Prevalence of Type II and Type III Workplace Violence against Physicians: A Systematic Review and Meta-analysis

Behdin Nowrouzi-Kia, Emily Chai, Koyo Usuba, Behnam Nowrouzi-Kia, Jennifer Casole


Background: Workplace violence (WPV) in the health care sector remains a prominent, under-reported global occupational hazard and public health issue. Objective: To determine the types and prevalence of WPV among doctors.

Methods: Primary papers on WPV in medicine were identified through a literature search in 4 health databases (Ovid Medline, EMBASE, PsychoINFO and CINAHL). The study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines for the mapping and identification of records. To assess the studies included in our review, we used the Critical Appraisal Skills Programme cohort review checklist and the Risk of Bias Assessment.

Results: 13 out of 2154 articles retrieved were reviewed. Factors outlining physician WPV included (1) working in remote health care areas, (2) understaffing, (3) mental/emotional stress of patients/visitors, (4) insufficient security, and (5) lacking preventative measures. The results of 6 studies were combined in a meta-analysis. The overall prevalence of WPV was 69% (95% CI 58% to 78%).

Conclusion: The impact of WPV on health care institutions is profound and far-reaching; it is quite common among physicians. Therefore, steps must be taken to promote an organizational culture where there are measures to protect and promote the well-being of doctors.


Physicians; Workplace violence; Systematic review [publication type]; Meta-analysis [publication type]; Occupational medicine

doi: 10.15171/ijoem.2019.1573

 pISSN: 2008-6520
 eISSN: 2008-6814

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