Workplace Violence Against Nurses in Croatia: A Cross-Sectional Study on ItsFrequency, Impact, and Solutions

Authors

  • Danela Relić Faculty of Health Studies, Catholic University of Croatia
  • Ivica Matić Faculty of Health Studies, Catholic University of Croatia
  • Livia Puljak Faculty of Health Studies, Catholic University of Croatia
  • Marta Čivljak aculty of Health Studies, Catholic University of Croatia

DOI:

https://doi.org/10.5644/ama2006-124.505

Keywords:

Nurses, Violence, Workplace, Psychological Consequences, Patients

Abstract

Objective. This study aimed to analyze the frequency of workplace violence against nurses in Croatia, its psychological consequences, and existing institutional measures to address this issue.

Materials and Methods. A cross-sectional online survey was conducted among Croatian nurses in October and November 2023 using a convenience sample recruited via a social media platform. The questionnaire included 38 closed-ended questions covering socio-demographic data, experiences of physical, verbal, and sexual violence, and measures implemented to prevent or address workplace violence.

Results. A total of 318 nurses participated in the study. Most participants (70%) reported experiencing some form of workplace violence in the past 12 months. Verbal violence was most frequent (66%), followed by physical (21%) and sexual violence (13%). Patients were the most common perpetrators of physical violence (84%), followed by relatives and healthcare staff. No statistically significant differences were found between the reporting of violent incidents and the level of nurses’ education, nor between the intensity of psychological consequences and years of nurses’ work experience. Nearly half of the participants (48%) stated that no formal measures existed in their workplace to prevent or respond to violence.

Conclusion. Among nurses participating in this study, workplace violence was frequently reported, while work experience was not associated with psychological consequences. The findings indicate that workplace violence remains a relevant issue and may inform future efforts to improve preventive measures in healthcare settings.

References

NIOSH. Violence, Occupational Hazards in Hospitals [Internet]. Cincinnati; 2002. [cited 2024 Aug 2]. Available from: https://www.cdc.gov/niosh/docs/2002-101/pdfs/2002-101.pdf.

World Health Organization Preventing violence against health workers [Internet]. [cited 2023 Jun 27]. Available from: https://www.who.int/activities/preventing-violence-against-health-workers.

Liu J, Gan Y, Jiang H, Li L, Dwyer R, Lu K, et al. Prevalence of workplace violence against healthcare workers: a systematic review and meta-analysis. Occup Environ Med. 2019;76(12):927-37. doi: 10.1136/oemed-2019-105849. Epub 2019 Oct 13.

Zhang S, Zhao Z, Zhang H, Zhu Y, Xi Z, Xiang K. Workplace violence against healthcare workers during the COVID-19 pandemic: a systematic review and meta-analysis. Environ Sci Pollut Res Int. 2023;30(30):74838-52. doi: 10.1007/s11356-023-27317-2. Epub 2023 May 20.

Vento S, Cainelli F, Vallone A. Violence Against Healthcare Workers: A Worldwide Phenomenon With Serious Consequences. Front Public Health. 2020;8:570459. doi: 10.3389/fpubh.2020.570459.

Magnavita N, Heponiemi T, Chirico F. Workplace Violence Is Associated With Impaired Work Functioning in Nurses: An Italian Cross-Sectional Study. J Nurs Scholarsh. 2020;52(3):281-91. doi: 10.1111/jnu.12549. Epub 2020 Mar 25.

D’Ettorre G, Pellicani V, Mazzotta M, Vullo A. Preventing and managing workplace violence against healthcare workers in Emergency Departments. Acta Biomed. 2018;89(4-S):28-36. doi: 10.23750/abm.v89i4-S.7113.

Chakraborty S, Mashreky SR, Dalal K. Violence against physicians and nurses: a systematic literature review. Z Gesundh Wiss. 2022;30(8):1837-55. doi: 10.1007/s10389-021-01689-6. Epub 2022 Jan 22.

Spencer C, Sitarz J, Fouse J, DeSanto K. Nurses’ rationale for underreporting of patient and visitor perpetrated workplace violence: a systematic review. BMC Nurs. 2023 Apr 23;22(1):134. doi: 10.1186/s12912-023-01226-8.

Song C, Wang G, Wu H. Frequency and barriers of reporting workplace violence in nurses: An online survey in China. Int J Nurs Sci. 2020;8(1):65-70. doi: 10.1016/j.ijnss.2020.11.006.

Jiang L, Probst TM, Benson W, Byrd J. Voices carry: Effects of verbal and physical aggression on injuries and accident reporting. Accid Anal Prev. 2018;118:190-9. doi: 10.1016/j.aap.2018.02.017. Epub 2018 Mar 5.

Batrnek T. Abuse of nurses and technicians in the workplace [graduation thesis]. Osijek, Croatia: Josip Juraj Strossmayer University in Osijek, Faculty of Medicine; 2017.

Tomagová M, Zeleníková R, Kozáková R, Žiaková K, Babiarczyk B, Turbiarz A. Vioence against nurses in healthcare facilities in the Czech Republic and Slovakia. Cent Eur J Nurs Midwifery. 2020;11(2):52-61. doi: 10.15452/cejnm.2020.11.0009.

Ravlić M. Workplace violence against nurses and technicians [graduate thesis]. Varaždin, Croatia: University North; 2020.

Tawiah PA, Appiah-Brempong E, Okyere P, Adu-Fosu G, Ashinyo ME. Prevalence, risk factors and psychological consequences of workplace violence among health workers in the Greater Accra region, Ghana: a cross-sectional study. BMC Public Health. 2024;24(1):563. doi: 10.1186/s12889-024-17962-8.

Nyberg A, Kecklund G, Hanson LM, Rajaleid K. Workplace violence and health in human service industries: a systematic review of prospective and longitudinal studies. Occup Environ Med. 2021;78(2):69-81. doi: 10.1136/oemed-2020-106450. Epub 2020 May 15.

Babiarczyk B, Turbiarz A, Tomagová M, Zeleníková R, Önler E, Sancho Cantus D. Reporting of workplace violence towards nurses in 5 European countries - a cross-sectional study. Int J Occup Med Environ Health. 2020;33(3):325-38. doi: 10.13075/ijomeh.1896.01475. Epub 2020 Mar 26.

Kvas A, Seljak J. Unreported workplace violence in nursing. Int Nurs Rev. 2014;61(3):344-51. doi: 10.1111/inr.12106. Epub 2014 May 22.

Huang L, Chang H, Peng X, Zhang F, Mo B, Liu Y. Formally reporting incidents of workplace violence among nurses: A scoping review. J Nurs Manag. 2022;30(6):1677-87. doi: 10.1111/jonm.13567. Epub 2022 Apr 1.

Schablon A, Wendeler D, Kozak A, Nienhaus A, Steinke S. Prevalence and Consequences of Aggression and Violence towards Nursing and Care Staff in Germany-A Survey. Int J Environ Res Public Health. 2018;15(6):1274. doi: 10.3390/ijerph15061274.

de Raeve P, Xyrichis A, Bolzonella F, Bergs J, Davidson PM. Workplace Violence Against Nurses: Challenges and Solutions for Europe. Policy Polit Nurs Pract. 2023;24(4):255-264. doi: 10.1177/15271544231182586.

Croatian Institute for Public Health. International Nurses Day 2023 [Internet]. Zagreb: 2023. [cited 2024 May 17]. Available from: https://www.hzjz.hr/sluzbajavno-zdravstvo/medunarodni-dan-medicinskih-sestara-2023-g/.

Downloads

Published

25.03.2026

Issue

Section

Clinical Medicine

Categories

How to Cite

Workplace Violence Against Nurses in Croatia: A Cross-Sectional Study on ItsFrequency, Impact, and Solutions. (2026). Acta Medica Academica. https://doi.org/10.5644/ama2006-124.505

Most read articles by the same author(s)

1 2 > >>