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Review

Vol. 4 No. 2 (2025): May 2025

Workplace violence against nurses and the challenge of underreporting: A literature review

DOI
https://doi.org/10.55048/jpns162
Published
2025-05-15

Abstract

Background: Workplace violence (WPV) against nurses is a critical global concern that negatively affects nurse well-being, professional performance, and patient safety. Despite its widespread occurrence, WPV is consistently underreported. This persistent gap between high incidence and low reporting limits accurate surveillance, weakens institutional responses, and delays the development of effective prevention strategies.

Objective: To identify the reasons behind the low reporting rate of WPV among health workers, especially nurses

Design: Literature review.

Data Sources: Scopus, Google Scholar, and Taylor & Francis databases were searched using the keywords “Workplace Violence,” “Healthcare Workers,” and “Nurses.”

Review Process: Inclusion criteria comprised articles that discussed WPV prevalence and reporting behaviors and dated from 2020 onward. Screening of titles, abstracts, and full texts was performed, followed by detailed analysis of eligible studies.

Results: Eleven studies from 10 Asian countries were included, with sample sizes ranging from 11 participants in a qualitative study to more than 20,000 registered nurses. Across settings, workplace violence was widespread, with prevalence rates ranging from 13.6% to nearly 90%. Despite this high occurrence, reporting remained limited. Personal barriers to reporting included fear of negative consequences, shame, guilt, and the perception that violence is an unavoidable part of nursing practice. Organizational barriers included unclear or inconvenient reporting procedures, lack of training, absence of system privacy, limited managerial support, and mistrust in reporting mechanisms. Collectively, these factors reinforced underreporting and contributed to unsafe work environments for nurses.

Conclusion: Underreporting of WPV among nurses persists due to both individual and organizational barriers. Addressing this issue requires supportive reporting systems, training on WPV management, and fostering a non-punitive safety culture. Without targeted interventions, unsafe work environments will persist, compromising both nurse well-being and quality of patient care.

References

  1. Abuhasheesh, S., Al-Hussami, M., Shehadeh, J., & Elhajji, F. D. (2024). The impact of workplace violence on healthcare professionals’ quality of life: The mediating role of social support. Discover Social Science and Health, 4(62), 1–12. https://doi.org/10.1007/s44155-024-00121-0 DOI: https://doi.org/10.1007/s44155-024-00121-0
  2. Al-Maskari, S. A., Al-Busaidi, I. S., & Al-Maskari, M. A. (2020). Workplace violence against emergency department nurses in Oman: A cross-sectional multi-institutional study. International Nursing Review, 1–9. https://doi.org/10.1111/inr.12574 DOI: https://doi.org/10.1111/inr.12574
  3. Alsaqat, R. T., Alhassan, A. K., & Al Sweleh, F. S. (2023). Verbal workplace violence in the health sector in Saudi Arabia. Medicine, 102, 1–8. https://doi.org/10.1097/MD.0000000000036760 DOI: https://doi.org/10.1186/s12913-023-10080-y
  4. Chang, H. T., Lam, T. S. K., & Chu, M. C. M. (2024). Workplace violence against healthcare workers in the emergency department in Hong Kong. Hong Kong Journal of Emergency Medicine, 31, 95–106. https://doi.org/10.1002/hkj2.12017 DOI: https://doi.org/10.1002/hkj2.12017
  5. Eshah, N., Jamal, O., Jabri, A., Aljboor, M. A., Abdalrahim, A., Albashtawy, M., Alkhawaldeh, A., Saifan, A., Ayed, A., & Rayan, A. (2024). Workplace violence against healthcare workers: A literature review. SAGE Open Nursing, 10, 1–12. https://doi.org/10.1177/23779608241258029 DOI: https://doi.org/10.1177/23779608241258029
  6. Garg, R., Garg, N., Sharma, D. K., & Gupta, S. (2020). ScienceDirect low reporting of violence against health-care workers in India in spite of high prevalence. Medical Journal Armed Forces India, 75, 211–215. https://doi.org/10.1016/j.mjafi.2018.11.011 DOI: https://doi.org/10.1016/j.mjafi.2018.11.011
  7. Hamed, M. M. M., & Konstantinidis, S. (2022). Barriers to incident reporting among nurses: A qualitative systematic review. Western Journal of Nursing Research, 44(5), 506–523. DOI: https://doi.org/10.1177/0193945921999449
  8. Hameed, A. T., Sachit, A. A., & Dabis, H. A. (2020). Workplace violence against health care providers in emergency departments: An underrated problem. Indian Journal of Forensic Medicine & Toxicology, 14(4), 1509–1515.
  9. Honarvar, B., Ghazanfari, N., Shahraki, H. R., Rostami, S., & Lankarani, K. B. (2020). Violence against nurses: A neglected and healt-threatening epidemic in the University Affiliated Public Hospitals in Shiraz, Iran. Indian Journal of Occupational and Envrionmental Medicine, 10(3), 111–123. https://doi.org/10.15171/ijoem.2019.1556 DOI: https://doi.org/10.15171/ijoem.2019.1556
  10. Khan, M. N., Haq, Z. U., Khan, M., Wali, S., Baddia, F., Rasul, S., Khan, S., Polkowski, M., & Ramirez-mendoza, J. Y. (2021). Prevalence and determinants of violence against health care in the metropolitan city of Peshawar: A cross sectional study. BMC Public Health, 21, 1–11. https://doi.org/10.1186/s12889-021-10243-8 DOI: https://doi.org/10.1186/s12889-021-10243-8
  11. Lei, Z., Yan, S., Jiang, H., Feng, J., Han, S., & Herath, C. (2022). Prevalence and risk factors of workplace violence against emergency department nurses in China. International Journal of Public Health, 67, 1–10. https://doi.org/10.3389/ijph.2022.1604912 DOI: https://doi.org/10.3389/ijph.2022.1604912
  12. Minhat, H. S., & Sahiran, M. N. (2024). Debunking the Obstacles to Reporting Workplace violence among the healthcare workers in melaka, malaysia: A qualitative study. Malaysian Journal of Medicine and Health Sciences, 20(2), 142–150. https://doi.org/10.47836/mjmhs.20.2.19 DOI: https://doi.org/10.47836/mjmhs.20.2.19
  13. Nithimathachoke, A., & Wichiennopparat, W. (2021). High incidence of workplace violence in metropolitan emergency departments of Thailand: A cross sectional study. Archives of Academic Emergency Medicine, 9(1), 1–9. https://doi.org/10.22037/aaem.v9i1.1140
  14. Pidada, I. B. G. S. P., & Wahab, A. (2024). Survey analysis of workplace violence among public healthcare workers in Yogyakarta, Indonesia. Egyptian Journal of Forensic Sciences, 14(37), 1–9. https://doi.org/10.1186/s41935-024-00407-z DOI: https://doi.org/10.1186/s41935-024-00407-z
  15. Sari, H., Yildiz, I., Baloglu, S. C., Ozel, M., & Tekalp, R. (2023). The frequency of workplace violence against healthcare workers and affecting factors. PLoS ONE, 18(7), 1–12. https://doi.org/10.1371/journal.pone.0289363 DOI: https://doi.org/10.1371/journal.pone.0289363
  16. Song, C., Wang, G., & Wu, H. (2021). Frequency and barriers of reporting workplace violence in nurses. International Journal of Nursing Sciences, 1–26. https://doi.org/10.1016/j.ijnss.2020.11.006 DOI: https://doi.org/10.1016/j.ijnss.2020.11.006
  17. Spencer, C., Sitarz, J., Fouse, J., & Desanto, K. (2023). Nurses’ rationale for underreporting of patient and visitor perpetrated workplace violence: A systematic review. BMC Nursing, 22(134), 1–12. https://doi.org/10.1186/s12912-023-01226-8 DOI: https://doi.org/10.1186/s12912-023-01226-8
  18. Towhari, A. A., & Bugis, B. A. (2020). The awareness of violence reporting system among healthcare providers and the impact of New Ministry of Health Violence Penalties in Saudi Arabia. Risk Management and Healthcare Policy, 13, 2057–2065. DOI: https://doi.org/10.2147/RMHP.S258106
  19. Tyler, V. (2023). Workplace violence and aggression in hospital inpatient settings from the perspective of nurses and midwives in Regional Australia. Southern Cross University.
  20. World Health Organization. (2022). Preventing violence against health workers. https://www.who.int/activities/preventing-violence-against-health-workers

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