Prevalence, associated factors, and outcomes of workplace violence against doctors in China: a systematic review and meta-analysis.

backgroundWorkplace violence is a major occupational and public health concern in healthcare settings. Although doctors are a high-risk group, existing research has primarily focused on healthcare workers in general or on nurses, with less attention to doctors. This systematic review and meta-analysis synthesized evidence on the prevalence, types, associated factors, outcomes, and perceived impacts of workplace violence against doctors in China.

methodsThis review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. PubMed, Web of Science, Scopus, and China National Knowledge Infrastructure were systematically searched from database inception to 31 December 2025. Eligible studies were Chinese- or English-language cross-sectional or mixed-methods studies with extractable cross-sectional data that reported the 12-month prevalence of overall workplace violence among doctors in China. Data were synthesized using random-effects meta-analysis in R, and heterogeneity was assessed using Cochran's Q and I

resultsNineteen studies involving 114,270 doctors were included. The pooled 12-month prevalence of workplace violence against doctors in China was 60.85% (95% CI: 49.16%-71.42%; range: 14.26%-90.40%). Verbal violence was the most common type, with a pooled prevalence of 49.56% (95% CI: 29.69%-69.57%), followed by threats (28.08%; 95% CI: 15.90%-44.64%), physical violence (14.36%; 95% CI: 7.77%-25.02%), sexual harassment (11.81%; 95% CI: 5.75%-22.73%), and sexual assault (4.66%; 95% CI: 2.19%-9.62%). Patients and their family members or relatives were the main perpetrators. Workplace violence was associated with demographic factors, professional characteristics, workload-related factors, and clinical setting and organizational factors, including male sex, higher educational attainment, professional title or level, longer working hours, and high-risk clinical settings. Subgroup analyses showed a significantly lower pooled prevalence during the COVID-19 pandemic than before the pandemic. Workplace violence was also associated with adverse psychological, occupational, and organizational outcomes; perceived impacts included emotional distress, reduced work efficiency, decreased patient trust, and thoughts of leaving the profession.

conclusionsWorkplace violence against doctors in China remains highly prevalent, with verbal violence as the dominant form. The findings suggest that workplace violence may be more likely in high-demand clinical contexts characterized by heavy workloads, frequent doctor-patient interactions, and unmet patient expectations. Structural, organizational, and policy measures are needed to reduce service pressure, strengthen prevention and reporting systems, and protect doctors' well-being and retention. PROSPERO REGISTRATION NUMBER: CRD420251088438.