Washington, D.C., 20 January 2016 (PAHO/WHO) - Health professionals frequently face situations of verbal or physical violence in the course of their duties, which has an impact on their work and health. This is the conclusion of a research paper published in the Pan American Journal of Public Health, the peer-reviewed scientific journal of the Pan American Health Organization (PAHO).

The research findings are based on an anonymous, confidential online survey of nearly 20,000 health professionals in Spanish-speaking Latin American countries (mainly Argentina, Mexico, and Ecuador), via the Intramed website. The objective of the study was to contribute information to inform the development of strategies to prevent and tackle these problems.

"Assaults on health workers are a frequent problem with emotional and work-related impacts, causing health professionals to have a sense of insecurity in the workplace," write the authors. "This is a serious problem not only because it exposes thousands of people to becoming victims of assault, but because it violates a basic right to safety in the workplace and its impact diminishes the quality of the service provided, thereby affecting the health of the population as a whole."

The study found that 66.7% of respondents reported having suffered some form of aggression in the workplace in the past year. This represents an increase over the previous Intramed survey (2006), in which 54.6% of professionals said they had been assaulted.

Among the professionals who had experienced aggression, 11.3% were attacked physically, forcing almost 30% of them to suspend their work. Nearly three quarters of assaults occurred in public institutions, mainly in the emergency sector. The most common triggers were delays in care (44.2%), lack of resources for care (33.6%), the circumstances in which a medical report was given (28.2%), and notification of death (8.6%).

"Delays in care pose a serious problem, particularly in the emergency sectors, reflecting organizational problems and a lack of necessary and properly qualified personnel. The lack of resources also dramatically expresses the fragility of the health care system," the researchers explained.

The authors clarified that, in most cases, aggressors were of sound mind. Only a small percentage of aggressors were said to be acting under the effect of a toxic substance or showed signs of psychiatric disturbance.

Among the professions studied, physicians and nurses were those who reported the most assaults, especially younger professionals, 25-34 and 35-44 years old. This could be attributed, among other causes, to greater exposure (working in the emergency sector) and to the fact that these professionals may have fewer tools to communicate with patients and families.

Nearly half of the respondents (46.6%) reported feeling insecure in their workplaces, even when their institution had security personnel and where various measures had been suggested to reduce assaults, including community education.

The researchers said the results of the study show that efforts are needed to improve training for professionals in communicating medical information and, especially, in how to deliver bad news. Specific measures are also needed to protect health workers in the emergency sectors and outpatient care, where most assaults occur.

The authors also suggest that, in risky scenarios, care should be provided by groups of two or more workers, and that improving the conditions in which care is provided should be a priority.

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The Pan American Journal of Public Health, which is published and distributed digitally, is an open access and peer-reviewed publication from PAHO/WHO. Its mission is the dissemination of scientific information in public health to strengthen national and local health systems, and improve the health of the peoples of the Americas.

Links

Pan American Journal of Public Health

Assaults on professionals in the health field (in Spanish)