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Médecine du travail du personnel hospitalier

Training efforts to reduce reports of workplace violence in a community health care facility.

J Prof Nurs. 2006 Sep-Oct;22(5):289-95.
Training efforts to reduce reports of workplace violence in a community health care facility.
‘Anderson C.
Associate Professor, School of Nursing, University of Texas at Arlington, Arlington, TX.’

The objective of this study was to measure reports of workplace violence (WPV) after an online training program on WPV for health care workers. Recognition of the prevalence of WPV (physical, emotional-verbal, and sexual) suggests a great need for employers to provide training to all health care workers as a first-line effort to reduce or prevent WPV. A 3-hour online training program for WPV was offered to 43 workers attending an informational session. Volunteers included 22 participants designated for training and 21 volunteers designated to serve as control subjects. Pretraining WPV work area assessments were completed by all participants and compared between training participants and control subjects. At 6 months, comparisons were made between 3 groups: Group A, those who completed the training; Group B, control subjects; and Group C, those who did not complete the training within the designated period. Group C was defined as a separate group because some participants within this group were workers from the same work areas as were Group A participants. Comparisons of preassessments and postassessments of WPV for Group A and assessments of WPV across the three groups were made. Participants reported 200 WPV events over a 6-month period before training. Pretraining reports of WPV were statistically different between training participants and control subjects for total and emotional-verbal WPV events. At 6 months after the training, a reduction in sample size and reports of all types of WPV was noted across the three groups (i.e., those who completed the training, those who did not complete it, and control subjects). Owing to the small number of reported physical and sexual WPV events, only total and emotional-verbal WPV events were examined. No difference was noted between the three groups for total events; however, emotional-verbal abuse was statistically significant between the groups. In addition, a statistically significant difference was noted among participants before and after the completion of the online training. Despite the reported prevalence of WPV, a significant number of health care workers did not make training a priority. Participants who were designated for training and who subsequently completed it reported the most number of events before and after training. Proportionately per number of participants after training, fewer total WPV events were reported; however, because of the attrition rate and group sample size, significance was not reached. Reports of emotional-verbal abuse remained high after training, which could suggest a heightened awareness of this type of WPV with a personal redefinition of WPV or a heightened staff and administration sensitivity to reporting. Although differences existed among training participants and control subjects before training, significance could not be achieved among the three groups owing to validity threats, including subject mortality, diffusion between groups, selection bias, and small sample size. However, the finding that training can make a difference is important and encourages replication of this study with a larger sample size and a larger setting. Finding high rates of emotional-verbal abuse across work areas and support for training benefits enhance the need for training programs with an increased focus on emotional-verbal WPV.

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