Change in workplace violence against female healthcare workers in a tertiary hospital in Henan Province, China: a four-wave cross-sectional study

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BACKGROUND: Workplace violence (WPV) is a widespread issue that harms the dignity and well-being of female healthcare workers globally. This study assesses changes in WPV against female employees in a central Chinese hospital over four waves of research from 2018 to 2022. METHODS: Cross-sectional surveys were conducted annually from 2018 to 2019 and 2021 to 2022, excluding 2020 due to COVID-19. The questionnaire, developed with the ILO and WHO, gathered data on demographics, experiences of physical and psychological violence, incident handling, and awareness of hospital policies. RESULTS: A total of 3,466 responses were collected, showing a significant reduction in both physical and psychological WPV. Physical violence incidence dropped from 7.82% in 2018 to 1.2% in 2022 (R = -0.13, P < 0.001), and psychological violence decreased from 46.94% to 22.89% (R = -0.20, P < 0.001). Female healthcare workers with heightened concern about WPV were more likely to report both types of violence (e.g. for physical violence, OR in 2022, 13.87; 95% CI, 1.67-115.21). Frequent patient contacts consistently correlated with higher psychological WPV (e.g. OR in 2022, 4.27; 95% CI, 2.07-8.78). Factors like working in outpatient/emergency departments, unfamiliarity with WPV reporting, and lack of encouragement to report also contributed to violence, though not consistently significant. Despite declining violence rates, satisfaction with institutional handling of incidents remained low (below 25%), while satisfaction with handling of sexual harassment improved significantly from 0% to 41.67%(P = 0.002). Prevention measures, such as environmental improvements and patient screening, saw increased perception over the years. CONCLUSION: The study shows a systematic decline in WPV against female healthcare workers in this hospital, indicating potential benefits of the comprehensive interventions. However, low satisfaction with incident handling and persistent barriers to reporting highlight the need for strengthening organizational response mechanisms. These findings have practical implications for designing more effective and context-specific WPV prevention and support strategies in healthcare settings.

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