Risk factors associated with patient and visitor violence in general hospitals: Results of a multiple regression analysis

S. Hahn*, M. Müller, V. Hantikainen, G. Kok, T. Dassen, R.J.G. Halfens

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review


Background: Patient and visitor violence (PVV) is the most dangerous occupational hazard that health professionals must contend with. Staff training is recommended to prevent and manage PVV. There is minimal research focusing on risk factors associated with PVV in general hospital settings. Therefore, staff training is mostly based upon expert knowledge and knowledge from psychiatric and emergency settings.

Objectives: This study investigates health professionals' experiences with PVV in order to describe risk factors related to PVV that occur in general hospital settings.

Design: A retrospective cross-sectional survey was conducted in 2007.

Setting: A university general hospital in Switzerland.

Participants: 2495 out of 4845 health professionals participated (58.0% nurses & midwives, 19.2% medical doctors, 3.6% physical therapists, occupational therapists & nutritionists, 6.1% ward secretaries, medical & radiology assistants, 6.3% nursing assistants or less qualified nursing staff and 5.1% other staff). All had direct patient contact and 82% were female.

Methods: Data were collected via questionnaires using the Survey of Violence Experienced by Staff German-Version-Revised, the German version of the shortened Perception of Aggression Scale and the Perception of Importance of Intervention Skills Scale. Descriptive statistics and multiple logistic regression analyses were used.

Results: Risk factors associated with PVV depend upon the form of violence. Those trained in aggression management and/or those who work predominantly with patients over 65 years of age experience twice as much PVV as others. Health professionals working in emergency rooms, outpatient units, intensive care units, recovery rooms, anesthesia, intermediate care and step-down units also experience PVV more often. When health professionals are older in age, are from the medical profession, are students, or when they have an attitude rating preventive measures as being less important and aggression as emotionally letting off steam, they experience less PVV.

Conclusion: Training could change the perception and the recognition of PVV, and could therefore increase the risk of experiencing PVV. The health professionals' specific occupation along with attitude and age, the patients' age, the communication and the workplace are all relevant risk factors. Further studies should investigate the impact of aggression management training and other measures that would reduce PVV. (C) 2012 Elsevier Ltd. All rights reserved.

Original languageEnglish
Pages (from-to)374-385
Number of pages12
JournalInternational Journal of Nursing Studies
Issue number3
Publication statusPublished - Mar 2013


  • Aggression
  • General hospital
  • Health professionals
  • Patient
  • Risk factors
  • Visitor
  • Workplace violence

Cite this