RESEARCH PAPER
AGGRESSION AND VIOLENCE TOWARDS MEDICAL SPECIALISTS IN THE CENTER FOR EMERGENCY MEDICAL CARE IN THE REPUBLIC OF BULGARIA
1
Department Health Care, Faculty of Medicine, Trakia University, Stara Zagora, Bulgaria
Submission date: 2024-12-06
Final revision date: 2025-03-24
Acceptance date: 2025-04-07
Publication date: 2025-05-05
KEYWORDS
TOPICS
ABSTRACT
Background:
The article aims to determine the most common manifestations of violence on the part of patients and their relatives towards the medical specialists working in the Centers for Emergency Medical Care (CEMC) in the Republic of Bulgaria. For this reason, emergency physicians and patients were surveyed. Scientific developments, reports, and publications by researchers and experts were studied and analyzed.
Material and methods:
An interview and direct anonymous survey of 120 respondents working in the CEMC was conducted from 2018 to 2019.
Results:
The lack of personal formation, emotional intelligence, cultural and moral upbringing, social experience, and moral and ethical values are the basis of aggressive behavior. The daily psycho-emotional load, accompanied by unfounded acts of violence by the patients and their relatives, leads to physical and mental fatigue, the development of burnout syndrome, as well as stress and dissatisfaction with the profession among the medical specialists of the CEMC.
Conclusions:
Emergency medicine requires not only a high level of professional training but also mental and physical endurance to work in conditions of high risk not only to the health and life of the patient but also to their own.
The article aims to determine the most common manifestations of violence on the part of patients and their relatives towards the medical specialists working in the Centers for Emergency Medical Care (CEMC) in the Republic of Bulgaria. For this reason, emergency physicians and patients were surveyed. Scientific developments, reports, and publications by researchers and experts were studied and analyzed.
Material and methods:
An interview and direct anonymous survey of 120 respondents working in the CEMC was conducted from 2018 to 2019.
Results:
The lack of personal formation, emotional intelligence, cultural and moral upbringing, social experience, and moral and ethical values are the basis of aggressive behavior. The daily psycho-emotional load, accompanied by unfounded acts of violence by the patients and their relatives, leads to physical and mental fatigue, the development of burnout syndrome, as well as stress and dissatisfaction with the profession among the medical specialists of the CEMC.
Conclusions:
Emergency medicine requires not only a high level of professional training but also mental and physical endurance to work in conditions of high risk not only to the health and life of the patient but also to their own.
REFERENCES (32)
1.
Georgieva E. [Prevention of occupational stress. Communication portals]. [Dissertation]. Sofia: Medical University of Sofia; 2017. p. 213 (Bulgarian).
2.
Georgieva Z. [Status and strategic guidelines for the prevention of occupational stress among hospital nurses]. [Dissertation]. Varna: Medical University of Varna; 2018. p. 164 (Bulgarian).
3.
Allen J, Anderson CA. Aggression and violence: definitions and distinctions. In: Sturmey P, editor. The Wiley handbook of violence and aggression. Hoboken, NJ: John Wiley & Sons; 2017. p. 1-14. https://doi.org/10.1002/978111....
4.
Bushman BJ, & Huesmann LR. Aggression. In Fiske ST, Gilbert DT, Lindzey G, editors. Handbook of social psychology. 5th ed., vol. 2. Hoboken, NJ: John Wiley & Sons; 2010. p. 833-863. https://doi.org/10.1002/978047....
5.
Hernandez-Meier J, Xu Z, Kohlbeck SA, Levas M, Shepherd J, Hargarten S. Linking emergency care and police department data to strengthen timely information on violence-related paediatric injuries. Emergency Medicine Journal. 2023; 40: 653-659. https://doi.org/10.1136/emerme....
6.
medicalnews.bg. [Dr. Boyko Penkov: It is inhumane to attack someone who has come to save you, help you, and ease your suffering] [Internet]. Medical News [access 2025 Jan 17]. Available from: https://medicalnews.bg/2019/02... (in Bulgarian).
7.
Ministry of Health. [Concept for development of the system for emergency medical care in the Republic of Bulgaria 2014-2020] [Internet] Sofia: Ministry of Health [access 2025 Jan 17]. Available from: https://old.mh.government.bg/m... (in Bulgarian).
8.
Turgut K, Yavuz E, Yıldız MK, Poyraz MK. Violence toward emergency physicians: a prospective-descriptive study. World J Emerg Med. 2021; 12(2): 111-116. https://doi.org/10.5847/wjem.j....
9.
American College of Emergency Physicians. Violence in the emergency department [Internet]. Irving, TX: American College of Emergency Physicians [access 2025 Jan 17]. Available from: https://www.acep.org/administr....
10.
Association of American Medical Colleges. Rising violence in the emergency department [Internet]. Washington, D.C.: AAMC; 2020 Feb 24 [access 2025 Jan 17]. Available from: https://www.aamc.org/news/risi....
11.
Zerhouni O, Bègue L, Brousse G, Carpentier F, Dematteis M, Pennel L, et al. Alcohol and violence in the emergency room: a review and perspectives from psychological and social sciences. Int. J. Environ. Res. Public Health. 2013; 10: 4584-4606. https://doi.org/10.3390/ijerph....
12.
Czyzewski L, Rybak, K. Assessment of the exposure of nurses from emergency departments to aggressive behavior of patients. Disaster and Emergency Medicine Journal. 2018; 3(4): 111-118. https://doi.org/10.5603/DEMJ.2....
13.
Gillespie L, Gates M, Miller M, Howard K. Violence against healthcare workers in a pediatric emergency department. Advanced Emergency Nursing Journal. 2010; 32(1): 68-82. https://doi.org/10.1097/TME.0b....
14.
Yıldız İ, Yıldız T. Pediatric emergency nurses’ workplace violence experiences: a qualitative study. International emergency nursing. 2022; 62: 101160. https://doi.org/10.1016/j.ienj....
15.
Hislop E. Melby V. The lived experience of violence in accident and emergency. Accid. Emerg. Nurs. 2003; 11(1): 5-11. https://doi.org/10.1016/S0965-....
16.
Bilgin A, Kovanci S, Öcalan S. „Working in the emergency department is not a job; it's like a war” A narrative inquiry and interpretive phenomenology of the violence experienced by emergency nurses in Turkey. International Journal of Nursing Practice. 2023; 30(4): e13225. https://doi.org/10.1111/ijn.13....
17.
Al-Qadi M. Nurses’ perspectives of violence in emergency departments: a metasynthesis. International Emergency Nursing. 2020; 52: 100905. https://doi.org/10.1016/j.ienj....
18.
Ashton A, Morris L, Smith I. A qualitative meta-synthesis of emergency department staff experiences of violence and aggression. International Emergency Nursing. 2018; 39: 13-19. https://doi.org/10.1016/j.ienj....
19.
Hsu MC, Chou MH, OuyanWCg. Dilemmas and repercussions of workplace violence against emergency nurses: a qualitative study. International Journal of Environmental Research and Public Health. 2022; 19(5): 2661. https://doi.org/10.3390/ijerph....
20.
Benning L, Teepe W, Kleinekort J, Thoma J, Röttger C, Prunotto A, et al. Workplace violence against healthcare workers in the emergency department — a 10-year retrospective single-center cohort study. Scand J Trauma Resusc Emerg Med. 2024; 32(1): 88. https://doi.org/10.1186/s13049....
21.
Hou Y, Corbally M, Timmins F. Violence against nurses by patients and visitors in the emergency department: a concept analysis. J. Nurs. Manag. 2022; 30(6): 1688-1699. https://doi.org/10.1111/jonm.1....
22.
Yusoff H, Hanis A, Halim I, Naiemy R, David C, Faridah K, et al. Contemporary evidence of workplace violence against the primary healthcare workforce worldwide: a systematic review. Hum Resour Health. 2023; 21(1): 82. https://doi.org/10.1186/s12960....
23.
U.S. Bureau of Labor Statistics. Workplace violence in healthcare [Internet]. Washington, D.C.: U.S. Bureau of Labor Statistics; 2020 Apr 8 [access 2025 Jan 17]. Available from: https://www.bls.gov/iif/factsh....
24.
Aljohani B, Burkholder J, Tran K, Chen C, Beisenova K, Pourmand A. Workplace violence in the emergency department: a systematic review and meta-analysis. Public Health. 2021; 196: 186-197. https://doi.org/10.1016/j.puhe....
25.
Grinberg K, Revach C, Lipsman G. Violence in hospitals and burnout among nursing staff. Int Emerg Nurs. 2022; 65: 101230. https://doi.org/10.1016/j.ienj....
26.
Kim S, Lynn R, Baernholdt M, Kitzmiller R, Jones B. How does workplace violence –reporting culture affect workplace violence nurse burnout, and patient safety?. J Nurs Care Qual. 2023; 38(1): 11. https://doi.org/10.1097/NCQ.00....
27.
Quinn M, Koopman M. Violence risk assessment in the emergency department. J Emerg Nurs. 2023; 49(3): 352-359. https://doi.org/10.1016/j.jen.....
28.
García-Pérez D, Rivera-Sequeiros A, Sánchez-Elías M, Lima-Serrano M. Workplace violence on healthcare professionals and underreporting: characterization and knowledge gaps for prevention. Enferm. Clínica (Engl. Ed.). 2021; 31(6): 390-395. https://doi.org/10.1016/j.enfc....
29.
Gupta I, Shaker E, Che H, Regina K, Catherine W, Amteshwar S, et al. Prevalence of workplace violence and effects of de-escalation training among hospitalists: a pilot study. J Community Hosp Intern Med Perspect. 2023; 13(3): 1-5. https://doi.org/10.55729/2000-....
30.
Dana I, Alice B, Josh J, Jim D, Jill G, Kathleen C, et al. Code de-escalation: decreasing restraint use during agitation management in a community hospital emergency department. Am J Emerg Med. 2024; 76: 193-198. https://doi.org/10.1016/j.ajem....
31.
Wirth T, Peters C, Nienhaus A, Schablon A. Interventions for workplace violence prevention in emergency departments: a systematic review. Int J Environ Res Public Health. 2021; 18(16): 8459. https://doi.org/10.3390/ijerph....
32.
Reißmann S, Tanja W, Vanessa B, David G, Albert N, Volker H, et al. “I think we still do too little”: measures to prevent violence and aggression in German emergency departments – a qualitative study. BMC Health Serv Res. 2023; 23(1): 97. https://doi.org/10.1186/s12913....
| eISSN: | 2354-0265 |
| ISSN: | 2353-6942 |
We process personal data collected when visiting the website. The function of obtaining information about users and their behavior is carried out by voluntarily entered information in forms and saving cookies in end devices. Data, including cookies, are used to provide services, improve the user experience and to analyze the traffic in accordance with the Privacy policy. Data are also collected and processed by Google Analytics tool (more).
You can change cookies settings in your browser. Restricted use of cookies in the browser configuration may affect some functionalities of the website.
You can change cookies settings in your browser. Restricted use of cookies in the browser configuration may affect some functionalities of the website.
