Mental Health Nurses in Indonesia: A Cross-sectional Survey of Workplace Violence and its Associated Factors

Authors

  • Iyus Yosep Faculty of Nursing, Padjadjaran University, Indonesia.
  • Henny Mediani Faculty of Nursing, Padjadjaran University, Indonesia.
  • Linlin Lindayani Sekolah Tinggi Ilmu Keperawatan PPNI Jawa Barat, Bandung, Indonesia.

Keywords:

Indonesia, Mental health, Mental health hospital, Mental Health Nurses, Psychiatric Nurses, Workplace violence, Physical aggression, Physical attack, Verbal abuse

Abstract

                Violence in the workplace is a problem that acknowledges no national borders and has a big impact on nurse wellbeing and working performance globally. This descriptive cross-sectional study examined violence and its associated factors experienced by nurses in Indonesia. Data were obtained from 120 registered nurses working at a mental health hospital in West Java. Workplace violence was assessed using the 2003 World Health Organization Survey Questionnaire on Workplace Violence in the Health Sector. Logistic regression was used to determine factors associated with workplace violence.
               A total of 46.7% of nurses reported being verbally abuse, 29.2% having been physically attacked, and 24.2% experiencing both verbal abuse and physical attack. Among those experiencing both verbal abuse and physical attack, 27.6% of this occurred in acute care settings, and 32.1% happened during unit round and routine treatment. Nurses who had graduated with a diploma III were more likely to experience a physical attack and both physical and verbal abuse than those with a bachelor degree. Those who worked in the acute care unit tended to experience more physical violence and verbal abuse than in other units. The findings demonstrated a high incidence of occupational violence against mental health nurses, including high-intensity verbal abuse, physical aggression, and combination. Leaders and managers within the Indonesian mental health system, including physicians and nurses, as well as government officials need to develop and implement policies to combat this. Adequate budgets are needed to provide ongoing and routine prevention and management of violence and aggression training for all mental health workers in the clinics.

References

Li YL, Li RQ, Qiu D, Xiao SY. Prevalence of workplace physical violence against health care professionals by patients and visitors: a systematic review and meta-analysis. Int J Environ Res Public Health. 2020;17(1):299. doi:10.3390/ijerph17010299.

Koukia E., Zyga S. Critical cases faced by mental health nurses and assistant nurses in psychiatric hospitals in Greece. Int J Caring Sci. 2013;6(3):465-71.

Spector PE., Zhou ZE., Che XX. Nurse exposure to physical and nonphysical violence, bullying, and sexual harassment: a quantitative review. Int J Nurs Stud. 2014; 51(1):72-84. doi: 10.1016/j.ijnurstu.2013.01.010.

Babiarczyk B, Turbiarz A, Tomagová M, Zeleníková R, Önler E, Sancho Cantus D. Reporting of workplace violence towards nurses in 5 European countries - a cross-sectional study. Int J Occup Med Environ Health. 2020;33(3):325- 38. doi:10.13075/ijomeh.1896. 01475.

Azami M, Moslemirad M, YektaKooshali MH, et al. Workplace violence against Iranian nurses: a systematic review and meta-analysis. Violence Vict. 2018;33(6): 1148-75. doi:10.1891/0886-6708.33.6.1148.

Chaiwuth S, Chanprasit C, Kaewthummanukul T, Chareosanti J, Srisuphan W, Stone TE. Prevalence and risk factors of workplace violence among registered nurses in tertiary hospitals. PRIJNR [Internet]. 2020 Sep 16 [cited 2021 Apr.5];24(4):538-52. Available from: https://he02. tci-thaijo.org/index.php/PRIJNR/article/view/227889

Niu SF, Kuo SF, Tsai HT, Kao CC, Traynor V, Chou KR. Prevalence of workplace violent episodes experienced by nurses in acute psychiatric settings. PLoS One. 2019; 14(1):e0211183. doi: 10.1371/journal.pone.0211183.

Ministry of Health of the Republic of Indonesia. Basic health research 2018; Riset Kesehatan Dasar 2018. Available from: http://www.pusdatin.kemkes.go.id/.

Ministry of Health of the Republic of Indonesia. Indonesian health regulation 36 of 2009. Available from: https://www. ilo.org/dyn/natlex/natlex4.detail?p_lang=en&p_isn=91185

Pols H., Wibisono S. Psychiatry and mental health care in Indonesia from colonial to modern times. Mental health in Asia and the Pacific. Springer; 2017. p. 205-21. doi: 10.1080/09540260600775421.

Dickinson T., Cook M., Playle J., Hallett C. Nurses and subordination: a historical study of mental nurses’ perceptions on administering aversion therapy for ‘sexual deviations’. Nurs Inq. 2014;21(4):283-93.

World Health Organization. Survey questionnaire on workplace violence in the health sector. Geneva, Switzerland, 2003.

Zhang SE, Wang J, Liu L, Meng DX, Wang HN, Zhao X, Wang XH, Liu B, Cao DP, Sun T. Does abusive supervision lead nurses to suffer from workplace violence? a cross-sectional study. J Nurs Manag. 2021. doi:10.1111/jonm.13326.

Zhao SH, Shi Y, Sun ZN, et al. Impact of workplace violence against nurses› thriving at work, job satisfaction and turnover intention: a cross-sectional study. J Clin Nurs. 2018; 27(13-14):2620-32. doi:10.1111/jocn.14311.

Sun T., Gao L., Li F., Shi Y., Xie F., Wang J., et al. Workplace violence, psychological stress, sleep quality and subjective health in Chinese doctors: a large cross-sectional study. BMJ Open. 2017;7(12):e017182. doi: 10.1136/bmjopen- 2017-017182.

Xu T., Magnusson Hanson LL., Lange T., Starkopf L., Westerlund H., Madsen IEH., et al. Workplace bullying and workplace violence as risk factors for cardiovascular disease: a multi-cohort study. Eur Heart J. 2019;40(14): 1124-34. doi: 10.1093/eurheartj/ehy683.

Hartley S, Raphael J, Lovell K, Berry K. Effective nurse-patient relationships in mental health care: a systematic review of interventions to improve the therapeutic alliance. Int J Nurs Stud. 2020; 102:103490. doi: 10.1016/j.ijnurstu. 2019.103490.

Whittington R. Attitudes toward patient aggression amongst mental health nurses in the ‘zero tolerance’ era: associations with burnout and length of experience. J Clin Nurs. 2002;11(6):819-25. doi: 10.1046/j.1365-2702. 2002.00659.x.

Xiang Y-T., Zhao Y-J., Liu Z-H., Li X-H., Zhao N., Cheung T., et al. The COVID-19 outbreak and psychiatric hospitals in China: managing challenges through mental health service reform. Int J Biol Sci. 2020;16(10):1741-4. doi: 10.7150/ijbs.45072.

Liu J., Zheng J., Liu K., Liu X., Wu Y., Wang J., et al. Workplace violence against nurses, job satisfaction, burnout, and patient safety in Chinese hospitals. Nurs Out. 2019; 67(5):558-66. doi: 10.1016/j.outlook.2019.04.006.

Akanni OO., Osundina AF., Olotu SO., Agbonile IO., Otakpor AN., Fela-Thomas AL. Prevalence, factors, and outcome of physical violence against mental health professionals at a Nigerian psychiatric hospital. East Asian Arch Psychiatry. 2019;29(1):15-19.

Liu J., Gan Y., Jiang H., Li L., Dwyer R., Lu K., et al. Prevalence of workplace violence against healthcare workers: a systematic review and meta-analysis. Occup Environ Med. 2019;76(12):927-37. doi: 10.1136/ oemed-2019-105849.

Giménez Lozano JM, Martínez Ramón JP, Morales Rodríguez FM. Doctors and nurses: a systematic review of the risk and protective factors in workplace violence and burnout. Int J Environ Res Public Health. 2021;18(6): 3280. doi: 10.3390/ijerph18063280.

Purpora C., Blegen MA. Job satisfaction and horizontal violence in hospital staff registered nurses: the mediating role of peer relationships. J Clin Nurs. 2015;24(15-16):2286-94. doi: 10.1111/jocn.12818.

Fakhr‐Movahedi A., Salsali M., Negharandeh R., Rahnavard Z. A qualitative content analysis of nurse–patient communication in Iranian nursing. Int Nurs Rev. 2011; 58(2): 171-80. doi: 10.1111/j.1466-7657.2010.00861.x.

Lyndon A., Zlatnik MG., Wachter RM. Effective physician-nurse communication: a patient safety essential for labor and delivery. Am J Obstet Gynecol. 2011;205(2): 91-6.

Magnavita N., Heponiemi T. Violence towards health care workers in a Public Health Care Facility in Italy: a repeated cross-sectional study. BMC Health Serv Res. 2012;12(1): 108. doi: 10.1186/1472-6963-12-108.

Dugré JR, Guay JP, Dumais A. Risk factors of compliance with self-harm command hallucinations in individuals with affective and non-affective psychosis. Schizophr Res. 2018;195:115-21. doi:10.1016/j.schres.2017.09.001.

Beaudoin M, Potvin S, Giguère CE, Discepola SL, Dumais A. Persistent cannabis use as an independent risk factor for violent behaviors in patients with schizophrenia. NPJ Schizophr. 2020;6(1):14. doi:10.1038/s41537-020-0104-x.

Coomber B., Barriball KL. Impact of job satisfaction components on intent to leave and turnover for hospital-based nurses: a review of the research literature. Int J Nurs Stud. 2007;44(2):297-314. doi: 10.1016/j.ijnurstu.2006.02.004.

WHO. Process of translation and adaptation of instruments. Available from:https://www.who.int/substance_abuse/ research_tools/translation/en/

Al-Azzam M, Al-Sagarat AY, Tawalbeh L, Poedel RJ. Mental health nurses’ perspective of workplace violence in Jordanian mental health hospitals. Perspect Psychiatr Care. 2018;54(4):477-87. doi:10.1111/ppc.12250.

Konttila J, Holopainen A, Pesonen HM, Kyngäs H. Occurrence of workplace violence and the psychological consequences of it among nurses working in psychiatric outpatient settings [published online ahead of print, 2020 Dec 11]. J Psychiatr Ment Health Nurs. 2020;10.1111/ jpm.12723. doi:10.1111/jpm.12723.

Abbas MA, Fiala LA, Abdel Rahman AG, Fahim AE. Epidemiology of workplace violence against nursing staff in Ismailia Governorate, Egypt. J Egypt Public Health Assoc. 2010;85(1-2):29-43.

Birnbaum R. Remembering the “right to treatment”. Am J Psychiatry. 2012;169(4):358-9. doi: 10.1176/appi. ajp.2012.11121869.

Lawn S, McMillan J, Comley Z, Smith A, Brayley J. Mental health recovery and voting: why being treated as a citizen matters and how we can do it. J Psychiatr Ment Health Nurs. 2014;21(4):289-95. doi: 10.1111/jpm. 12109.

Tingle J. The urgent need to improve care for people with mental ill health. Br J Nurs. 2015;24(13):710-1. doi: 10.12968/ bjon.2015.24.13.710.

Aguglia A, Belvederi Murri M, Conigliaro C, et al. Workplace violence and burnout among mental health workers. Psychiatr Serv. 2020;71(3):284-88. doi: 10.1176/appi.ps.201 900161.

Good, B.J. Haunted by Aceh: specters of violence in post- Suharto Indonesia.” in Genocide and mass violence: memory, symptom, and recovery. Cambridge: Cambridge University Press. 2015.

Valenti E, Banks C, Calcedo-Barba A, Bensimon CM, Hoffmann K-M, Pelto-Piri V, et al. Informal coercion in psychiatry: a focus group study of attitudes and experiences of mental health professionals in ten countries. Soc Psychiatry Psychiatr Epidemiol. 2015;50(8):1297-308. doi: 10.1007/s00127-015-1032-3.

AbuAlRub RF, Khalifa MF, Habbib MB. Workplace violence among Iraqi hospital nurses. J Nurs Scholarsh. 2007; 39: 281–8. doi: 10.1111/j.1547-5069. 2007.00181.x.

Talas MS, KocaÖz S, AkgÜc S. A survey of violence against staff working in the emergency department in Ankara, Turkey. Asian Nurs Res. 2011; 5:197–203. doi: 10.1016/ j.anr. 2011.11.001.

Angland S, Dowling M, Casey D. Nurses’ perceptions of the factors which cause violence and aggression in the emergency department: a qualitative study. Int Emerg Nurs. 2014;22(3):134-9. doi: 10.1016/j.ienj.2013.09.005.

Tingle J. The urgent need to improve care for people with mental ill health. Br J Nurs. 2015;24(13):710-1. doi:10.12968/bjon.2015.24.13.710.

Látalová K. Violence and duration of untreated psychosis in first-episode patients. Int J Clin Pract. 2014;68(3):330-5. doi:10.1111/ijcp.12327.

Pai H, Lee S. Risk factors for workplace violence in clinical registered nurses in Taiwan. J Clin Nurs. 2011;20(9‐10): 1405-12. doi: 10.1111/j.1365-2702.2010.03650.x.

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Published

2021-09-03

How to Cite

1.
Yosep I, Mediani H, Lindayani L. Mental Health Nurses in Indonesia: A Cross-sectional Survey of Workplace Violence and its Associated Factors. PRIJNR [Internet]. 2021 Sep. 3 [cited 2024 Nov. 21];25(4):614-25. Available from: https://he02.tci-thaijo.org/index.php/PRIJNR/article/view/248805