Violence against junior medical doctors in Iraq: A trial for de-escalation

Abstract

Background: Workplace violence represents a severe problem facing health systems in almost all countries globally. Communication failure is thought to be the major issue that initiates violence. Objective: This study aimed to test the effectiveness of a short training course for junior doctors on how to deal with patients’ aggressive attitudes in a trial to de-escalate violence against them. Materials and Methods: This interventional randomized trial was conducted in a sample of hospitals in Baghdad and Karbala governorates, Iraq, from August 2021 through July 2022. A pre-training survey was conducted to collect data from a sample of junior doctors (1079) to explore their exposure to violent attacks. The one-arm randomized trial measured the difference in exposure of 190 doctors to violent attacks during a comparable period, six months before and six months after the training. Results: Three-quarters (74.8%) of the sample reported exposure to lifetime violence. The prevalence of exposure to violence in the six months before the intervention was 66.8%, while six months after the training, it dropped to 53.2%, with a statistically significant difference. Conclusion: A two-day training proved effective in reducing violent incidents. This result indicates the necessity of starting a nationwide, wide-scale, regular, periodic training program for junior doctors to de-escalate violence. The findings of this study represent a message to policymakers to make more efforts to lessen violence against healthcare workers.