Maddox Atticus, Mackenzie Lynette
Faculty of Medicine and Health, School of Health Sciences, University of Sydney, Sydney, New South Wales, Australia.
Aust Occup Ther J. 2025 Apr;72(2):e70009. doi: 10.1111/1440-1630.70009.
Workplace violence is a common experience for many health professionals. However, little is known about the experience of occupational therapists, specifically those that visit people in their own homes, and experience violence in that context. Home visiting is a fundamental component of practice for many occupational therapists and often takes place with the occupational therapist being alone. This study aimed to explore the experience of this group of occupational therapists, their responses to workplace violence such as reporting, and the impact of their experience on their wellbeing.
A cross-sectional online survey was distributed among occupational therapists via NSW Health services and Occupational Therapy Australia with snowball sampling and links on Twitter, LinkedIn, and Facebook. The survey gathered information on demographics, work organisation, exposure to workplace violence, and strategies used to respond to this. Wellbeing was measured using the Abbreviated Maslach Burnout Inventory and the Kessler Psychological Distress Scale.
A total of 101 surveys were returned: 97% (n = 97) were female, the mean age was 39 years, 52% (n = 52) were located in capital cities, and most worked in disability care (47%, n = 47) or aged care (46%, n = 46) and worked full time (60%, n = 60). Only 5% (n = 5) identified that they never worked alone. Of those who experienced violence at least occasionally, 74% (n = 74) reported verbal aggression, 27% (n = 27) physical aggression from clients or family members, 20% (n = 20) physical aggression using objects, 43% (n = 43) verbal sexual aggression, 46% (n = 46) unwanted sexual attention, and 3.2% (n = 3) sexual assault. Moderate to very high distress was exhibited by 26% (n = 26) of respondents, and 71% (n = 71) exhibited moderate to high emotional exhaustion.
As the target participants were occupational therapists, consumer and community involvement was not sought.
This study has demonstrated the exposure of occupational therapists to risks when visiting clients in their homes and identifies the need for risk management, training, and support for occupational therapists working in this environment.
Occupational therapists often visit people in their own homes to assess their needs and provide interventions. The home is an important environment as this is where functional activities take place. However, occupational therapists can be at risk of workplace violence from clients and their families, especially if they visit clients alone. Clients may be upset and frustrated by their situations and could strike out. We know very little about workplace violence experienced by occupational therapists, and this study used an online survey to explore how commonly this occurs, the type of incidents experienced, the actions that occupational therapists took following the incident, and how these experiences affected their well-being. We found that workplace violence included verbal attacks and physical and sexual violence. Overall, 76.2% of participants reported any kind of violence. The most frequent type of violence was verbal abuse followed by unwanted sexual attention, verbal sexual abuse, and physical violence with and without objects. Three participants reported a sexual assault. However, fewer participants took actions following the incidents such as reporting it informally or formally. This means that workplace violence is likely to be underreported by occupational therapists. We also found that occupational therapists who were exposed to workplace violence reported higher distress, higher cynicism, and lower professional accomplishment, suggesting a risk of burnout. As employers are required to protect the health and safety of their employees, these findings are very important, and the occupational therapy profession should also address them.
职场暴力是许多医疗专业人员常有的经历。然而，对于职业治疗师的经历，尤其是那些上门探访患者且在此过程中遭遇暴力的职业治疗师的经历，我们所知甚少。上门探访是许多职业治疗师工作的基本组成部分，而且通常是治疗师独自进行。本研究旨在探索这群职业治疗师的经历、他们对职场暴力的应对方式（如报告情况）以及这种经历对其幸福感的影响。
通过新南威尔士州卫生服务机构和澳大利亚职业治疗协会，采用滚雪球抽样法，并在推特、领英和脸书上发布链接，向职业治疗师发放了一份横断面在线调查问卷。该调查收集了有关人口统计学、工作机构、职场暴力暴露情况以及应对策略等方面的信息。使用简化版马氏职业倦怠量表和凯斯勒心理困扰量表来测量幸福感。
共收回101份调查问卷：97%（n = 97）为女性，平均年龄为39岁，52%（n = 52）位于首府城市，大多数人从事残疾护理工作（47%，n = 47）或老年护理工作（46%，n = 46），且为全职工作（60%，n = 60）。只有5%（n = 5）的人表示他们从不独自工作。在那些至少偶尔经历过暴力的人中，74%（n = 74）报告遭受过言语攻击，27%（n = 27）报告遭受过来自客户或家庭成员的身体攻击，20%（n = 20）报告遭受过使用物品的身体攻击，43%（n = 43）报告遭受过言语性侵犯，46%（n = 46）报告遭受过不必要的性关注，3.2%（n = 3）报告遭受过性侵犯。26%（n = 26）的受访者表现出中度至非常高的困扰，71%（n = 71）的受访者表现出中度至高度的情绪耗竭。
由于目标参与者是职业治疗师，因此未寻求消费者和社区的参与。
本研究表明职业治疗师在上门探访客户时面临风险，并指出需要对在这种环境下工作的职业治疗师进行风险管理、培训和提供支持。
职业治疗师经常上门探访患者以评估他们的需求并提供干预措施。家庭是一个重要的环境，因为功能活动在此进行。然而，职业治疗师可能会面临来自客户及其家人的职场暴力风险，尤其是当他们独自探访客户时。客户可能会因自身状况而心烦意乱、感到沮丧，从而可能会动手。我们对职业治疗师所经历的职场暴力了解甚少，本研究通过在线调查来探究这种情况的普遍程度、所经历事件的类型、职业治疗师在事件发生后的行为以及这些经历如何影响他们的幸福感。我们发现职场暴力包括言语攻击以及身体和性暴力。总体而言，76.2%的参与者报告经历过某种形式的暴力。最常见的暴力类型是言语辱骂，其次是不必要的性关注、言语性侵犯以及使用或未使用物品的身体暴力。三名参与者报告遭受过性侵犯。然而，较少有参与者在事件发生后采取行动，如非正式或正式报告。这意味着职场暴力很可能被职业治疗师少报。我们还发现，遭受职场暴力的职业治疗师报告有更高的困扰、更高的愤世嫉俗情绪以及更低的职业成就感，这表明存在职业倦怠的风险。由于雇主有责任保护员工的健康和安全，这些发现非常重要，职业治疗行业也应予以关注。
