Aggression and violence against health care workers in Germany--a cross sectional retrospective survey.

Franz S, Zeh A, Schablon A, Kuhnert S, Nienhaus A (2010)
BMC Health Serv Res 10(1): 51.

Zeitschriftenaufsatz | Veröffentlicht | Englisch
Franz, SimoneUniBi; Zeh, Annett; Schablon, Anja; Kuhnert, Saskia; Nienhaus, Albert
Abstract / Bemerkung
BACKGROUND: Although international scientific research on health issues has been dealing with the problem of aggression and violence towards those employed in health care, research activities in Germany are still at an early stage. In view of this, the aim of this study was to examine the frequency and consequences of aggressive behaviour towards nurses and health care workers in different health sectors in Germany and to assess the need for preventive measures. METHODS: We conducted a cross-sectional retrospective survey. Nurses and health care workers from two nursing homes, a psychiatric clinic and a workshop for people with disabilities were interviewed using a standardised questionnaire. The sample covered 123 individuals (response rate 38.8%). The survey assessed the frequency, the type and the consequences of aggressive behaviour, and social support in connection with coping with aggression in the workplace. Odds ratios (OR) and 95% confidence intervals (CI) for putative risk factors which may influence the stress induced by aggression at the workplace were calculated using conditional logistic regression. RESULTS: During the previous twelve months 70.7% of the respondents experienced physical and 89.4% verbal aggression. Physical aggression more frequently occurred in nursing homes (83.9% of the employees) and verbal aggression was more common in the psychiatric clinic (96.7% of the employees). The proportion of the individuals affected in the workshop for people with disabilities was lower (41.9% and 77.4% respectively). The incidents impaired the physical (55%) and emotional well-being (77.2%) of the employees. The frequency of incidents (weekly: OR 2.7; 95% CI 1.1-6.4) combined with the lack of social support (OR 2.8; 95% CI 1.2-6.6) increased the probability of higher stress due to aggression. CONCLUSIONS: This study corroborates previous reports of frequent physical and verbal aggression towards care workers in the various areas of health care. The present study highlights differences between various areas of health care in Germany and the aggravating effect of prevention neglect such as missing social support at the workplace. Therefore our data suggest the need for improved target group specific prevention of aggressive incidents towards care workers and the need for effective aftercare in Germany.
BMC Health Serv Res
Page URI


Franz S, Zeh A, Schablon A, Kuhnert S, Nienhaus A. Aggression and violence against health care workers in Germany--a cross sectional retrospective survey. BMC Health Serv Res. 2010;10(1): 51.
Franz, S., Zeh, A., Schablon, A., Kuhnert, S., & Nienhaus, A. (2010). Aggression and violence against health care workers in Germany--a cross sectional retrospective survey. BMC Health Serv Res, 10(1), 51.
Franz, S., Zeh, A., Schablon, A., Kuhnert, S., and Nienhaus, A. (2010). Aggression and violence against health care workers in Germany--a cross sectional retrospective survey. BMC Health Serv Res 10:51.
Franz, S., et al., 2010. Aggression and violence against health care workers in Germany--a cross sectional retrospective survey. BMC Health Serv Res, 10(1): 51.
S. Franz, et al., “Aggression and violence against health care workers in Germany--a cross sectional retrospective survey.”, BMC Health Serv Res, vol. 10, 2010, : 51.
Franz, S., Zeh, A., Schablon, A., Kuhnert, S., Nienhaus, A.: Aggression and violence against health care workers in Germany--a cross sectional retrospective survey. BMC Health Serv Res. 10, : 51 (2010).
Franz, Simone, Zeh, Annett, Schablon, Anja, Kuhnert, Saskia, and Nienhaus, Albert. “Aggression and violence against health care workers in Germany--a cross sectional retrospective survey.”. BMC Health Serv Res 10.1 (2010): 51.
Alle Dateien verfügbar unter der/den folgenden Lizenz(en):
Copyright Statement:
Dieses Objekt ist durch das Urheberrecht und/oder verwandte Schutzrechte geschützt. [...]
Access Level
OA Open Access
Zuletzt Hochgeladen
MD5 Prüfsumme

49 Zitationen in Europe PMC

Daten bereitgestellt von Europe PubMed Central.

Mental health nurses' perspective of workplace violence in Jordanian mental health hospitals.
Al-Azzam M, Al-Sagarat AY, Tawalbeh L, Poedel RJ., Perspect Psychiatr Care 54(4), 2018
PMID: 29077201
Physical violence against health staff by mentally ill patients at a psychiatric hospital in Botswana.
Olashore AA, Akanni OO, Ogundipe RM., BMC Health Serv Res 18(1), 2018
PMID: 29751808
The attributes of successful de-escalation and restraint teams.
Snorrason J, Biering P., Int J Ment Health Nurs 27(6), 2018
PMID: 29862625
Prevalence and Consequences of Aggression and Violence towards Nursing and Care Staff in Germany-A Survey.
Schablon A, Wendeler D, Kozak A, Nienhaus A, Steinke S., Int J Environ Res Public Health 15(6), 2018
PMID: 29914142
Workplace Violence in County Hospitals in Eastern China: Risk Factors and Hospital Attitudes.
Wang N, Wu D, Sun C, Li L, Zhou X., J Interpers Violence (), 2018
PMID: 30079797
Iceberg of workplace violence in health sector of Bangladesh.
Hasan MI, Hassan MZ, Bulbul MMI, Joarder T, Chisti MJ., BMC Res Notes 11(1), 2018
PMID: 30286796
Factors in healthcare violence in care of pregnancy termination cases: A case study.
Qin C, Chen WT, Deng Y, Liu X, Wu X, Sun M, Gong N, Tang S., PLoS One 13(11), 2018
PMID: 30427851
Social support in the workplace for physicians in specialization training.
Mikkola L, Suutala E, Parviainen H., Med Educ Online 23(1), 2018
PMID: 29464988
Encouraging employees to report verbal violence in primary health care in Serbia: A cross-sectional study.
Fisekovic Kremic MB, Terzic-Supic ZJ, Santric-Milicevic MM, Trajkovic GZ., Zdr Varst 56(1), 2017
PMID: 28289458
Patient Violence Toward Psychiatric Health Care Workers in Israel as Viewed Through Incident Reports.
Drori T, Guetta H, Ben Natan M, Polakevich Y., J Am Psychiatr Nurses Assoc 23(2), 2017
PMID: 28060602
Workplace Violence against Health Care Workers in North Chinese Hospitals: A Cross-Sectional Survey.
Sun P, Zhang X, Sun Y, Ma H, Jiao M, Xing K, Kang Z, Ning N, Fu Y, Wu Q, Yin M., Int J Environ Res Public Health 14(1), 2017
PMID: 28106851
Prevalence and Risk Factors ofWorkplace Violence towardMental Health Staff Departments in Jordanian Hospitals.
Al-Azzam M, Tawalbeh L, Sulaiman M, Al-Sagarat AY, Harb E., Issues Ment Health Nurs 38(5), 2017
PMID: 28165848
Workplace violence against emergency nurses in Taiwan: A phenomenographic study.
Han CY, Lin CC, Barnard A, Hsiao YC, Goopy S, Chen LC., Nurs Outlook 65(4), 2017
PMID: 28487095
Prevalence of Violence Toward Community Nurses: A Questionnaire Survey.
Gabrovec B., Workplace Health Saf 65(11), 2017
PMID: 28414575
A cross-sectional study on the prevalence and associated risk factors for workplace violence against Chinese nurses.
Shi L, Zhang D, Zhou C, Yang L, Sun T, Hao T, Peng X, Gao L, Liu W, Mu Y, Han Y, Fan L., BMJ Open 7(6), 2017
PMID: 28647719
Violence against physicians and nurses in a hospital: How does it happen? A mixed-methods study.
Shafran-Tikva S, Chinitz D, Stern Z, Feder-Bubis P., Isr J Health Policy Res 6(1), 2017
PMID: 29089061
Person-centred dementia care: a reality check in two nursing homes in Ireland.
Colomer J, de Vries J., Dementia (London) 15(5), 2016
PMID: 25370077
User Violence and Nursing Staff Burnout: The Modulating Role of Job Satisfaction.
Galián-Muñoz I, Ruiz-Hernández JA, Llor-Esteban B, López-García C., J Interpers Violence 31(2), 2016
PMID: 25392390
Does administrative support negate the consequences of nurse abuse?
Azar M, Badr LK, Samaha H, Dee V., J Nurs Manag 24(1), 2016
PMID: 25721708
Affective Organizational Commitment in Swiss Nursing Homes: A Cross-Sectional Study.
Graf E, Cignacco E, Zimmermann K, Zúñiga F., Gerontologist 56(6), 2016
PMID: 26035877
Workplace violence and its effect on burnout and turnover attempt among Chinese medical staff.
Chen S, Lin S, Ruan Q, Li H, Wu S., Arch Environ Occup Health 71(6), 2016
PMID: 26654585
Workplace violence against nursing staff in a Saudi university hospital.
Alkorashy HA, Al Moalad FB., Int Nurs Rev 63(2), 2016
PMID: 26830364
Prevalence of violence towards nursing staff in Slovenian nursing homes.
Gabrovec B, Eržen I., Zdr Varst 55(3), 2016
PMID: 27703541
Perception and prevalence of work-related health hazards among health care workers in public health facilities in southern India.
Senthil A, Anandh B, Jayachandran P, Thangavel G, Josephin D, Yamini R, Kalpana B., Int J Occup Environ Health 21(1), 2015
PMID: 25482656
Assessment and Analysis of Workplace Violence in a Greek Tertiary Hospital.
Mantzouranis G, Fafliora E, Bampalis VG, Christopoulou I., Arch Environ Occup Health 70(5), 2015
PMID: 24456571
Workplace violence against nurses in Chinese hospitals: a cross-sectional survey.
Jiao M, Ning N, Li Y, Gao L, Cui Y, Sun H, Kang Z, Liang L, Wu Q, Hao Y., BMJ Open 5(3), 2015
PMID: 25814496
Factors associated with nurses' reporting of patients' aggressive behavior: a cross-sectional survey.
Sato K, Wakabayashi T, Kiyoshi-Teo H, Fukahori H., Int J Nurs Stud 50(10), 2013
PMID: 23305760
Health care violence and abuse towards nurses in hospitals in north of Iran.
Khademloo M, Moonesi FS, Gholizade H., Glob J Health Sci 5(4), 2013
PMID: 23777737
Violence against radiologists. I: Prevalence and preventive measures.
Magnavita N, Fileni A, Pescarini L, Magnavita G., Radiol Med 117(6), 2012
PMID: 22580806
Frequency and consequences of violence and aggression towards employees in the German healthcare and welfare system: a cross-sectional study.
Schablon A, Zeh A, Wendeler D, Peters C, Wohlert C, Harling M, Nienhaus A., BMJ Open 2(5), 2012
PMID: 23087013
Assault rates and implementation of a workplace violence prevention program in the Veterans Health Care Administration.
Mohr DC, Mohr DC, Warren N, Hodgson MJ, Drummond DJ., J Occup Environ Med 53(5), 2011
PMID: 21555925
Nursing home caregivers' explanations for and coping strategies with residents' aggression: a qualitative study.
Zeller A, Dassen T, Kok G, Needham I, Halfens RJ., J Clin Nurs 20(17-18), 2011
PMID: 21682784

30 References

Daten bereitgestellt von Europe PubMed Central.

Framework guidelines for addressing workplace violence in the health sector
An epidemiological study of the magnitude and consequences of work related violence: the Minnesota Nurses' Study.
Gerberich SG, Church TR, McGovern PM, Hansen HE, Nachreiner NM, Geisser MS, Ryan AD, Mongin SJ, Watt GD., Occup Environ Med 61(6), 2004
PMID: 15150388
Fifteen years of research with the Staff Observation Aggression Scale: a review.
Nijman HL, Palmstierna T, Almvik R, Stolker JJ., Acta Psychiatr Scand 111(1), 2005
PMID: 15636589
Psychische Beanspruchungen durch Klientenaggressionen in den personenbezogenen Dienstleistungen Altenpflege und Lehre

Aggression and violence in health care professions.
Rippon TJ., J Adv Nurs 31(2), 2000
PMID: 10672105
[Violence and aggression in care-related jobs--a literature overview].
Zeh A, Schablon A, Wohlert C, Richter D, Nienhaus A., Gesundheitswesen 71(8-9), 2009
PMID: 19326331
Introductory remarks: violence in nursing - international perspectives
Violence in psychiatric Care: German experiences
Gewalt am Arbeitsplatz: Das Gesundheitswesen
Workplace violence in the health sector: a review of staff training and integration of training evaluation models
Nurses under threat: a comparison of content of 28 aggression management programs.
Farrell G, Cubit K., Int J Ment Health Nurs 14(1), 2005
PMID: 15733285
The Staff Observation Aggression Scale - Revised (SOAS-R)

Frequency and severity of aggressive incidents in acute psychiatric wards in Switzerland.
Abderhalden C, Needham I, Dassen T, Halfens R, Fischer JE, Haug HJ., Clin Pract Epidemiol Ment Health 3(), 2007
PMID: 18053203
Prevalence and types of aggressive behaviour among adults with intellectual disabilities.
Crocker AG, Mercier C, Lachapelle Y, Brunet A, Morin D, Roy ME., J Intellect Disabil Res 50(Pt 9), 2006
PMID: 16901292
Violence against emergency department workers.
Gates DM, Ross CS, McQueen L., J Emerg Med 31(3), 2006
PMID: 16982376
Incidence of violence towards staff caring for the elderly.
Astrom S, Bucht G, Eisemann M, Norberg A, Saveman BI., Scand J Caring Sci 16(1), 2002
PMID: 11985751
Staff's experience of and the management of violent incidents in elderly care.
Astrom S, Karlsson S, Sandvide A, Bucht G, Eisemann M, Norberg A, Saveman BI., Scand J Caring Sci 18(4), 2004
PMID: 15598249
Psychiatric nurses' experience with inpatient aggression
Violence in the care of adult persons with intellectual disabilities.
Strand M, Benzein E, Saveman BI., J Clin Nurs 13(4), 2004
PMID: 15086637
Non-physical violence: a risk factor for physical violence in health care settings.
Lanza ML, Zeiss RA, Rierdan J., AAOHN J 54(9), 2006
PMID: 17001838
Prevalence of physical and verbal aggressive behaviours and associated factors among older adults in long-term care facilities.
Voyer P, Verreault R, Azizah GM, Desrosiers J, Champoux N, Bedard A., BMC Geriatr 5(), 2005
PMID: 16280091
Aggressive behaviour and burnout among staff of homes for the elderly.
Evers W, Tomic W, Brouwers A., Int J Ment Health Nurs 11(1), 2002
PMID: 12400101
Violence in a general hospital: comparison of assailant and other assault-related factors on accident and emergency inpatient wards


Markieren/ Markierung löschen
Markierte Publikationen

Open Data PUB

Web of Science

Dieser Datensatz im Web of Science®


PMID: 20184718
PubMed | Europe PMC

Suchen in

Google Scholar