Prevalence and Impact of Violence Against Healthcare Workers in Brazilian Emergency Departments: A National Survey.

Introduction: Workplace violence (WPV) is a significant occupational hazard in healthcare, with emergency departments (EDs) recognized as high-risk environments. Although globally significant, data from Latin America remain scarce. In this study we aimed to evaluate the prevalence and effects of WPV...

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Published in:Western Journal of Emergency Medicine: Integrating Emergency Care with Population Health Vol. 26; no. 6; pp. 1769 - 1781
Main Authors: Dorn de Carvalho, Julia M., McGuire, Sarayna S., Oliveira, Lucas L. R., Bellolio, Fernanda, Ranzani, Otávio T., A. M. Pinheiro Besen, Bruno, Penna Guimarães, Helio, Mullan, Aidan F., Camila Lunardi, Maria, Hajjar, Ludhmila A., Maia, Ian Ward A.
Format: research tables/charts Journal Article
Published: Western Journal of Emergency Medicine: Integrating Emergency Care with Population Health Nov2025
Online Access:View this record in EBSCOhost
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      dt: Nov2025
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      pub: Western Journal of Emergency Medicine: Integrating Emergency Care with Population Health
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        10.5811/westjem.45138
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        atl: Prevalence and Impact of Violence Against Healthcare Workers in Brazilian Emergency Departments: A National Survey.
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          Dorn de Carvalho, Julia M.
          McGuire, Sarayna S.
          Oliveira, Lucas L. R.
          Bellolio, Fernanda
          Ranzani, Otávio T.
          A. M. Pinheiro Besen, Bruno
          Penna Guimarães, Helio
          Mullan, Aidan F.
          Camila Lunardi, Maria
          Hajjar, Ludhmila A.
          Maia, Ian Ward A.
        affil: Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Department of Emergency Medicine, São Paulo, Brazil
      sug:
        subj:
          Workplace Violence Evaluation
          Health Personnel Psychosocial Factors
          Emergency Service Brazil
          Human
          Adult
          Middle Age
          Brazil
          Verbal Abuse Risk Factors
          Cross Sectional Studies
          Surveys
          Violence Psychosocial Factors
          Odds Ratio
          Confidence Intervals
          Assault and Battery
          Risk Assessment
          Public Offenders Psychosocial Factors
          Patient Abuse
          Security Measures
          Workplace Violence Prevention and Control
          Stress Disorders, Post-Traumatic Symptoms
          Personnel Turnover
          Job Performance
          Time
          World Wide Web Applications
          Male
          Female
          Occupational Safety
          Staff Development
          Descriptive Statistics
          Chi Square Test
          Fisher's Exact Test
          Univariate Statistics
          Logistic Regression
          Multivariate Analysis
          Data Analysis Software
          Funding Source
          Adult: 19-44 years
          Middle Aged: 45-64 years
          Male
          Female
      ab: Introduction: Workplace violence (WPV) is a significant occupational hazard in healthcare, with emergency departments (EDs) recognized as high-risk environments. Although globally significant, data from Latin America remain scarce. In this study we aimed to evaluate the prevalence and effects of WPV on healthcare workers in Brazilian EDs. Methods: We conducted a cross-sectional survey of healthcare workers in Brazilian EDs. Respondents indicated verbal and physical violence experienced within the preceding six months, along with associated psychological and occupational impacts. Univariable models identified significant associated factors, followed by multivariable models to determine independent associated factors of WPV. We reported results as adjusted odds ratios (aOR) with 95% confidence intervals. Statistical analyses were performed in R v4.4.1, and significance was defined as P < .05. Results: The response rate was 19.1% (1,255/6,570), Of those responses, 61.3% (769/1,255) met the inclusion criteria and were included in the analysis. Of all respondents, 84.0% were physicians. Respondents indicated 79.6% (612/769) occurrence of WPV, including verbal abuse (79.5%) and physical assault (12.1%). Physical assaults against co-workers were witnessed by 40.3% of respondents. Perpetrators included visitors (85.3%), patients (80.7%), and co-workers (35.8%). The absence of institutional preventive measures was associated with increased WPV (aOR, 2.47; 95% CI, 1.71-3.57; P < .001), while the presence of security staff reduced WPV (aOR, 0.61; 95% CI, 0.42-0.89; P = .01). Indicated impact included post-traumatic stress symptoms (88.4%), considering leaving their job (49.5%), impaired workplace performance (75.2%), and time off work (10%), including 11.5% permanently leaving. Conclusion: Workplace violence is highly prevalent in Brazilian EDs, with substantial psychological and occupational consequences. The absence of protocols or preventive measures may increase WPV risk, emphasizing the urgent need for public policies to protect healthcare workers in emergency settings.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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