Register      Login
Australian Health Review Australian Health Review Society
Journal of the Australian Healthcare & Hospitals Association
RESEARCH ARTICLE (Open Access)

Associations between Australian clinical medical practitioner exposure to workplace aggression and workforce participation intentions

Danny J. Hills
+ Author Affiliations
- Author Affiliations

Disciplines of Nursing and Midwifery, Faculty of Health, University of Canberra, ACT 2601, Australia. Email: danny.hills@canberra.edu.au

Australian Health Review 40(1) 36-42 https://doi.org/10.1071/AH14246
Submitted: 14 December 2014  Accepted: 18 April 2015   Published: 1 June 2015

Journal Compilation © AHHA 2016

Abstract

Objective The aim of the present study was to determine the association between clinician exposure to workplace aggression from any source in the previous 12 months and workforce participation intentions.

Methods A cross-sectional survey, in the third wave of the Medicine in Australia: Balancing Employment and Life (MABEL) study, was conducted between March 2010 and June 2011. Respondents were a representative sample of 9449 Australian general practitioners (GPs) and GP registrars (n = 3515), specialists (n = 3875), hospital non-specialists (n = 1171) and specialists in training (n = 888). Associations between aggression exposure and workforce participation intentions were determined using logistic regression modelling.

Results In adjusted models, aggression exposure was positively associated with a greater likelihood of intending to reduce clinical workload in the next 5 years (odds ratio (OR) = 1.15, 95% confidence interval (CI) 1.02–1.29) and intending to leave patient care within 5 years (OR = 1.20, 95% CI 1.07–1.35). When also accounting for well being factors, aggression exposure remained positively associated with intending to leave patient care within 5 years (OR = 1.13, 95% CI 1.00–1.27).

Conclusions Exposure to workplace aggression presents a risk to the retention of medical practitioners in clinical practice and a potential risk to community access to quality medical care. More concerted efforts in preventing and minimising workplace aggression in clinical medical practice are required.

What is known about the topic? Very few studies have addressed the impact of workplace aggression on workforce participation intentions of medical practitioners.

What does this paper add? This paper provides evidence that exposure to workplace aggression from any source is associated with intentions to reduce clinical workload or leave patient care.

What are the implications for practitioners? There is a need to prevent or minimise the risk of exposure to workplace aggression from any source because the impacts may extend beyond the known psychological or physical effects to practitioner decisions about ongoing participation in the provision of clinical services.


References

[1]  di Martino V. Workplace violence in the health sector. Country case studies Brazil, Bulgaria, Lebanon, Portugal, South Africa, Thailand and an additional Australian study. Synthesis report. Geneva: International Labour Office, International Council of Nurses, World Health Organization and Public Services International. Joint Programme on Workplace Violence in the Health Sector; 2002.

[2]  Buckley P. Violence at work 2012/13: findings from the crime survey for England and Wales. London: Health Service Executive; 2014. Available at: http://www.hse.gov.uk/statistics/causinj/violence/violence-at-work.pdf [verified 14 December 2014].

[3]  Estrada F, Nilsson A, Jerre K, Wikman S. Violence at work: the emergence of a social problem. J Scand Stud Criminol Crime Prev 2010; 11 46–65.
Violence at work: the emergence of a social problem.Crossref | GoogleScholarGoogle Scholar |

[4]  Hills D, Joyce C, Humphreys J. A national study of workplace aggression in Australian clinical medical practice. Med J Aust 2012; 197 336–40.
A national study of workplace aggression in Australian clinical medical practice.Crossref | GoogleScholarGoogle Scholar | 22994831PubMed |

[5]  Magin P, Adams J, Sibbritt D, Joy E, Ireland M. Experiences of occupational violence in Australian urban general practice: a cross-sectional study of GPs. Med J Aust 2005; 183 352–6.
| 16201952PubMed |

[6]  Forrest LE, Herath PM, McRae IS, Parker RM. A national survey of general practitioners’ experiences of patient-initiated aggression in Australia. Med J Aust 2011; 194 605–8.
| 21644878PubMed |

[7]  Hills DJ, Joyce CM. Personal, professional, and work factors associated with Australian clinical medical practitioners’ experiences of workplace aggression. Ann Occup Hyg 2013; 57 898–912.
Personal, professional, and work factors associated with Australian clinical medical practitioners’ experiences of workplace aggression.Crossref | GoogleScholarGoogle Scholar | 23519949PubMed |

[8]  Hills D, Joyce C. Workplace aggression in clinical medical practice: associations with job satisfaction, life satisfaction and self-rated health. Med J Aust 2014; 201 535–40.
Workplace aggression in clinical medical practice: associations with job satisfaction, life satisfaction and self-rated health.Crossref | GoogleScholarGoogle Scholar | 25358579PubMed |

[9]  Gerberich SG, Church TR, McGovern PM, Hansen HD, Nachreiner NM, Geisser MS, Ryan AD, Mongin SJ, Watt GD. An epidemiological study of the magnitude and consequences of work related violence: the Minnesota nurses’ study. Occup Environ Med 2004; 61 495–503.
An epidemiological study of the magnitude and consequences of work related violence: the Minnesota nurses’ study.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD2c3ltF2msA%3D%3D&md5=5a4286ec8c3917974d1a32b598a5cd1cCAS | 15150388PubMed |

[10]  Health Policy and Economic Research Unit. Violence in the workplace: the experience of doctors in Great Britain. London: British Medical Association; 2008. Available at: http://safetyandassuranceltd.co.uk/wp-content/uploads/2011/08/DRs-ref-Violence.pdf [verified 14 December 2014].

[11]  Ceramidas DM, Parker R. A response to patient-initiated aggression in general practice: Australian professional medical organisations face a challenge. Aust J Primary Health 2010; 16 252–9.
A response to patient-initiated aggression in general practice: Australian professional medical organisations face a challenge.Crossref | GoogleScholarGoogle Scholar |

[12]  Heponiemi T, Kouvonen A, Virtanen M, Vanska J, Elovainio M. The prospective effects of workplace violence on physicians’ job satisfaction and turnover intentions: the buffering effect of job control. BMC Health Serv Res 2014; 14 19
The prospective effects of workplace violence on physicians’ job satisfaction and turnover intentions: the buffering effect of job control.Crossref | GoogleScholarGoogle Scholar | 24438449PubMed |

[13]  Hills D, Joyce C, Humphreys J. Workplace aggression prevention and minimisation in Australian clinical medical practice settings: a national study. Aust Health Rev 2013; 37 607–13.
Workplace aggression prevention and minimisation in Australian clinical medical practice settings: a national study.Crossref | GoogleScholarGoogle Scholar | 24120266PubMed |

[14]  Australian Institute of Health and Welfare (AIHW). Rural, regional and remote health: a guide to remoteness classifications. Rural health series no. 4, catalogue no. PHE 53. Canberra: AIHW; 2004.

[15]  Pearlin LI, Schooler C. The structure of coping. J Health Soc Behav 1978; 19 2–21.
The structure of coping.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DyaE1c7nt1WnsA%3D%3D&md5=8202e11ef25de1455bb6d02163a5d575CAS | 649936PubMed |

[16]  Warr P, Cook J, Wall T. Scales for the measurement of some work attitudes and aspects of psychological well-being. J Occup Psychol 1979; 52 129–48.
Scales for the measurement of some work attitudes and aspects of psychological well-being.Crossref | GoogleScholarGoogle Scholar |

[17]  LeBlanc MM, Kelloway EK. Predictors and outcomes of workplace violence and aggression. J Appl Psychol 2002; 87 444–53.
Predictors and outcomes of workplace violence and aggression.Crossref | GoogleScholarGoogle Scholar | 12090602PubMed |

[18]  Dupré KE, Dawe K-A, Barling J. Harm to those who serve: effects of direct and vicarious customer-initiated workplace aggression. J Interpers Violence 2014; 29 2355–77.
Harm to those who serve: effects of direct and vicarious customer-initiated workplace aggression.Crossref | GoogleScholarGoogle Scholar | 24518666PubMed |

[19]  Yagil D. When the customer is wrong: a review of research on aggression and sexual harassment in service encounters. Aggress Behav 2008; 13 141–52.
When the customer is wrong: a review of research on aggression and sexual harassment in service encounters.Crossref | GoogleScholarGoogle Scholar |

[20]  Joyce C. The medical workforce in 2025: What’s in the numbers? MJA Open 2012; 1 6–9.

[21]  Casteel C, Peek-Asa C, Greenland S, Chu LD, Kraus JF. A study of the effectiveness of a workplace violence intervention for small retail and service establishments. J Occup Environ Med 2008; 50 1365–70.
A study of the effectiveness of a workplace violence intervention for small retail and service establishments.Crossref | GoogleScholarGoogle Scholar | 19092491PubMed |

[22]  Casteel C, Peek-Asa C, Nocera M, Smith JB, Blando J, Goldmacher S, O’Hagan E, Valiante D, Harrison R. Hospital employee assault rates before and after enactment of the California hospital safety and security act. Ann Epidemiol 2009; 19 125–33.
Hospital employee assault rates before and after enactment of the California hospital safety and security act.Crossref | GoogleScholarGoogle Scholar | 19185807PubMed |

[23]  Cozens PM, Saville G, Hillier D. Crime prevention through environmental design (CPTED): a review and modern bibliography. J Property Management 2005; 23 328–56.
Crime prevention through environmental design (CPTED): a review and modern bibliography.Crossref | GoogleScholarGoogle Scholar |

[24]  Loomis D, Marshall SW, Wolf SH, Runyan CW, Butts JD. Effectiveness of safety measures recommended for prevention of workplace homicide. JAMA 2002; 287 1011–17.
Effectiveness of safety measures recommended for prevention of workplace homicide.Crossref | GoogleScholarGoogle Scholar | 11866649PubMed |

[25]  Keizer K, Lindenberg S, Steg L. The spreading of disorder. Science 2008; 322 1681–5.
The spreading of disorder.Crossref | GoogleScholarGoogle Scholar | 1:CAS:528:DC%2BD1cXhsVOgtbrE&md5=76b22c6d81cea343f90ecba9d8d97244CAS | 19023045PubMed |

[26]  Occupational Safety and Health Administration. Guidelines for preventing workplace violence for health care and social service workers. Washington: US Department of Labor; 2004.

[27]  Rowe L, Morris-Donovan B, Watts I. General practice: a safe place: tips and tools. South Melbourne: The Royal Australian College of General Practitioners; 2009.