An Investigation on Workplace Violence in an Infectious Disease Hospital: A Mixed-Methods Study from the Perspectives of Healthcare Workers and Patients

Abstract

Workplace violence (WPV) against healthcare workers (HCWs) in infectious disease hospitals, particularly in high-risk settings, remains a critical yet understudied occupational hazard. A mixed-methods study was conducted at a Chinese infectious disease hospital, combining quantitative surveys (N = 675) and semi-structured interviews (28 HCWs, 17 patients/families). Logistic regression was used to analyze WPV incidence and predictors, while a thematic analysis of interview data identified contextual drivers. Psychological violence (34.1%) was significantly more prevalent than physical violence (2.2%), with outpatient departments (44.1%) and temporary staff (OR = 1.72) at the highest risk. Qualitative themes revealed systemic triggers, including communication breakdowns, environmental stressors, and organizational gaps in safety protocols and reporting. This study addressed a critical gap by incorporating the perspectives of HCWs and patients, revealing that WPV perceptions vary due to differing expectations and experiences. From these results, the CARE (Communication, Advocacy, Respect, Education) framework proposes actionable strategies: standardized SBAR communication protocols, enhanced security protocols in high-risk units, and mandatory anti-violence training. These findings underscore the need to strengthen the occupational health system to mitigate WPV and to improve healthcare quality.