Factors, Impacts, and Prevention Strategies of Violence Against Nurses: A Qualitative Study
Keywords:
Violence against nurses, Causes of violence, Impact of violence, Violence prevention strategies, Therapeutic communication
Abstract
Violence against nurses remains a significant challenge affecting their physical safety, psychological well-being, and professional performance. This study explored the factors contributing to violent behavior against nurses, their diverse impacts, and effective prevention strategies. A qualitative design was used to collect data from thirteen participants through interviews and to analyze them thematically. The study findings revealed that internal factors such as high workload, ineffective communication, and staff attitudes, alongside external factors including patient and family expectations, emotional states, and socio-cultural influences, contributed to violent incidents. The impacts identified included physical injury, psychological trauma, decreased motivation, and compromised quality of care. Participants highlighted prevention strategies involving positive nurse attitudes, patient and family education, effective communication, precise reporting mechanisms, institutional support, psychosocial support, and use of digital technology. The study concluded that addressing violent behavior against nurses requires a comprehensive and multidimensional approach that integrates personal, organizational, and technological interventions. It is recommended that nursing practice prioritize therapeutic communication and empathy, supported by strong policies and psychosocial resources to improve nurse safety and quality of care.
References
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Ferracuti, S., Barchielli, B., Napoli, C., Giannini, A. M., & Parmigiani, G. (2022). Managing and preventing acts of violence against health workers: results of a review evaluating hospital control procedures. Journal of Aggression, Conflict and Peace Research, 14(2), 100–111. https://doi.org/10.1108/JACPR-07-2021-0615
Foli, K. J. (2022). A Middle-Range Theory of Nurses’ Psychological Trauma. Advances in Nursing Science, 45(1). https://doi.org/10.1097/ANS.0000000000000388
Havaei, F., & MacPhee, M. (2020). The impact of heavy nurse workload and patient/family complaints on workplace violence: An application of human factors framework. Nursing Open, 7(3), 731–741. https://doi.org/10.1002/nop2.444
Heryyanoor et al. (2024). Analisis Faktor Penyebab Perilaku Kekerasan Terhadap Perawat di Fasilitas Layanan Kesehatan. Sekolah Tinggi Ilmu Kesehatan Intan Martapura.
Jang, S. J., Son, Y., & Lee, H. (2022). Prevalence, associated factors and adverse outcomes of workplace violence towards nurses in psychiatric settings: A systematic review. International Journal of Mental Health Nursing, 31(3), 450–468. https://doi.org/https://doi.org/10.1111/inm.12951
Jennings, B. M., Baernholdt, M., & Hopkinson, S. G. (2022). Exploring the turbulent nature of nurses’ workflow. Nursing Outlook, 70(3), 440–450. https://doi.org/https://doi.org/10.1016/j.outlook.2022.01.002
Kang, Y., & Bang, C. (2024). Workload-related issues among nurses caring for patients with behavioral and psychological symptoms of dementia: a scoping review. Healthcare, 12(18), 1893. https://doi.org/https://doi.org/10.3390/healthcare12181893
Karatuna, I., Jönsson, S., & Muhonen, T. (2020). Workplace bullying in the nursing profession: A cross-cultural scoping review. International Journal of Nursing Studies, 111, 103628. https://doi.org/https://doi.org/10.1016/j.ijnurstu.2020.103628
Kholis, A. H., Hidayah, N., Priyanti, R. P., & ... (2019). Trauma Psikologis Perawat Instalasi Gawat Darurat dalam Menghadapi Kekerasan Verbal di Tempat Kerja: Penelitian Kualitatif. Jurnal Keperawatan BSI, 7(2), 78–87. http://ejurnal.ars.ac.id/index.php/keperawatan%0Ahttp://ejurnal.ars.ac.id/index.php/keperawatan/article/view/121
Kim, S., Lynn, M. R., Baernholdt, M., Kitzmiller, R., & Jones, C. B. (2023). How Does Workplace Violence–Reporting Culture Affect Workplace Violence, Nurse Burnout, and Patient Safety? Journal of Nursing Care Quality, 38(1). https://journals.lww.com/jncqjournal/fulltext/2023/01000/how_does_workplace_violence_reporting_culture.5.aspx
Kompas.com. (2021). Kekerasan Perawat di Palembang, ini Sikap Persatuan Perawat Nasional Indonesia. https://www.kompas.com/sains/read/2021/04/17/150200923/kekerasan-perawat-di-palembang-ini-sikap-persatuan-perawat-nasional?page=all
Kompas TV. (2023). Perawat RSUD Kendari Dipukul Keluarga Pasien Hingga Alami Gangguan Pendengaran. https://www.youtube.com/watch?v=zO1g5uyatvI
Krut, B. A., Laing, C. M., Moules, N. J., & Estefan, A. (2021). The impact of horizontal violence on the individual nurse: A qualitative research study. Nurse Education in Practice, 54, 103079. https://doi.org/https://doi.org/10.1016/j.nepr.2021.103079
Laksono, S. (2024). Kekerasan oleh Pasien terhadap Tenaga Kesehatan : Suatu Perspektif. Jamarsi: Jurnal Ahli Manajemen Dan Administrasi Rumah Sakit, 1(3), 15–17.
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Li, Y. L., Li, R. Q., Qiu, D., & Xiao, S. Y. (2020). Prevalence of workplace physical violence against health care professionals by patients and visitors: A systematic review and meta-analysis. International Journal of Environmental Research and Public Health, 17(1). https://doi.org/10.3390/ijerph17010299
Magnavita, N., Mele, L., Meraglia, I., Merella, M., Vacca, M. E., Cerrina, A., Gabriele, M., Labella, M., Soro, M. T., & Ursino, S. (2022). The impact of workplace violence on headache and sleep problems in nurses. International Journal of Environmental Research and Public Health, 19(20), 13423.
Mercan, N., & Mersin, S. (2025). Evaluating the therapeutic communication skills of nursing students in the clinical setting: The experiences of students, patients and patients’ relatives. Heliyon, 11(1). https://doi.org/10.1016/j.heliyon.2025.e41677
Mottaghi, S., Poursheikhali, H., & Shameli, L. (2020). Empathy, compassion fatigue, guilt and secondary traumatic stress in nurses. Nursing Ethics, 27(2), 494–504. https://doi.org/10.1177/0969733019851548
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2025-06-24
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