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A National Study on Nurses’ Exposure to Occupational Violence in Lebanon: Prevalence, Consequences and Associated Factors

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  • Mohamad Alameddine
  • Yara Mourad
  • Hani Dimassi

Abstract

Background: Healthcare institutions have commonly reported exposure of employees, particularly nurses, to high levels of occupational violence. Despite such evidence in the Middle East Region, there is a dearth of national studies that have systematically investigated this phenomenon. This study investigates the prevalence, characteristics, consequences and factors associated with nurses’ exposure to occupational violence in Lebanon. Methods: A cross-sectional design was utilized to survey a nationally representative sample of 915 nurses registered with the Order of Nurses in Lebanon. Stratified random sampling by governorate was utilized. Individually-mailed questionnaires collected information on exposure to violence, degree of burnout and demographic/professional background. The main outcome variables were exposure to verbal abuse (never, 1–3, 4–9 and 10+ times) and physical violence (never, ever) over the past 12-months. Descriptive statistics were used to estimate prevalence of violence. Multivariable, binomial and multinomial regression models were carried out to investigate the correlates of exposure to verbal abuse and physical violence, respectively. Results: Response rate was 64.8%. Over the last year, prevalence of nurses’ exposure to verbal abuse was 62%, (CI: 58–65%) and physical violence was 10%, (CI: 8–13%). Among respondents, 31.7% of nurses indicated likelihood to quit their jobs and 22.3% were undetermined. Furthermore, 54.1% reported high levels of emotional exhaustion and 28.8% reported high levels of depersonalization. Compared to nurses with no exposure to verbal abuse, nurses reporting high exposure had high levels of emotional exhaustion (OR:6.4; CI:1.76–23.32), depersonalization (OR:6.8; CI: 3–15) and intention to quit job (OR:3.9; CI: 1.8–8.3). They further reported absence of anti-violence policies at their institutions (OR: 3; CI: 1.5–6.3). Nurses that were ever exposed to physical violence were more likely to be males (OR: 2.2; CI: 1.1–4.3), working day and night shifts (OR: 2.8; CI: 1.4–5.5) and subject to ten or more incidents of verbal abuse per year (OR: 46.7; CI: 10.1–214). Conclusions: An alarming two-thirds of respondents reported exposure to verbal abuse which was found to be a significant predictor of the three subscales of burnout, intention to quit and exposure to physical violence. The prevalence of exposure to physical violence is disconcerting due to its severe consequences. Policy and decision-makers are urged to use study findings for policy and practice interventions to create safe work environments conducive to nurses’ productivity and retention.

Suggested Citation

  • Mohamad Alameddine & Yara Mourad & Hani Dimassi, 2015. "A National Study on Nurses’ Exposure to Occupational Violence in Lebanon: Prevalence, Consequences and Associated Factors," PLOS ONE, Public Library of Science, vol. 10(9), pages 1-15, September.
  • Handle: RePEc:plo:pone00:0137105
    DOI: 10.1371/journal.pone.0137105
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    1. Hesketh, Kathryn L. & Duncan, Susan M. & Estabrooks, Carole A. & Reimer, Marlene A. & Giovannetti, Phyllis & Hyndman, Kathryn & Acorn, Sonia, 2003. "Workplace violence in Alberta and British Columbia hospitals," Health Policy, Elsevier, vol. 63(3), pages 311-321, March.
    2. Alessandra Zampieron & Marilena Galeazzo & Susanna Turra & Alessandra Buja, 2010. "Perceived aggression towards nurses: study in two Italian health institutions," Journal of Clinical Nursing, John Wiley & Sons, vol. 19(15‐16), pages 2329-2341, August.
    3. Jessica L Taylor & Lynn Rew, 2011. "A systematic review of the literature: workplace violence in the emergency department," Journal of Clinical Nursing, John Wiley & Sons, vol. 20(7‐8), pages 1072-1085, April.
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    1. Magno Conceição das Merces & Julita Maria Freitas Coelho & Iracema Lua & Douglas de Souza e Silva & Antonio Marcos Tosoli Gomes & Alacoque Lorenzini Erdmann & Denize Cristina de Oliveira & Sueli Bonfi, 2020. "Prevalence and Factors Associated with Burnout Syndrome among Primary Health Care Nursing Professionals: A Cross-Sectional Study," IJERPH, MDPI, vol. 17(2), pages 1-12, January.
    2. Jesús Cebrino & Silvia Portero de la Cruz, 2020. "A worldwide bibliometric analysis of published literature on workplace violence in healthcare personnel," PLOS ONE, Public Library of Science, vol. 15(11), pages 1-16, November.
    3. Osama Al Khatib & Hana Taha & Lujain Al Omari & Mohammed Qussay Al-Sabbagh & Abdallah Al-Ani & Faysal Massad & Vanja Berggren, 2023. "Workplace Violence against Health Care Providers in Emergency Departments of Public Hospitals in Jordan: A Cross-Sectional Study," IJERPH, MDPI, vol. 20(4), pages 1-11, February.
    4. Teris Cheung & Paul H. Lee & Paul S. F. Yip, 2017. "Workplace Violence toward Physicians and Nurses: Prevalence and Correlates in Macau," IJERPH, MDPI, vol. 14(8), pages 1-15, August.
    5. Jose Miguel Giménez Lozano & Juan Pedro Martínez Ramón & Francisco Manuel Morales Rodríguez, 2021. "Doctors and Nurses: A Systematic Review of the Risk and Protective Factors in Workplace Violence and Burnout," IJERPH, MDPI, vol. 18(6), pages 1-19, March.
    6. Yi-Lu Li & Rui-Qi Li & Dan Qiu & Shui-Yuan Xiao, 2020. "Prevalence of Workplace Physical Violence against Health Care Professionals by Patients and Visitors: A Systematic Review and Meta-Analysis," IJERPH, MDPI, vol. 17(1), pages 1-19, January.
    7. Mohamad Alameddine & Nariman Chamoun & Rachel Btaiche & Nour El Arnaout & Nathalie Richa & Helen Samaha-Nuwayhid, 2017. "The workforce trends of nurses in Lebanon (2009–2014): A registration database analysis," PLOS ONE, Public Library of Science, vol. 12(8), pages 1-10, August.

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