: violence as (un)predictable, violence as (un)preventable and the cumulative toll of violence. In making sense of why patients become violent, participants described different 'types' of aggressive patients and variably attributed behaviours to situation, disposition or a combination of both. Regardless of perceived causal factors, staff overwhelmingly appeared to view violence as predictable. Participants also reflected on the wider structural problems underpinning violence, frequently alluding to their sense of relative powerlessness to initiate change. The cumulative toll of violence was a common thread, with staff describing their acquisition of 'resilience' and reflecting on its role in their responses to escalating situations. CONCLUSIONS: Many hospital staff are resigned to the inevitability of violence. The concept of staff 'resilience' following violence is not unproblematic, having the potential to serve as a guise for acceptance and as an additional variable for which staff are held accountable. When designing strategies, organisations should ensure that accountability for violence reduction is distributed across multiple levels. This study makes a novel contribution by exploring the perspectives of multiple staff groups working across diverse hospital settings, and adds to a sparse literature on this subject in the UK. IMPLICATIONS FOR THE PROFESSION: Efforts to address violence against healthcare staff need to be power-conscious, ensuring that accountability is distributed across multiple levels. REPORTING METHOD: This study is reported in line with the Consolidated Criteria for Reporting Qualitative Studies (COREQ). PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution.

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PURPOSE: Child maltreatment (CM) is associated with psychosis; however little is known about the frequency, type, and timing of abuse in the personality pathology domain of psychoticism (PSY) in the DSM-5. The purpose of this study was to analyze childhood trauma typology and frequency according to gender and to identify sensitive periods of susceptibility to CM in women with high PSY. METHODS: The Maltreatment and Abuse Chronology Exposure (MACE) scale was used to evaluate the frequency, severity and timing of each type of maltreatment. The full sample consisted of 83 participants with different psychiatric diagnoses. Psychoticism was assessed with the DSM-5 Personality Inventory (PID-5). To identify the differences in CM exposure between the PSY+ (high psychoticism) and PSY- (low psychoticism) groups, the Mann-Whitney U test, the chi square test and random forest (RF) test were used. RESULTS: Comparing PSY + and PSY-, revealed gender differences in the impact of abuse, with highly frequent and severe types of abuse, in women. In women, PSY + and PSY-, were differentiated especially in non-verbal emotional abuse, peer physical bullying and parental verbal abuse. Several periods with a major peak at age seven followed by peaks at age 17 and 12 years old were identified. CONCLUSION: Increased exposure to CM occurs in women with PSY+. A sensitivity to CM exposure during early childhood and late adolescence could be a risk factor for psychoticism in women.

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BACKGROUND: Globally, close to one-third of all workplace violence (WV) occurs in the health sector. Exposure to WV among healthcare professionals in Ghana has been widely speculated, but there is limited evidence on the problem. This study therefore investigated WV, its risk factors, and the psychological consequences experienced by health workers in Ghana. METHODS: An analytic cross-sectional study was conducted in the Greater Accra region from January 30 to May 31, 2023, involving selected health facilities. The participants for the study were selected using a simple random sampling technique based on probability proportional-to-size. The data analyses were performed using STATA 15 software. Logistic regression analyses were employed to identify the factors associated with WV, considering a significance level of p-value < 0.05. RESULTS: The study was conducted among 607 healthcare providers and support personnel across 10 public and private hospitals. The lifetime career, and one-year exposure to any form of WV was 414 (68.2%) [95% CI: (64.3-71.9%)] and 363 (59.8%) [95% CI: (55.8-63.7%)], respectively. Compared to other forms of WV, the majority of healthcare workers, 324 (53.4%) experienced verbal abuse within the past year, and a greater proportion, 85 (26.2%) became 'super alert' or vigilant and watchful following incidents of verbal abuse. Factors significantly linked to experiencing any form of WV in the previous 12 months were identified as follows: older age [AOR = 1.11 (1.06, 1.17)], working experience [AOR = 0.91 (0.86, 0.96)], having on-call responsibilities [AOR = 1.75 (1.17, 2.61)], and feeling adequately secure within health facility [AOR = 0.45 (0.26, 0.76)]. CONCLUSION: There was high occurrence of WV, and verbal abuse was the most experienced form of WV. Age, work experience, on-call duties, and security within workplace were associated with exposure to WV. Facility-based interventions are urgently needed to curb the incidence of WV, especially verbal abuse.

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Weight-related abuse is defined as verbal or physical maltreatment specific to one's weight. The Weight-Related Abuse Questionnaire (WRAQ) is an instrument specifically designed to measure weight-related abuse. The main goal of this research was to study the factor structure and measurement invariance of the Spanish version of the WRAQ in a non-clinical and a clinical sample. The clinical sample included 150 participants with obesity (60 % women) from the Hospital de Valme (Sevilla, Spain). The non-clinical sample included 301 students (79 % women) from the Spanish Open University (UNED). Scales to measure weight self-stigma and fear of gaining weight were used to analyze the convergent validity of the WRAQ. A confirmatory factor analysis showed that a two-factor model (verbal and physical abuse) was an acceptable fit for the data in both the clinical and non-clinical samples. Multigroup Confirmatory Factor Analysis revealed scalar measurement invariance by sample and gender. Cronbach's alpha coefficients and composite reliability for both samples were found to be good, with values ranging from 0.83 to 0.96. Fear of gaining weight was correlated to verbal (r = 0.36, p < .01) and physical (r = 0.12, p < .05) abuse, and weight self-stigma was also related to physical (r = 0.21, p < .01) and verbal (r = 0.41, p < .01) abuse. These results suggest that the WRAQ can be used in clinical and non-clinical samples to assess verbal and physical abuse in both men and women.

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BACKGROUND: Workplace violence (WPV) is a global problem that affects healthcare workers' physical and mental health and impairs work performance. Pakistan's healthcare system is not immune to WPV, which the World Health Organization recognises as an occupational hazard. OBJECTIVES: The primary objective of this systematic review is to determine the prevalence of physical, verbal, or other forms of WPV in healthcare workers in Pakistan. Secondary objectives include identifying the associated risk factors and perpetrators of WPV. METHODS: A systematic review of six electronic databases was conducted through August 2022. Studies were included if they met the following criteria: 1) healthcare workers (HCWs), including physicians, nurses, and paramedic staff working in the private or public sector of Pakistan; 2) exposure to physical, verbal, or any type of violence. Data were extracted and analysed for the prevalence of WPV, types of violence, associated risk factors, and perpetrators of violence. RESULTS: Twenty-four studies including 16,070 HCWs were included in this review. Verbal violence was the most common form of violence levied, with its highest prevalence (100%) reported in Islamabad and lowest verbal violence prevalence (25%) in Karachi. Verbal abuse was preponderant against female HCWs, while physical abuse was directed more towards males. The most common perpetrators were patient attendants, followed by the patients. CONCLUSION: Our review determines a 25-100% prevalence of WPV against HCWs in Pakistani medical setups. This occupational hazard needs the attention of relevant authorities in the country to put protective enforcement policies in place. Large-scale surveys should be conducted to better gauge the current plight of HCWs in the nation.

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Background: A women's right to a positive childbirth experience should be the heart of any care provided. To assess the quality of childbirth services and mistreatment by healthcare providers among reproductive age group women and to explore factors influencing the same between women and stakeholders. Material and Methods: A community-based, mixed-method study was conducted from April to September 2021 in field practice areas of a medical college in Puducherry district. The sample size for the quantitative study was 348 and the women were chosen using a multi-stage sampling technique. Women were interviewed with a semi-structured questionnaire. In-depth and key informant interviews between women and stakeholders were done for the qualitative data collection. Results: Three-fourths (77.0%) of women preferred government tertiary healthcare facilities for obstetric care. Although 69.0% and 75.6% of the participants did not experience any verbal and physical abuse, respectively, the qualitative study results were quite the opposite. While 92.8% of the women complained that no birth companion was allowed during their delivery. Moreover, 79.9% of the women did not have the freedom to choose their comfortable birthing position. The levels of mistreatment in the rural areas were slightly higher than that of the urban areas. Conclusion: Quality care is a fundamental approach to maternity care. A fair bit of women experiences mistreatment during childbirth in healthcare setups. However, the chief concern here is the perception of such abuse by the mothers as normal due to their lack of knowledge regarding women's rights.

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BACKGROUND: In recent years, the prevalence of childhood emotional abuse has surpassed other forms of maltreatment. Childhood verbal abuse (CVA) is a key attribute of emotional abuse, yet CVA is not recognized as its own form of maltreatment and thus, has not received adequate attention. Clear terminology, definitions, and measures are needed to aid in assessing the occurrence and impact of CVA for its recognition and prevention. OBJECTIVE: We aim to synthesize the evidence on the terms, definitions, and measurements of CVA and identify outcomes associated with CVA. PARTICIPANTS AND SETTING: A systematic review focused on adult perpetration of CVA among children and adolescents using clinical, community-based, and population-based samples. METHODS: The Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines were followed and four databases were utilized in May 2022: PsycINFO, MEDLINE, EMBASE, and ProQuest. A total of 149 quantitative and 17 qualitative studies were identified. RESULTS: Across studies reviewed, the most common perpetrators of CVA were parents, mothers, and teachers. Definitional themes for CVA included negative speech volume, tone, and speech content, and their immediate impact. The most frequent measures cited were Adverse Childhood Experiences Study (ACE) Questionnaire and the Conflict Tactics Scale (CTS); 50 % used self-created measures. CVA was associated with a range of internalizing and externalizing outcomes across the lifespan. CONCLUSIONS: Recognizing CVA as a form of maltreatment will be a starting point for its identification and prevention. Primary prevention of CVA using trauma-informed approaches must include adult training on the importance of safety, support, and nurturance during verbal communication with children.

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BACKGROUND:  Acute psychiatric units are found to be stressful working environments because of the nature of illness patients present with. OBJECTIVES:  This study aimed to determine self-reported incidents of physical and verbal violence towards nurses working in acute psychiatric units in Western Cape, South Africa. METHOD:  A questionnaire was used to collect data. Chi-square test was performed to determine association between gender, category and experience of violence. Mann-Whitney U test was carried out to determine associations between years of employment and the likelihood of experiencing physical violence and verbal abuse. RESULTS:  Overall physical violence 35 (34.3%) and verbal abuse 83 (83%) incidents. Most female respondents reported both physical violence (74.2%, n = 26) and verbal abuse (72.2%, n = 60), with (56.2%, n = 18) professional nurses reporting physical violence. Years of employment was statistically significantly associated with the likelihood of nurses experiencing physical violence (p = 0.007). CONCLUSION:  Most respondents (74.2%, n = 26) were females and they mostly experienced physical violence and verbal abuse while 28.2% (n = 29) were males. Years of service were associated with the likelihood of experiencing physical violence.Contribution: The knowledge gained will add on existing knowledge about the challenge of violence experienced by nurses in the workplace and might have an influence on policymakers.

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Objective: Several lines of evidence indicate verbal abuse (VA) critically impacts the developing brain; however, whether VA results in changes in brain neurochemistry has not been established. Here, we hypothesized that exposure to recurrent parental VA elicits heightened glutamate (Glu) responses during the presentation of swear words, which can be measured with functional magnetic resonance spectroscopy (fMRS). Methods: During an emotional Stroop task consisting of blocks of color and swear words, metabolite concentration changes were measured in the ventromedial prefrontal cortex (vmPFC) and the left amygdalohippocampal region (AMHC) of healthy adults (14 F/27 M, 23 ± 4 years old) using fMRS. The dynamic changes in Glu and their associations with the emotional state of the participants were finally evaluated based on 36 datasets from the vmPFC and 30 from the AMHC. Results: A repeated-measures analysis of covariance revealed a modest effect of parental VA severity on Glu changes in the vmPFC. The total score on the Verbal Abuse Questionnaire by parents (pVAQ) was associated with the Glu response to swear words (ΔGluSwe). The interaction term of ΔGluSwe and baseline N-acetyl aspartate (NAA) level in the vmPFC could be used to predict state-trait anxiety level and depressive mood. We could not find any significant associations between ΔGluSwe in the AMHC and either pVAQ or emotional states. Conclusion: Parental VA exposure in individuals is associated with a greater Glu response towards VA-related stimuli in the vmPFC and that the accompanying low NAA level may be associated with anxiety level or depressive mood.

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Workplace violence is an increasing public health concern around the world. In Vietnam, attacks on healthcare workers have become a huge issue in recent years. Our study aims to shed more light on the issue and look at what variables affect acts of violence toward healthcare workers. We conducted this cross-sectional study by surveying 550 medical students from 3 universities in Vietnam. Following this survey on SurveyMonkey's platform (surveymonkey.com), the participants were suggested to invite their associates who met the selection criteria to join in this online survey. The structured questionnaire included demographics and details on the violence. There were 90.5% of respondents were medical students, the mean age was 23.3, and verbal abuse had a prevalence rate of 29.3%. Women respondents are less likely to suffer from violent experiences than men (OR = 0.48, 95% CI = 0.28-0.84), and those specializing in nurse and technician also faced a lower rate of acts of aggression (physical violence: OR = 0.35; 95% CI = 0.19-0.63, sexual harassment: OR = 0.36; 95% CI = 0.15-0.87, and any type of violence: OR = 0.55, 95% CI = 0.37-0.82). Medical students working in Ho Chi Minh City (OR = 0.55; 95% CI = 0.34-0.89), and other regions (OR = 0.40; 95% CI = 0.19-0.85) were significantly less likely to face verbal abuse than those working in Hanoi. The workplace culture needs to be changed to make sure that people feel comfortable reporting, especially those who are younger. Protecting medical students also ensures patient safety since victims of assault in the workplace can have severe aftereffects affecting their ability to provide good patient care. Hence, policies need to be implemented at both the government and hospital administration levels to keep health workers safe.

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Introduction Workplace violence (WPV) is a significant problem for healthcare professionals across the world, regardless of whether they work in developed or developing countries. Studies have shown that in India, up to 75% of doctors have experienced some form of violence in the workplace. The purpose of the present study was to examine the extent of violence against doctors and its impact on patient management. Methodology This cross-sectional study was conducted in a tertiary care hospital in New Delhi in June 2022. A total of 326 resident doctors from six departments were selected using stratified random sampling. Data were collected using a semi-structured interview schedule and a pre-validated questionnaire. Statistical analysis was done using Stata 17, and ethical clearance was obtained from the Institute Ethical Committee. Result Workplace violence was prevalent among healthcare professionals, with 80.4% (95% confidence interval (CI): 75.6%-84.5%) experiencing verbal abuse and 21.7% (95% CI: 17.4%-84.5%) experiencing physical violence. Perceived delays in treatment and patient deaths were the most common causes of violence. Most participants were hesitant to report WPV due to time-consuming reporting processes and a lack of organisational support. WPV had a negative impact on doctors' mental and personal well-being, with 73.3% reporting its negative impact. WPV has led to a decrease in the provision of surgical and medical interventions. Conclusion The study findings suggest that a significant proportion of doctors in a tertiary care hospital in Delhi encounter some form of workplace violence. Despite the high incidence of WPV, reporting of these events remains low due to inadequate support and deficient reporting procedures within healthcare organisations. The negative impact of WPV is not limited to the physicians' psycho-social well-being but extends to their approach to patient care as well. Therefore, taking appropriate actions to prevent WPV is crucial for ensuring the safety and well-being of healthcare professionals and improving patient outcomes.

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BACKGROUND: During the COVID-19 pandemic, we have witnessed increased complaints from third parties about violent conditions through social media. This study aimed to determine the prevalence of domestic violence (DV) against women following exposure to the COVID-19 pandemic and its relevance to some related factors. MATERIALS AND METHODS: This study was conducted from July 2020 to May 2021 on married women of Babol, Iran. Eligible women entered into the study in a multi-stage cluster random sampling method. Data collection tools included demographic and family data, questionnaire HITS (Hurt, Insult, Threaten and Scream). Relationships were estimated using the Univariate and multivariate regression models.  Results: The mean age of 488 women and their spouses was 34.62 ± 9.14 and 38.74 ± 9.07, respectively. Of the total female participants, 37 (7.6%), 68 (13.9%), and 21 (4.3%) were victims of total violence, verbal abuse, and physical violence, respectively. Ninety-five women (19.5) had a history of coronavirus infection. Women who were satisfied with their income and husbands were university educated, their chances of DV were reduced by 72% (95% CI (0.09-0.85), OR = 0.28) and 67% (95% CI (0.11-0.92), OR = 0.33) respectively. Drug abuse by husbands increased the likelihood of DV by up to 4 times (OR = 4.00), and more contact with their husbands at home due to home quarantine was more than twice as likely to have DV (OR = 2.64).  Conclusion: Since the level of domestic violence was lower than before the coronavirus pandemic, it seems that most Iranian women were more under the support of their husbands during the coronavirus pandemic to endure the fear and panic caused by the pandemic. Women whose husbands had a university education and sufficient income had less domestic violence.

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BACKGROUND: Workers under the age of 25 may be at particular risk for workplace violence, given their predominant employment in the high-risk retail and service industries. Little research exists, however, that estimates the scope of the problem within this population. To fill this gap, we conducted the first national study of workplace violence against young people in the United States. METHODS: We analyzed survey data collected via telephone interview from a national sample of 1031 young workers ages 14 through 24 who held a formal job in the last 12 months. Weighted frequencies were calculated and χ2 tests of significance were used to detect differences between groups. RESULTS: Many youth experience workplace violence (60%). Verbal abuse of the sort that made victims feel scared and unsafe (53%) and sexual harassment (24%) were the most commonly reported forms of violence. Females were more likely than males to experience workplace violence overall (p < 0.001) and sexual harassment (p < 0.001) in particular. Males were more likely to experience verbal abuse (p < 0.001). Workplace violence was most prevalent among workers in healthcare settings and eating and drinking places. The occupation with the highest prevalence of workplace violence was customer service. CONCLUSIONS: Workplace violence is common among young workers in the United States and more widespread than prior estimates have suggested. This study is the first to provide a true national prevalence estimate of the problem of workplace violence among young workers ages 14 to 24 in the United States. These findings should be used to locate areas of concern and target resources where they are needed most to address this significant problem.

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BACKGROUND: Threatening and aggressive behaviors in healthcare settings constitute a significant problem that can affect not only the physical and mental integrity of staff but also patient safety and the quality of healthcare. Literature highlights verbal abuse as the most common form of non-physical violence and is estimated from 51.8% to 63.4% worldwide. PURPOSE: The purpose of the study was the investigation of verbal abuse incidence toward physicians and nurses and the differences noted between them in a regional hospital. METHODS: The study took place in a public regional hospital in southern Greece. A number of 185 nurses and 60 physicians completed the verbal abuse scale (VAS) for assessing verbal violence in the work environment; selected socio-demographic and occupational characteristics were also recorded. RESULTS: Physicians have undergone verbal abuse once a week at a percentage of 38.3%, while at the same frequency; nurses record a percentage of 12.4%. Regarding the relationship between the victim of verbal abuse and the abuser, 26.7% of the physicians answered that the abuser was another senior member of the staff, while the percentage for nurses is higher and reaches 31.9%. According to VAS items, accusing and blaming (mean±SD=3.00±0.96) is noted as the most common form of verbal abuse for physicians, judging and criticizing stands out as the most frequent (3.17±1.11) and the most stressful action (3.25±1.11) form for nurses. The most frequent behavior by the physicians is to put the verbal abuse situation in a humorous context (2.78±1.14). In contrast, nurses are trying to clarify any misunderstanding that may occur (3.10±1.00). CONCLUSIONS: Verbal abuse incidents are experienced by both physicians and nurses. They are stressful for the victims and can significantly affect work relationships and job satisfaction.

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BACKGROUND: Violence directed at healthcare workers (HCWs) is common and may be more frequent in the emergency department (ED). In addition to physical injury, other consequences of workplace violence in the ED include an increased risk of burnout, post-traumatic stress disorder, reduced job satisfaction, and feelings of avoidance and futility. Understanding behaviors underlying workplace violence is the first step to employing mitigation strategies. The objective of this descriptive study was to assess the prevalence and types of violence against HCWs in a large, urban ED. METHODS: This study took place in the ED of an urban hospital with an annual ED census of approximately 100,000. A previously existing general patient safety incident "dropbox" for HCWs was utilized to capture workplace violence reports. At the completion of the study period, all data was collated into the electronic database and each report was categorized based on the nature and severity of the abuse. Further, all events were also coded as either involving or not involving specifically racist, sexist, or homophobic content. The primary outcomes were the number of reported events over the study period, and the percentage of total events that fell into each category. The secondary outcomes were the overall prevalence and ratio of events that included racist, sexist, or homophobic language or provocation. RESULTS: Over the 5-month survey period, 130 reports of workplace violence were recorded, on average 0.85 per day. Perpetrators were mostly male, and most victims were nurses. Hospital security was involved in 26% of cases. At least 37% of incidents involved patients that were intoxicated and/or had history of psychiatric illness. Type I events (swearing provocatively, shouting, and legal threats) were the most common at 44% of encounters while 22% involved physical violence. Racist, sexist, and homophobic comments were involved in 8 (6%), 18 (14%), and 3 (2%) incidents respectively. CONCLUSION: We found that workplace violence against HCWs was common in this study, and sometimes involved a component of racist, sexist, or homophobic bias. Consistent with previous ED literature, we found that abusive events occurred almost daily and that approximately 20% of events involved physical violence. Future efforts toward policy change to address workplace violence in health care is needed at local, state, and national levels.

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