Occupational violence in general practice: a whole-of-practice problem. Results of a cross-sectional study
Parker J. Magin A B F , Jenny May C , Patrick McElduff D , Susan M. Goode A , Jon Adams E and Georgina L. Cotter AA University of Newcastle, Newcastle, NSW 2308, Australia. Email: susan.goode@newcastle.edu.au; georgina.cotter@newcastle.edu.au
B General Practice Training Valley to Coast, Mayfield, NSW 2304, Australia.
C Department of Rural Health, University of Newcastle, Tamworth, NSW 2340, Australia. Email: jenny.may@hnehealth.nsw.gov.au
D Hunter Medical Research Institute, Newcastle, NSW 2300, Australia. Email: patrick.mcelduff@newcastle.edu.au
E School of Population Health, University of Queensland, Herston, QLD 4006, Australia. Email: j.adams@sph.uq.edu.au
F Corresponding author. Email: parker.magin@newcastle.edu.au
Australian Health Review 35(1) 75-80 https://doi.org/10.1071/AH10874
Submitted: 24 January 2010 Accepted: 18 May 2010 Published: 25 February 2011
Abstract
Objective. To examine the experiences of occupational violence in general practitioner (GP) and non-GP staff. Further objectives were to compare prevalence of violence in GP and non-GP staff and to examine levels of apprehension and perceptions of control over violence.
Design. Cross-sectional questionnaire-based study.
Setting. A network of research general practices, New South Wales, Australia.
Participants. GPs and non-GP staff – receptionist, practice-management, nursing and allied health staff.
Main outcome measure(s). Experience of occupational violence during the previous 12 months. Other outcomes examined were workplace apprehension regarding violence, perception of occupational violence as a problem in general practice, and perception of control over violence in the workplace.
Results. A total of125 questionnaire replies were received (response rate 55%), 59.3% of GPs and 74.6% of non-GPs had experienced work-related violence during the previous 12 months. The difference was not significant (OR 0.65, 95% CI 0.20–2.06). Subjects in rural practices were more likely than those in urban practices to have experienced violence (OR 3.79, 95% CI 1.15–12.5). Personal experience of violence (OR 35.9, 95% CI 6.24–207) and a perception that violence is increasing (OR 8.33, 95% CI 1.89–36.6) were associated with apprehension regarding violence at work.
What is known about the topic? The prevalence and impact upon GPs of occupational violence is well established, but occupational violence has been little-researched in non-GP staff.
What does this paper add? This study demonstrates that occupational violence is a major issue for non-GP staff – at least as much as it is for GPs.
What are the implications for practitioners? Apprehension and fear among general practice staff are strongly associated with experiences of violence and must be addressed at a whole-of-practice level with measures to reduce violence and improve safety.
References
[1] Wynne R, Clarkin N, Cox T, Griffiths A. Guidance on the prevention of violence at work. Luxembourg: European Commission, DG-V; 1997.[2] Mayhew C, Chappell D. Workplace violence: an overview of patterns of risk and the emotional/stress consequences on targets. Int J Law Psychiatry 2007; 30 327–39.
| Workplace violence: an overview of patterns of risk and the emotional/stress consequences on targets.Crossref | GoogleScholarGoogle Scholar | 17628681PubMed |
[3] Upson A. Violence at work: Findings from the 2002/2003 British Crime Survey. Home Office Report. London: Home Office; 2004.
[4] Health and Policy Economic Research Unit. Violence at work: the experience of UK doctors. London: British Medical Association; 2003.
[5] Health and Policy Economic Research Unit. Violence at work: the experience of doctors in Great Britain. London: British Medical Association; 2008.
[6] Magin PJ, Adams J, Sibbritt DW, Joy E, Ireland MC. Experiences of occupational violence in Australian urban general practice: a cross-sectional study of GPs. Med J Aust 2005; 183 352–6.
| 16201952PubMed |
[7] Tolhurst H, Baker L, Murray G, Bell P, Sutton A, Dean S. Rural general practitioner experience of work-related violence in Australia. Aust J Rural Health 2003; 11 231–6.
| Rural general practitioner experience of work-related violence in Australia.Crossref | GoogleScholarGoogle Scholar | 14641220PubMed |
[8] Koritsas S, Coles J, Boyle M, Stanley J. Prevalence and predictors of occupational violence and aggression towards GPs: a cross-sectional study. Br J Gen Pract 2007; 57 967–70.
| Prevalence and predictors of occupational violence and aggression towards GPs: a cross-sectional study.Crossref | GoogleScholarGoogle Scholar | 18252072PubMed |
[9] Wright NM, Dixon CA, Tompkins CN. Managing violence in primary care: an evidence-based approach. Br J Gen Pract 2003; 53 557–62.
| 14694671PubMed |
[10] Rowe L, Kidd M. Increasing violence in Australian general practice is a public health issue. Med J Aust 2007; 187 118–9.
| 17635098PubMed |
[11] Magin P, Adams J, Ireland M, Joy E, Heaney S, Darab S. The response of general practitioners to the threat of violence in their practices: results from a qualitative study. Fam Pract 2006; 23 273–8.
| The response of general practitioners to the threat of violence in their practices: results from a qualitative study.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD283otlChug%3D%3D&md5=398a7aba842e1cc29bf06742ac2b71a8CAS | 16461449PubMed |
[12] Elston MA, Gabe J, Denney D, Lee R, O’Bierne M. Violence against doctors: a medical(ised) problem? The case of National Health Service general practitioners. Sociol Health Illn 2002; 24 575–98.
| Violence against doctors: a medical(ised) problem? The case of National Health Service general practitioners.Crossref | GoogleScholarGoogle Scholar |
[13] Chambers F, Kelly M. Violence at work: the experience of general practice receptionists. Ir Med J 2006; 99 169–71.
| 1:STN:280:DC%2BD28vpslekug%3D%3D&md5=4ca8037c3010abcbddb5860bf49731b3CAS | 16921820PubMed |
[14] Dixon CA, Tompkins CN, Allgar VL, Wright NM. Abusive behaviour experienced by primary care receptionists: a cross-sectional survey. Fam Pract 2004; 21 137–9.
| Abusive behaviour experienced by primary care receptionists: a cross-sectional survey.Crossref | GoogleScholarGoogle Scholar | 15020379PubMed |
[15] Bayman PA, Hussain T. Receptionists’ perceptions of violence in general practice. Occup Med 2007; 57 492–8.
| Receptionists’ perceptions of violence in general practice.Crossref | GoogleScholarGoogle Scholar |
[16] D’Urso P, Hobbs R. Aggression and the general practitioner. BMJ 1989; 298 97–8.
| Aggression and the general practitioner.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DyaL1M7ltVOhsA%3D%3D&md5=b697997789a6d127213cc28dd3705aebCAS | 2493309PubMed |
[17] Ness GJ, House A, Ness AR. Aggression and violent behaviour in general practice: population based survey in the north of England. BMJ 2000; 320 1447–8.
| Aggression and violent behaviour in general practice: population based survey in the north of England.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD3c3os1Cmug%3D%3D&md5=9c9108261d3e565a8ff22f0acf1226e0CAS | 10827050PubMed |
[18] Neville RG. Violent patients in general practice. Practitioner 1986; 230 1105–8.
| 1:STN:280:DyaL1c%2FktVyruw%3D%3D&md5=c406324f65618aa3b756583fee9078a9CAS | 3671315PubMed |
[19] Magin P, Joyce T, Adams J, Goode S, Cotter G. Receptionists’ experience of occupational violence: a qualitative study. Br J Gen Pract 2009; 59 578–83.
| Receptionists’ experience of occupational violence: a qualitative study.Crossref | GoogleScholarGoogle Scholar |
[20] Australian Institute of Health and Welfare. RRMA classification. Available at http://www.aihw.gov.au/ruralhealth/remotenessclassifications/rrma.cfm [verified 14 August 2009].
[21] Australian Bureau of Statistics. SEIFA: Socio-Economic Indexes for Area. Available at http://www.abs.gov.au/websitedbs/D3310114.nsf/home/Seifa [verified 14 August 2009].
[22] Royal Australian College of General Practitioners. Safety for general practitioners and their practice teams. 2006. Available at http://www.racgp.org.au/gpissues/safety [verified 9 December 2008].
[23] Magin P, Adams J, Joy E, Ireland M, Heaney S, Darab S. General practitioners’ perceptions of the causes of violence in their practice and the implications for GPs’ safety and practice. Can Fam Physician 2008; 54 1278–84.
| 18791105PubMed |
[24] Coles J, Koritsas S, Boyle M, Stanley J. GPs, violence and work performance – ‘just part of the job?’ Aust Fam Physician 2007; 36 189–91.
| 17339990PubMed |
[25] Magin PJ, Adams J, Sibbritt DW, Joy E, Ireland MC. Effects of occupational violence on Australian general practitioners’ provision of home visits and after-hours care: a cross-sectional study. J Eval Clin Pract 2008; 14 336–42.
| Effects of occupational violence on Australian general practitioners’ provision of home visits and after-hours care: a cross-sectional study.Crossref | GoogleScholarGoogle Scholar | 18324940PubMed |
[26] Beck U. Risk Society: Towards a New Modernity. London: Sage; 1992.
