By: Dr. Irniza Rasdi
Department of Environmental and Occupational Health,
Faculty of Medicine and Health Sciences,
Universiti Putra Malaysia
Lately, workplace violence has been attracting much attention among working population. People are starting to realize that they have the right to protect themselves from any kind of violence at their workplace.
According to the World Health Organization (WHO) (2003), workplace violence (WPV) can be divided into four main groups which are physical, sexual, psychological and verbal violence. It can also be divided according to the sources of violence which are internal violence, performed by employers and employees of the same company and external violence, performed by outsiders including clients and criminals.
Physical violence is the most officially reported but lately accumulating reports were made on non-physical violence including verbal and psychological at the workplace. The non-physical violence is defined by the WHO (2003) as the use of power, including threat of physical force, against another person or group that can result in harm to physical, mental, spiritual, moral or social development. It includes verbal abuse, bullying/mobbing, harassment, and threats.
Based on the comprehensive data generated by the British Crime Survey (BCS) and the British Health and Safety Executive’s (HSE), the occupational grouping with the highest risk of WPV was protective service occupations like police officer at 12.6 % which indicate 12,600 per 100,000 workers, more than 14 times the average risk. Then followed by health related-occupational group including health and social welfare associate professionals at 3.3 % while medical and dental practitioners at 2.3% (Chappell & Di Martino, 2006).
In Malaysia, several studies have been made on WPV in various occupational settings. For example, findings of a study among Malaysian public servants indicated that 83.2% of the respondents were victims of bullying as they were exposed to at least two bullying behaviours on weekly or daily basis during the last six months (Omar et al., 2015).
In the study, the most frequent negative acts experienced were being given task with unreasonable or impossible targets or deadlines, being ordered to work below their level of competence and intimidating behaviour. The findings also showed that destructive leadership behaviour has a strong influence on workplace bullying.
Findings of a recent study among healthcare workers in a public hospital in Kuala Lumpur (Nursyafiqah et. al., 2018) indicated that the prevalence of reported WPV was 71.3% where nurses (73.2%) had slightly higher prevalence than doctors (69.2%). This results is lower than that found among nurses in Chinese Psychiatric Hospital (82.4%) (Zeng et al., 2013) but much higher than those healthcare workers found in a Psychiatric Hospital in Taiwan (25%) (Chen et al., 2008), and in primary health care in Saudi Arabia (28%) (El-Gilany, 2010).
The most common forms of WPV was verbal abuse (70.6%), followed by bullying/mobbing (29.4%), physical violence (11.0%), and sexual harassment (6.6%). Verbal abuse is usually reported far more common than others because it is also an initial phase of subsequent physical violence and bullying/mobbing. The effects of verbal abuse should not be underestimated as it can be more damaging than the other types of violence.
The perpetrators
The perpetrators were mostly among relatives of patients and visitors followed by the patients. Respondents working in Emergency and Trauma (E&T) Department was 17 times more likely to report workplace violence than those working in Pediatric Department. A possible explanation may be due to waiting period of more than 20 minutes, refusal of referred services, persistent and untreated pain, patients’ anxiety and misunderstandings related to professional language barrier or difference tradition, or unconducive work environment. Also, for every 1 year younger, respondents were 5 times more likely to experience workplace violence controlling for other factors.
Similar results were found in earlier study among nurses in a public hospital in Melaka (Suhaila & Rampal, 2012). Younger age may reflect lack of work experience and lower education level, resulting in less ability to dealing with violence. In Malaysia particularly in public hospital with overtime demand and overwhelmed number of patients, working as doctors and nurses is already stressful and lack of skills in dealing with workplace violence definitely will worsen the subsequent effects.
In managing WPV, employers must play their role in enforcing the strategies to prevent violence by eliminating risk factors in the work environment. There is growing recognition that a comprehensive approach is required for confronting violence. Instead of searching for a single solution good for any problem and situation, the full range of causes which generate violence should be analysed and a variety of intervention strategies shall be adopted. Training and awareness program are important in
References:
Chappell D, Di Martino V. Violence at work. 3rd ed. International Labour Organization: Geneva; 2006.
Chen, W.-C., Hwu, H.-G., Kung, S.-M., Chiu, H.-J., & Wang, J.-D. (2008). Prevalence and Determinants of Workplace Violence of Health Care Workers in a Psychiatric Hospital in Taiwan. Journal of Occupational Health, 50(3), 288–293.
El-Gilany, A.-H., El-Wehady, A., & Amr, M. (2010). Violence Against Primary Health Care Workers in Al-Hassa, Saudi Arabia. Journal of Interpersonal Violence, 25(4), 716–734.
Nursyafiqah Zainal, Irniza Rasdi*, Suhainizam Muhamad Saliluddin (2018). The Risk Factors of Workplace Violence among Healthcare Workers in Public Hospital. Malaysian Journal of Medicine and Health Sciences. 14(2):120-127.
Omar, Z., Mokhtar, M., & Hamzah, S. R. A. (2015). Prevalence of workplace bully in selected public service agency in Malaysia: do destructive leadership behaviour matters?. International Journal of Education and Training (InjET), 1(1), 1-9.
Suhaila, O., & Rampal, K. G. (2012). Prevalence of sexual harassment and its associated factors among registered nurses working in government hospitals in Melaka state, Malaysia. Medical Journal of Malaysia, 67(5), 506–517.
World Health Organisation. (2003). Joint Programme on Workplace Violence in the Health Sector - questionnaire. Human Rights, 1–14. Retrieved from http://www.who.int/violence_injury_prevention/violence/interpersonal/en/WVquestionnaire.pdf?ua=1 in 12 December 2018.