ArticleBMJ open2020
How do aggression source, employee characteristics and organisational response impact the relationship between workplace aggression and work and health outcomes in healthcare employees? A cross-sectional analysis of the National Health Service staff survey in England.
Article in BMJ open, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 1 of them a synthesis that pooled it.
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Who cites it
9 citing papers in PubMed, 1 synthesis or guideline pooled it, 14 citations in OpenAlex.
- Understanding why health professionals are leaving the UK national health service (NHS) - A systematic review and narrative synthesis.Journal of health services research & policy · 2026Pooled it
- Violence and abuse towards general practice staff by patients and the public: a scoping review.The British journal of general practice : the journal of the Royal College of General Practitioners · 2025Article
- Organisational factors associated with healthcare workforce development, recruitment, and retention in the United Kingdom: a systematic review.BMC nursing · 2024Article
- The Relationship between Patients' Demands and Workplace Violence among Healthcare Workers: A Multilevel Look Focusing on the Moderating Role of Psychosocial Working Conditions.International journal of environmental research and public health · 2024Article
- Perpetrators of gender-based workplace violence amongst nurses and physicians-A scoping review of the literature.PLOS global public health · 2024Article
- A gender-based review of workplace violence amongst the global health workforce-A scoping review of the literature.PLOS global public health · 2024Article
- Article
- Aggressive Behavior and Psychiatric Inpatients: a Narrative Review of the Literature with a Focus on the European Experience.Current psychiatry reports · 2021Review
- Article
Corrections and comments
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Authors and funding
5 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesTo examine the prevalence of aggression in healthcare and its association with employees' turnover intentions, health and engagement, as well as how these effects differ based on aggression source (patients vs colleagues), employee characteristics (race, gender and occupation) and organisational response to the aggression.
designMultilevel moderated regression analysis of 2010 National Health Service (NHS) survey.
setting147 acute NHS trusts in England.
participants36 850 participants across three occupational groups (14% medical/dental, 61% nursing/midwifery, 25% allied health professionals or scientific and technical staff).
main outcome measuresEmployee turnover intentions, health and work engagement.
resultsBoth forms of aggression (from patients and colleagues) have significant and substantial effects on turnover intentions, health and work engagement; however, for all three outcome variables, the effect of aggression from colleagues is more than twice the size of the effect of aggression from patients. Organisational response was found to buffer the negative effects of aggression from patients for turnover intentions and the negative effects of aggression from patients and colleagues for employee health. The results also demonstrated that nurses/midwives, women and Black employees are more likely to experience aggression; however, no clear patterns emerged on how aggression differentially impacts employees of different races, genders and occupations with respect to the outcome variables.
conclusionsAlthough aggression from patients and colleagues both have negative effects on healthcare employees' turnover intentions, health and work engagement, these negative effects are worse when it is aggression from colleagues. Having an effective organisational response can help ameliorate the negative effects of aggression on employees' health; however, it may not always buffer negative effects on turnover intentions and work engagement. Future research should examine other approaches, as well as how organisational responses and resources may need to differ based on aggression source.
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