Violence against Physicians Working in Emergency Departments in Assiut, Egypt

Abstract

Background: Workplace violence in hospital emergency departments (EDs) is a common problem, where health care staff is at highest risk. However, this issue is under researched in Egypt and little evidence exists. Objectives: This study was conducted to determine the magnitude and types of violence faced by ED physicians, the etiology and sources of violence, sociodemographic factors influencing violence, reporting the violent assaults, the emotional state of the physicians after violence and the probable solutions to this problem. Methods: This descriptive cross sectional study included 335 physicians working in the EDs of six hospitals in Assiut city, Egypt. Results: The majority of the respondents (78.2%) reported exposure to violence during the previous year: 78.6% verbal and 21.4% physical. There was statistically significant difference association between exposure to violence and poor security at hospitals. Exposure to physical violence was significantly higher among males and in the evening shifts. Taking care of another patient was the most frequent task done by the physicians during the violent assault, where physical violence was significantly more common than verbal violence. Too many family caretakers, lack of education of patient's relatives and insufficient equipment for treatment were the most frequent reasons associated with violence. Physical violence was significantly higher than verbal violence in case of patients suffering of drug abuse or serious illness. The most common coping methods used by the physicians were verbal reply, leaving the scene and calling the police. Patients' relatives were identified as the primary perpetrators of violence; however violence perpetrated by the patients was significantly higher in the governmental hospitals. About 85% of the physicians exposed to violence didn't receive adequate support from the hospital managers, which was significantly higher in the university hospitals than governmental hospitals. In university hospitals, too many family caretakers and serious illness of the patients were significantly associated with violence. However, insufficient equipment for treatment was significantly associated with violence in the governmental hospitals. The most common reactions experienced by the physicians after violence were anger, depression and frustrations. Inadequate coverage by security staff and lack of education of patients' relatives were identified as the major areas that need attention to address the problem. Conclusion: Physicians are at high risk of violent assaults in the EDs in Assiut city. Decision makers need to be aware of the causes and potential consequences of such events. There is a need for intervention to protect physicians and provide safer hospital environment.