Dear editor,
Workplace violence against healthcare workers is an increasing global problem (1, 2). Workplace violence against nursing students has been reported to be high in international studies, indicating that students are at a high risk of exposure to violence (3-5). Violence against nursing students may occur in both clinical and academic settings (6). Most studies on workplace violence have focused on healthcare workers and nurses, while there are limited studies on workplace violence against nursing students around the world. Nursing students spend most of their academic time in clinical settings. Therefore, they are at a high risk of workplace violence due to their younger age, lower clinical skills, and low communication skills (5, 7-10). Because of the importance and limited studies in this area, this study aimed to estimate the rate of violence against nursing students in Iran.
This cross-sectional study was carried out in 2018 in Ilam, Iran. In this study, 201 self-reported questionnaires were distributed, 193 of which were completed by students (response rate, 96%). Simple random sampling was used. To collect data, we used a self-reported questionnaire that had been used in previous studies (7, 9). This questionnaire consisted of two parts. The first section included demographic and educational variables, and the second part included items on the students’ experience of violence, type of violence, sources of violence, predisposing factors to violence, reporting of violence, and effects of violence. Statistical analysis was performed by SPSS version 22 (SPSS Inc., Chicago, IL, USA). Mean, standard deviation, frequency, and percentage were used to describe the data. The students were assured that participation in the study would be voluntary and their information would remain confidential. Informed consent was obtained from all students. The Research Committee approved this study (ethical code: IR.MEDILAM.REC.1398.031).
The majority of the students were female (60.1%), single (80.3%), and in the second year of their study (39.4%). The mean age of the students was 21.93 ± 2.14 (range 18-27 years). The overall rate of workplace violence was 40.4%. The rates of verbal violence and physical violence were 76.9% and 17.9%, respectively. The most important sources of violence against students were patients (33.3%), patients’ relatives (29.5%), and nurses (16.7%). The important reason for the violence was the “society’s lack of awareness of students’ responsibility”. The violence had adverse effects on the students, including anxiety, anger, embarrassment, headache, and thinking of leaving the nursing profession. Also, the rate of workplace violence under-reporting among Iranian nursing students was 59%.
The results showed that Iranian nursing students experience a high rate of workplace violence, especially verbal violence, which is consistent with several studies from other countries (3, 5, 7-10). Anti-bullying programs in the nursing curriculum, hospital security, and legal policies, and designing violence reporting and surveillance systems, are recommended to reduce workplace violence.
References
-
1.
Liu J, Gan Y, Jiang H, Li L, Dwyer R, Lu K, et al. Prevalence of workplace violence against healthcare workers: a systematic review and meta-analysis. Occup Environ Med. 2019;76(12):927-37. [PubMed ID: 31611310]. https://doi.org/10.1136/oemed-2019-105849.
-
2.
Groenewold MR, Sarmiento RFR, Vanoli K, Raudabaugh W, Nowlin S, Gomaa A. Workplace violence injury in 106 US hospitals participating in the Occupational Health Safety Network (OHSN), 2012-2015. Am J Ind Med. 2018;61(2):157-66. [PubMed ID: 29152784]. https://doi.org/10.1002/ajim.22798.
-
3.
Budden LM, Birks M, Cant R, Bagley T, Park T. Australian nursing students’ experience of bullying and/or harassment during clinical placement. Collegian. 2017;24(2):125-33. https://doi.org/10.1016/j.colegn.2015.11.004.
-
4.
Dikmen Y, Yılmaz D, Yıldırım Usta Y. Violence faced by nursing students in clinical practicals and its effects: A questionnaire survey. J Hum Sci. 2016;13(3). https://doi.org/10.14687/jhs.v13i3.4111.
-
5.
Tee S, Uzar Ozcetin YS, Russell-Westhead M. Workplace violence experienced by nursing students: A UK survey. Nurse Educ Today. 2016;41:30-5. [PubMed ID: 27138479]. https://doi.org/10.1016/j.nedt.2016.03.014.
-
6.
Courtney-Pratt H, Pich J, Levett-Jones T, Moxey A. "I was yelled at, intimidated and treated unfairly": Nursing students' experiences of being bullied in clinical and academic settings. J Clin Nurs. 2018;27(5-6):e903-12. [PubMed ID: 28771876]. https://doi.org/10.1111/jocn.13983.
-
7.
Koohestani HR, Baghcheghi N, Rezaei K, Abedi A, Seraji A, Zand S. Occupational violence in nursing students in Arak, Iran. Iran J Epidemiol. 2011;7(2):44-50.
-
8.
Magnavita N, Heponiemi T. Workplace violence against nursing students and nurses: an Italian experience. J Nurs Scholarsh. 2011;43(2):203-10. [PubMed ID: 21605325]. https://doi.org/10.1111/j.1547-5069.2011.01392.x.
-
9.
Samadzadeh S, Aghamohammadi M. Violence against Nursing Students in the Workplace: An Iranian Experience. Int J Nurs Educ Scholarsh. 2018;15(1). [PubMed ID: 29373317]. https://doi.org/10.1515/ijnes-2016-0058.
-
10.
Cheung K, Ching SS, Cheng SHN, Ho SSM. Prevalence and impact of clinical violence towards nursing students in Hong Kong: a cross-sectional study. BMJ Open. 2019;9(5). e027385. [PubMed ID: 31101698]. [PubMed Central ID: PMC6530330]. https://doi.org/10.1136/bmjopen-2018-027385.