Violence against emergency medicine personnel in China: results from a prospective national cross-sectional survey

Abstract

BACKGROUND: Violent crime rates in China are low by global standards, but the occurrence and fear of violence against medical professionals has affected the morale and workplace environment of frontline medical staff working in busy emergency departments across the country. We aimed to document workplace violence against emergency medicine personnel and identify whether this was associated with gender, professional role, seniority, or practice location. METHODS: This prospective survey was done at a national emergency medicine conference held in Beijing, China on April 17–19, 2015. Physician and nursing attendees (aged >18 years) who were clinically active in emergency medicine were recruited to complete an online survey using REDCap for data collection and management. We did descriptive statistics and χ 2 analysis. FINDINGS: 488 completed surveys were collected from 3000 participants (16%). 246 (51%) respondents were women. 28 province-level divisions of China were represented. 62 (13%) respondents were born in Beijing, 155 (32%) worked in Beijing, and 326 (68%) worked in the same province that they were born. 92 (19%) respondents were nurses and 396 (81%) were physicians. 145 (30%) respondents reported personally experiencing physical assault, 445 (91%) experiencing verbal assault, and 239 (49%) witnessing an altercation between patients' families and hospital staff. Being male (p<0·0001), not working in Beijing (p<0·0001) and being a physician (p=0·009) were associated with experiencing physical assault. For bystanders who saw a disturbance, associations were found for being male (p=0·026), working outside Beijing (p<0·0001), and working in the same province as your birthplace (p<0·0001). Assaults were not associated with seniority or salary. INTERPRETATION: Physical and verbal assault are common experiences for medical professionals working in emergency departments in China. Male physicians who work outside Beijing face higher risks of physical assault. Future prospective surveys and interviews of health-care professionals, patients, and their families might help to identify root causes and areas for assault prevention.