Cesare Manuele, Di Nitto Marco, Iovino Paolo, Caponnetto Valeria, Longobucco Yari, Marcomini Ilaria, Zaghini Francesco, Alvaro Rosaria, Burgio Alessandra, Cicolini Giancarlo, Lancia Loreto, Landa Paolo, Manara Duilio Fiorenzo, Mazzoleni Beatrice, Rasero Laura, Rocco Gennaro, Zega Maurizio, Sasso Loredana, Bagnasco Annamaria
A. Gemelli IRCCS University Hospital Foundation, Rome, Italy.
Section of Hygiene, Department of Health Science and Public Health, Catholic University of the Sacred Heart, Rome, Italy.
J Clin Nurs. 2025 Jul 1. doi: 10.1111/jocn.70007.
To describe the prevalence and determinants of workplace violence against nurses in the Italian home care setting.
Secondary cross-sectional analysis of data from the multicentre study AIDOMUS-IT.
Nurses employed in home care services provided by Italian Local Health Authorities were interviewed using a variety of instruments. A multivariable binary logistic regression model was performed to model the risk of workplace violence against nurses in the last 12 months. Variables related to violence were selected among sociodemographic characteristics (such as age and gender), work-related factors (including years of experience, team composition, overtime working, previous experience in mental health care, burnout) and organisational elements (including leadership and support, workload, staffing and resources adequacy, and time to reach the patients' homes). Adjusted odds ratios (aOR) were used to present the results.
A total of 3949 nurses participated in the study and 20.49% of them reported to have experienced an episode of violence in the last 12 months. Determinants of higher risk of violence episodes were younger age (aOR = 1.02, p = 0.002), higher workload (aOR = 1.01, p = 0.002), working in a multiprofessional team (aOR = 1.24, p = 0.018), perception of inadequate managerial leadership and support (aOR = 1.38, p = 0.003), and higher burnout levels (aOR = 1.01, p < 0.001).
The prevalence of workplace violence against Italian home care nurses is high. Several modifiable determinants were found to be associated with a higher risk of violence, which can potentially be mitigated with tailored interventions.
IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE: Effective preventive strategies must be developed to lessen workplace violence against nurses in the home care setting. These strategies should focus on strengthening nursing managers' leadership and support skills, enhancing team-building strategies, avoiding inadequate workload, monitoring nurses' burnout, estimating optimum staffing levels, and assigning advanced-career nurses to home care services. These measures are imperative to guarantee the quality and safety of home care organisations and to attain favourable outcomes in the provision of care.
This study aimed to explore the prevalence and determinants of workplace violence against nurses in the Italian home care settings. We found that out of the 3949 nurses surveyed, 20% of the sample reported one episode of violence during the last 12 months. Determinants of this violence included younger age, higher workload and burnout, being in a multiprofessional team, and perception of lack of leadership and support by the nurse manager. The results of this study can be used to tailor interventions aimed at mitigating the risk factors of violence, particularly those that can be modified (e.g., workload, burnout, and leadership).
The study adhered to the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines.
No patient or public contribution.
描述意大利居家护理环境中针对护士的工作场所暴力的发生率及其决定因素。
对多中心研究AIDOMUS-IT的数据进行二次横断面分析。
使用多种工具对受雇于意大利地方卫生当局提供的居家护理服务的护士进行访谈。采用多变量二元逻辑回归模型对过去12个月内针对护士的工作场所暴力风险进行建模。在社会人口学特征（如年龄和性别）、工作相关因素（包括工作经验年限、团队构成、加班工作、先前在精神卫生保健方面的经验、职业倦怠）和组织因素（包括领导与支持、工作量、人员配备和资源充足性以及到达患者家中的时间）中选择与暴力相关的变量。采用调整后的优势比（aOR）来呈现结果。
共有3949名护士参与了该研究，其中20.49%的护士报告在过去12个月内经历过暴力事件。暴力事件风险较高的决定因素包括年龄较小（aOR = 1.02, p = 0.002）、工作量较大（aOR = 1.01, p = 0.002）、在多专业团队中工作（aOR = 1.24, p = 0.018）、认为管理领导和支持不足（aOR = 1.38, p = 0.003）以及职业倦怠水平较高（aOR = 1.01, p < 0.001）。
针对意大利居家护理护士的工作场所暴力发生率较高。发现若干可改变的决定因素与较高的暴力风险相关，通过针对性干预有可能减轻这些风险。
对专业和/或患者护理的启示：必须制定有效的预防策略以减少居家护理环境中针对护士的工作场所暴力。这些策略应侧重于加强护理管理者的领导和支持技能、加强团队建设策略、避免工作量不足、监测护士的职业倦怠、估算最佳人员配备水平以及将经验丰富的护士分配到居家护理服务中。这些措施对于保证居家护理机构的质量和安全以及在提供护理方面取得良好效果至关重要。
本研究旨在探讨意大利居家护理环境中针对护士的工作场所暴力的发生率及其决定因素。我们发现，在接受调查的3949名护士中，20%的样本报告在过去12个月内发生过一次暴力事件。这种暴力的决定因素包括年龄较小、工作量较大和职业倦怠、在多专业团队中工作以及认为护士长缺乏领导和支持。本研究结果可用于制定旨在减轻暴力风险因素的干预措施，特别是那些可改变的因素（如工作量、职业倦怠和领导能力）。
本研究遵循了加强流行病学观察性研究报告（STROBE）指南。
无患者或公众参与。
