Incivility towards nurses: A Systematic Review and Meta-analysis

Incivility towards nurses: A Systematic Review and Meta-analysis | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research article Incivility towards nurses: A Systematic Review and Meta-analysis Foroozan Atashzadeh-Shoorideh, Soolmaz Moosavi, Abbas Balouchi, and 1 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-35232/v1 This work is licensed under a CC BY 4.0 License Status: Published Journal Publication published 03 Nov, 2021 Read the published version in Journal of Medical Ethics and History of Medicine → Version 1 posted You are reading this latest preprint version Abstract Background Creation and maintenance of a safe healthy work environment is one part of a nurse’s role. Evidence shows there is a presence of negative behaviors like incivility and violence in the nursing profession. This systematic review and meta-analysis determined the rate of incivility towards nurses and the factors affecting it. Methods All observational studies that primarily investigated the rate of incivility towards nurses were selected regardless of sampling method. The electronic databases “PubMed, Embase, Web of Sciences, Magiran, IranDoc, and Scopus” were searched for studies published during the period of January 1, 1996 to December 31, 2019. The quality of the selected studies was assessed with Hoy’s Critical Assessment Checklist. The study was undertaken using the random effects model. Data were analyzed with STATA14. Results Data on 61 articles, including data on 30801 individuals that were published during 1997–2019, entered the study. Prevalence of incivility was 50.10% (95%, CI: 48.05, 62.06). Conclusion Given the highly important role of nurses in care-giving, they deserve to have a safe working environment similar to other work milieus. Medical Ethics Incivility nurse work environment mobbing verbal abuse violence Figures Figure 1 Figure 2 Figure 3 Figure 4 Figure 5 Figure 6 Figure 7 Figure 8 Figure 9 Figure 10 Figure 11 Figure 12 Background Civility is defined as being polite and kind in mood and speech. Civil behavior refers to polite behavior toward others and ensuring that their dignity is maintained. On the contrary, incivility is defined as the negative behavior of insulting others or violating the common norms of behavior in the workplace [ 1 ]. Incivility is a new concept in the psychology of occupational health [ 2 ] with most of the related literature being published at the beginning of the current century. In recent years, the increasing number of publications on this topic indicates that incivility occurs more frequently in the work environment compared to other extreme behaviors. A study by Bjorkqvist et al. (1994) showed that 32% of the participants had experienced incivility [ 3 ]. Incivility was first defined by Anderson & Pearson (1999) as “negative behaviors with low-intensity and unclear intention that damages the targeted person” [ 3 ]. Nonetheless, terms such as lateral violence, disruptive behavior, abuse, conflict, bullying, and aggression are used to describe incivility. These behaviors occur frequently in healthcare environments, lead to numerous negative consequences and can lead to more severe violence [ 5 , 6 ]. Uncivil behaviors include verbal abuse, nonverbal abuse, sexual harassment, and passive aggressive behavior. Verbal abuse involves shouting, raising a voice, in a hostile manner or threatening a person verbally overt scolding or criticism, the use of insulting and disgracing words, disrespectful tones, impoliteness, sarcastic behavior, threatening, and humiliation [ 7 ]. Nonverbal abuse includes raising the eyebrows, tightening the eyes, scowling, creating physical distance, excluding one from conversations, and/or invading someone’s privacy [ 8 ]. Sexual harassment includes inappropriate behaviors that could be construed to have sexual intention, inappropriate sexual jokes, words that are sexual in nature, unwanted sexual advances, requests for sex, and accidental sexual contact [ 8 ]. Passive aggressive behaviors in the workplace can be as destructive as uncivil behaviors. Passive aggressive behaviors include lack of support for colleagues, planning to defeat the work opponent, refusing to communicate with an individual, impatience with other people’s questions, and manifesting a negative attitude, all of which affect colleagues’ confidence [ 9 ]. Studies on incivility in the work environment suggest that it is often produced by emotionally annoying interactions due to inappropriate demonstration of anger and anguish, being overworked, tension, lack of communication, heavy workload, occupational insecurity, organisational change, poor work organisation, differences in social power, and reciprocal relation of duties [ 2 ]. These variables, as stressors, may lead to depression and negative physical symptoms. Experience of incivility in the work environment is negatively correlated with psychosomatic health [ 3 ] and is recognised as the prerequisite for many aggressive behaviors and violence in work environment [ 6 ]. Generally, creation and maintenance of a safe work environment forms one part of the nursing role. Disruptive behaviors negatively affect patient outcomes and nursing performance. Nurses should support patients through dealing with disruptive behavior to create and maintain a safe environment for giving quality care. Several studies examined prevalence of incivility in nurses in specific countries or regions, however, no studies have estimated the overall prevalence of nurses’ incivility globally and only a few included meta-analysis. A review of previous studies showed that few studies have focused on incivility. Aazami et al.’s study (2018) investigated Iranian incivility towards nurses. The researcher in this study searched the databases “Magiran, Barakat Knowledge Network System, IranDoc, Regional Information Center for Science and Technology (RICST), Scientific Information Database (SID), Iranian National Library, PubMed/Medline, Cochrane Library, Scopus, Science Direct, ISI Web of Knowledge, CINAHL, and Google Scholar” up to 2017. In 26 studies, the rate of prevalence of variables under study including violence and verbal, physical, sexual, and racial threat in the work environment were 80.8%, 24.8%, 6.14%, and 44%, respectively [ 10 ]. The systematic review by Dalvand et al. (2018) was carried out to assess violence in Iranian nurses’ work place. In addition, 22 studies were extracted from databases “IranMedex, Google Scholar, MagIran, SID, Scopus, Web of Science, PubMed, and Science Direct” and evaluated. The results showed that 74% of nurses are exposed to verbal violence and 28% to physical violence. Previous research showed high prevalence of workplace violence toward nurses [ 11 ]. The systematic review by D’ambra & Andrews (2013) was aimed at assessing the effect of incivility on recently-graduated nurses. The researchers searched CINAHL, PsychInfo, and MEDLINE-EBSCOhost to extract English papers published during 2002–2012. Sixteen papers were extracted indicating that incivility in workplace is an important predictor of low job satisfaction among beginner nurses [ 12 ]. The systematic review by Edward et al. (2017) was conducted on the correlation between workplace violence and nurses’ anxiety. The databases “PsychInfo and MEDLINE-CINAHL” were searched up to 2013 and 53 papers were selected to be reviewed. The results demonstrated that nurses in emergency wards are more frequently exposed to verbal violence than other wards. The most frequent time of exposure to violence was at the point of direct care of patients and violence was either by the patients or by their attendants. Nurses did not report the violence due to various organizational reasons [ 13 ]. The review study of sources by Hawkins et al. (2018) assessed beginner nurses’ experiences with negative behaviors. The databases “CINAHL, MEDLINE, ProQuest, JBI, and Scopus” were searched for the 2007–2017 and eight qualitative and eight quantitative studies were assessed. The findings suggested that between 3% and 57% of the nurses experienced negative behaviors leading to depression, anxiety and work leave among nurses [ 14 ]. The systematic review by Zhu et al. (2019) aimed to explore incivility experience in nursing students. The databases “CINAHL, PubMed (MEDLINE), ProQuest Central, ProQuest Education Journals, ProQuest XML-Dissertations and Theses, Web of Science, Embase, EBSCO Discovery Service and PsycINFO” were searched for studies published during 1990–2018. The results showed that nursing students experienced incivility during their clinical training and the importance of the manager's role in reducing these behaviors [ 15 ]. Finally, the systematic review by Hodgins et al. (2013), aimed at assessing effective interventions for decreasing violence and incivility in workplace, was searched in “ASIA, Emerald, Ovid, JSTOR Web of Science, EBSCO: Academic Search Complete, Embase, Medline, Social Care Online, Science Direct, and Scopus”. Twelve studies were investigated. The results revealed that weak interpersonal communication was one of the most important causes of incivility. Training and awareness of incivility and violence can be effective in reducing the incidence of these behaviors [ 16 ]. Consequently, our systematic review and meta-analysis answered the following question: What is the rate of incivility in Iranian nurses’ workplace? Methods Design of the Study This systematic review was conducted on observational studies concerning the prevalence of incivility towards nurses’ workplace. To achieve the goals, the guideline “Meta-analysis of observational studies in epidemiology (MOOSE)” was used [17]. Inclusion Criteria All observational studies (descriptive and analytical) focusing on investigation of the rate of prevalence of incivility towards nurses were selected, regardless of the sampling method they had used. Letters-to-the-editor, protocols, review studies, case series, case reports and studies with sample volumes less than 25 were excluded from the study. In addition, the studies that had used researcher-made instruments to examine incivility, repetitious studies, and non-reporting of prevalence incivility were excluded from the study. There were no limitations in the language of the studies, and free-of-charge translators like ImTranslator, Bing, Google Translate, and Applied Languages were used to translate papers into other languages. Search Strategy In this study, the databases “Medline (via PubMed), Embase, Scopus, Web of Science, IranDoc, and Magiran” were searched for works published during January 1, 1996 to December 31, 2019. Moreover, the studies related to these, dissertations and conference papers were searched. The search strategy is given in Medline following Script: (((Incivility[Title/Abstract] OR Uncivil Behavior*[Title/Abstract] OR Workplace Incivility[Title/Abstract] OR Rudeness[Title/Abstract] OR Bullying[Title/Abstract] OR abuse[Title/Abstract] OR lateral violence[Title/Abstract] OR horizontal violence[Title/Abstract] OR relational aggression[Title/Abstract] OR workplace violence[Title/Abstract] OR negative act*[Title/Abstract] OR negative behavior*[Title/Abstract] OR disruptive behavior*[Title/Abstract] OR horizontal hostility[Title/Abstract])) OR incivility[MeSH Terms])) AND (Nurs*[Title/Abstract] OR Personnel Nurs*[Title/Abstract] OR Registered Nurs*[Title/Abstract] OR caregiver*[Title/Abstract])) AND (prevalence [Title/Abstract] OR incidence [Title/Abstract] OR frequency [Title/Abstract] OR occurrence [Title/Abstract] OR burden [Title/Abstract] OR epidemiology [Title/Abstract]) Data Extraction Two independent researchers (SM, AB) completed the initial screening of the studies based on titles and abstracts. In the next stage, the two researchers (SM, FA) studied the full texts of papers supposed to have reported consequences in more detail. Then, the relevant papers were outlined in a checklist. Data such as study features including author(s), publication date, and type of journal, setting of the study, goals, design, and type of study, sample volume, sampling method, and characteristics of the participants such as age, gender, ward, and work experience were extracted. In all of these stages, any disagreement or conflict between the two researchers was settled by consensus via bilateral debate or by a third party. Qualitative Assessment The selected studies were assessed qualitatively using Hoy’s Critical Assessment Checklist that consists of 10 items. Items 1-4 assess external validity (target population, sampling framework, sampling method, and bias of lack of responding), items 5-9 assess internal validity (data collection method, case definition, and instruments), and item 10 evaluates analytical bias [18]. This assessment was completed by two people independently. Any conflict was solved by debate and consensus or finally by third party intervention. Data Analysis Data were analysed by STATA14.0 statistical package (College Station, TX: Stata Corp LLC). The prevalence data of the studies were pooled and using “ metaprop one ” command, a pooled prevalence with a 95% confidence interval (95% CI) was reported. I 2 was used for assessing heterogeneity. Subgroup analysis and meta-regression were used for finding the potential sources of heterogeneity. The funnel plot was used to assess the small study effect (Publication bias). Results Description of the Studies Firstly, 6876 studies were identified from the electronic databases. After duplicate studies were removed and those not meeting inclusion criteria, finally 61 studies are covered in this review. The number of the extracted studies in terms of databases was as follows: PubMed: 1391, Web of Science: 225, Scopus: 3190, and EMBASE: 2070. After omitting 3451 repetitious studies, 3425 studies entered the screening phase and 3235 irrelevant studies were excluded. Next, 189 studies entered the full text reading stage, of which 128 studies were excluded due to differences in participants (69 cases) and study design (60 cases) so that finally, 61 studies entered the study (Fig. 1 ). Figure 1 . The search flowchart for articles in databases based on the PRISMA 2009 checklist The 61 studies were conducted between 1997 to 2019 used 30801 participants. Characteristics of the selected works are given in Table 1 . The largest and smallest participants of the studies were 3835 and 80, respectively. Most studies pertained to Asian countries (n = 34) followed by America (n = 15), Africa (n = 8), and Europe (n = 4). Among the Asian countries, Iran and Taiwan (n = 5) had the greatest number of studies. The number of studies was 30 in developed and 31 in developing countries. 19 studies used random sampling, 5 studies census sampling and 15 studies convenient sampling. Seven studies have not explained the sampling method clearly. 45 studies used cross-sectional design and 16 studies were descriptive. The minimal rate of response was 3% and the maximal rate was 100%. Three studies had not reported response rate. 6 studies were performed on psychiatrics, 6 on emergency care, and 2 on ICU. Most studies (n = 47) involved general hospitals and all wards. The most frequently used instruments were “Workplace Violence in the Health Sector” established with the cooperation of the International Labor Organization (ILO), the WHO, the ICN, and the PSI in 2003 (27 cases) and “Negative Acts Questionnaire” (eight cases). Table 1 Studies included in the systematic review (N = 61) ID Author Year Country Design Instrument Sample. Size Quality assessment 1 Sauer 2016 United states descriptive survey Negative Acts Questionnaire–Revised (NAQR) 2250 Low risk 2 Heydari 2015 Iran descriptive, cross -sectional Perceived workplace civility climate scale (PWCC) 200 Low risk 3 Budin 2013 United states descriptive survey Verbal Abuse Scale (VAS) developed by Manderino and Banton 2007 Low risk 4 Lu 2019 China cross-sectional workplace violence scale developed by Chen ZH's group 2124 Low risk 5 Tsukamoto 2019 Brazil cross-sectional Assessing violence in work suffered or witnessed by nursing staff developed by Bordignon and Monteiro 242 Low risk 6 Jaradat 2018 Palestine cross-sectional Workplace Violence in the Health Sector by ILO/ICN/WHO/PSI/2003 372 Low risk 7 Cheung 2017 Hong Kong cross-sectional Workplace Violence in the Health Sector by ILO/ICN/WHO/PSI/2003 16082 Low risk 8 Boafo 2015 Ghana cross-sectional Workplace Violence in the Health Sector by ILO/ICN/WHO/PSI/2003 1021 Low risk 9 Alkorashy 2016 Saudi Arabia cross-sectional Workplace Violence/ Abuse conducted by the Massachusetts Nurses Association Congress 500 Low risk 10 Fute 2014 Ethiopia cross-sectional Workplace Violence in the Health Sector by ILO/ICN/WHO/PSI/2003 660 Low risk 11 Baran Aksakal 2011 Turkey cross-sectional Workplace Violence in the Health Sector by ILO/ICN/WHO/PSI/2003 650 Low risk 12 Abou-ElWafa 2015 Egypt cross-sectional comparative Workplace Violence in the Health Sector by ILO/ICN/WHO/PSI/2003 286 Low risk 13 Bambi 2014 Italy cross-sectional LH questionnaire developed by Alspach 1504 Low risk 14 Galián-Muñoz 2013 Spain descriptive study HABS-U scale (Hospital Aggressive Behavior Scale-User) 200 Low risk 15 Lemelin 2003 Canada descriptive Workplace Violence Events Questionnaire by Anderson (2002) 300 Low risk 16 Manderino 1997 United states descriptive-correlational design Verbal Abuse Scale (VAS) 300 Low risk 17 Chen 2012 Taiwan descriptive-correlational design Workplace Violence in the Health Sector by ILO/ICN/WHO/PSI/2003 1004 Low risk 18 Suhaila 2012 Malaysia cross-sectional Utara Sexual Harassment Questionnaire (USHQ) by Sabitha 455 Low risk 19 Khademloo 2013 Iran cross-sectional Staff Observation Scale Revised (SOAS-R) by Nijman and colleagues 440 Low risk 20 Fallahi Khoshknab 2011 Iran cross-sectional Workplace Violence in the Health Sector by ILO/ICN/WHO/PSI/2003 200 Low risk 21 Berry 2011 United states descriptive cross-sectional survey Negative Acts Questionnaire–Revised (NAQR) 5000 Low risk 22 Ahmed 2012 Jordan cross-sectional descriptive Workplace Violence in the Health Sector by ILO/ICN/WHO/PSI/2003 500 Low risk 23 Pai 2011 Taiwan cross-sectional descriptive Workplace Violence in the Health Sector by ILO/ICN/WHO/PSI/2003 700 Low risk 24 AbuAlRub 2008 Jordan descriptive Workplace Violence in the Health Sector by ILO/ICN/WHO/PSI/2003 496 Low risk 25 Hsieh 2016 Taiwan cross-sectional Negative Acts Questionnaire–Revised (NAQR) 550 Low risk 26 Hampton 2018 United states cross-sectional descriptive Negative Acts Questionnaire–Revised (NAQR) 175 Low risk 27 Zhao 2015 China multi-stage cross-sectional Workplace Violence Scale (WVS) developed by Schat (Schat & Kelloway, 2003 1013 Low risk 28 Noorana Zahra 2018 Indonesia cross-sectional descriptive Workplace Violence in the Health Sector by ILO/ICN/WHO/PSI/2003 245 Low risk Low risk 29 Zhang 2014 China cross-sectional descriptive Workplace Violence in the Health Sector by ILO/ICN/WHO/PSI/2003 4123 Low risk 30 Karatza 2013 Greece cross-sectional descriptive Negative Acts Questionnaire–Revised (NAQR) 1000 Low risk 31 Jafree 2013-4 Pakistan cross-sectional descriptive Workplace Violence in the Health Sector by ILO/ICN/WHO/PSI/2003 804 Low risk 32 Ridenour 2015 United states cross-sectional descriptive Negative Acts Questionnaire–Revised (NAQR) 284 Low risk 33 Estes 2013 United states anonymous mail survey Organizational deviance scale developed by Bennett and Robinson (2000) 1524 Low risk 34 Esmaeilpour 2011 Iran cross-sectional descriptive Workplace Violence in the Health Sector by ILO/ICN/WHO/PSI/2003 196 Low risk 35 Fujishiro 2011 Philippines cross-sectional (ANA's) 2001 Health and Safety Survey 1000 Low risk 36 Abbas 2010 Egypt cross-sectional Workplace Violence in the Health Sector by ILO/ICN/WHO/PSI/2003 1600 Low risk 37 Shiao 2010 Taiwan cross-sectional Rosenberg et al. (1992) and the National Crime Victimization Survey (NCVS) (Warchol 1228 Low risk 38 Yildirim 2009 Turkey cross-sectional Nurses’ Perception of Bullying In the Workplace, Developed By Dilek & Aytolan (2008) Low risk 39 Joubert 2005 South Africa. cross-sectional Verbal Abuse Scale developed by Manderino 120 Low risk 40 Honarvar 2017-8 Iran cross-sectional Workplace Violence in the Health Sector by ILO/ICN/WHO/PSI/2003 420 Low risk 41 Yun 2012 Korea cross-sectional Negative Act Questionnaire-Revised (NAQ-R) 170 Low risk 42 Maio T 2015 Azorean Island descriptive-correlational design Negative Act Questionnaire-Revised (NAQ-R) Low risk 43 Jiao 2013 China cross-sectional Workplace Violence in the Health Sector by ILO/ICN/WHO/PSI/2003 700 Low risk 44 park M, Choi J.S 2018 Korea cross-sectional farley wokplace cyberbullying measuremennt 260 Low risk 45 Niu 2019 Taiwan cross-sectional Workplace Violence in the Health Sector by ILO/ICN/WHO/PSI/2003 480 Low risk 46 Obeidat 2018 Amman cross-sectional Negative Act Questionnaire-Revised (NAQ-R) 340 Low risk 47 Pandey 2018 Nepal descriptive cross-sectional Workplace Violence in the Health Sector by ILO/ICN/WHO/PSI/2003 200 Low risk 48 Al-Shamlan 2015 Saudi Arabia cross-sectional Workplace Violence in the Health Sector by ILO/ICN/WHO/PSI/2003 450 Low risk 49 Sisawo 2014 Gambia quantitative and qualitative designs Workplace Violence in the Health Sector by ILO/ICN/WHO/PSI/2003 223 Low risk 50 Chang 2012-3 Korea a cross-sectional survey Copenhagen Psychosocial Questionnaire (COPSOQ II) 391 Low risk 51 Sauer 2016 United States cross-sectional descriptive Negative Acts Questionnaire–Revised (NAQR) 2250 Low risk 52 An 2014 Korea descriptive correlational Negative Acts Questionnaire-Revised (NAQ-R) 380 Low risk 53 Tiruneh 2015 Ethiopia hospital based cross-sectional Workplace Violence in the Health Sector by ILO/ICN/WHO/PSI/2003 428 Low risk 54 Fafliora 2014 Greece cross-sectional Workplace Violence in the Health Sector by ILO/ICN/WHO/PSI/2003 120 Low risk 55 Kwok 2003-4 Hong Kong Cross-sectional Workplace Violence in the Health Sector by ILO/ICN/WHO/PSI/2003 1650 Low risk 56 Rowe 2005 United States descriptive Verbal Abuse Scale (VAS) 307 Low risk 57 Campbell 2011 united States cross-sectional Workplace Violence in the Health Sector by ILO/ICN/WHO/PSI/2003 4165 Low risk 58 Hanrahan 2010 united states cross-sectional Practice Environment Scale–Nursing Work Index (PES-NWI 688 Low risk 59 May 2002 united states descriptive, comparative Hospital Assault Survey for Nurses was developed for this study by Deborah 125 Low risk 60 Dehghan-Chaloshtari 2014 Iran descriptive Workplace Violence in the Health Sector by ILO/ICN/WHO/PSI/2003 100 Low risk 61 Cook 2001 united states descriptive Verbal Abuse Scale 200 Low risk Risk of Bias and P ublication Bias The qualitative assessment of the studies by Hoy et al.’s instrument showed low rate of statistical bias in the studies (Table 2 ). As shown in Fig. 2 , 3 , 4 and based on Egger test, there was no publication bias among the studies (P > 0.05). Table 2 Subgroup analysis of incivility prevalence Total Subgroup Number of studies Prevalence (95% CI) Heterogeneity % (p- value) Country classification Developed 33 52.14 42.77, 61.44 % 99.24 (< 0.001) Developing 19 60.19 49.58, 70.34 % 99.25 (< 0.001) Instrument WHO 22 60.68 50.49, 70.42 99.31 (< 0.001) % NAQ 11 39.68 26.24, 53.96 98.59 (< 0.001) % Verbal scale 5 74.47 48.23, 93.67 98.81 (< 0.001) % Other 14 51.16 36.46, 65.76 99.39 (< 0.001) % Setting General 40 47.47 40.57, 45.42 %99.07 (< 0.001) Emergency/acute care 8 77.90 59.81, 91.77 % 98.38 (< 0.001) Psychiatric 6 80.50 75.12, 85.37 % 89.53 (< 0.001) Sampling methods Random 27 87.58 52.49, 92.67 %99.36 (< 0.001) Convenience 20 10.53 53.41,50.64 99.02 (< 0.001)% Not reported 5 58.42 42.11,52.77 99.59 (< 0.001) % Verbal Country classification Developed 14 15.70 29.57, 58.81 98.99% (< 0.001) Developing 21 15.59 49.26, 68.69 99.17% (< 0.001) Instrument WHO 25 75.57 49.22, 65.87 %98.93 (< 0.001) NAQ 1 76.45 70.71, 81.35 0% (< 0.001) Verbal scale 1 24.96 92.77, 98.08 %0 (< 0.001) Other 8 17.74 55.98, 88.86 99.24% (< 0.001) Setting General 25 62.69 53.48, 71.45 %99.15 (< 0.001) Emergency/acute care 4 74.29 47.20, 93.97 %98.18 (< 0.001) Psychiatric 6 60.25 41.67, 77.43 %99.12 (< 0.001) Sampling methods Random 18 66.22 55.28, 76.35 % 99.28 (< 0.001) Convenience 10 60.99 49.36, 72.02 % 98.09 (< 0.001) Not reported 7 60.29 38.19, 80.39 99.23 (< 0.001)% Physical Country classification Developed 14 25.54 14, 39.13 %99.29 (< 0.001) Developing 20 21.23 15, 32.38 %99.17 (< 0.001) Instrument WHO 24 20.15 13.71, 27.46 %99.06 (< 0.001) NAQ 1 72.31 66.36, 77.57 %0 (< 0.001) Verbal scale - - - - Other 9 30.58 16.28, 47.11 % 99.21 (< 0.001) Setting General 24 20.18 14.36, 26.69 98.89% (< 0.001) Emergency/acute care 5 19 8.78, 31.91 94.91% (< 0.001) Psychiatric 5 51.42 24.91, 77.51 99.54% (< 0.001) Sampling methods Random 20 24.54 15.52, 34.85 99.44% (< 0.001) Convenience 9 24.12 11.01, 40.32 99.03% (< 0.001) Not reported 5 22.75 7.73,42.68 98.83% (< 0.001) Sexual Country classification Developed 9 20.67 9.26, 35.12 % 98.91 (< 0.001) Developing 13 9.57 5.41, 14.74 % 97.42 (< 0.001) Instrument WHO 17 10.25 6.11, 15.28 % 97.97 (< 0.001) NAQ - - - - Verbal scale - - - - Other 5 28.04 13.28, 45.73 %97.99 (0.00) Setting General 16 13.18 7.53,20.10 %98.71 (0.00) Emergency/acute care 4 14.09 2.71, 31.93 %96.85 (0.00) Psychiatric 2 22.61 19.37, 26.02 %0 (0.00) Sampling methods Random 14 13.48 8.23, 19.77 %98.02 (0.00) Convenience 6 11.63 0.89, 31.42 %98.02 (0.00) Not reported 1 24.63 21.43, 27.97 %0 (0.00) Mobbing No subgroup 10 35.69 21.23, 51.60 %98.77 (0.00) Psychological No subgroup 7 54.27 30.65,76.92 % 99.58(0.00) CI: Confidence interval However, there was some publication bias regarding the prevalence of incivility in sexual incivility and mobbing (P < 0.05) (Fig. 5 , 6 ). Fig.5. Forest plot based on the population studied the prevalence of sexual incivility in the range of 95% confidence interval Fig.6. Forest plot based on the population studied the prevalence of mobbing in the range of 95% confidence interval Results Of Meta-analysis Of The Studies Based on the results displayed in Table 2 , there was high heterogeneity of the studies. Hence, the random effects model with reverse variance was used. In this way, the total prevalence of incivility was 55.10% (95% CI: 48.5, 62.06), the prevalence of verbal, physical, and sexual incivility and mobbing behavior was 61.63% (95% CI: 56, 95, 70), 15.24% (95% CI: 33.17, 70.31), 67.13% (95% CI: 52.8, 77.19), and 69.35% (95% CI: 23.21, 60.51), respectively (Fig. 7 , 8 , 9 , 10 , and 11 ). Figure 7 − Funnel plot of publication bias of studies of the prevalence of incivility Figure 8 − Funnel plot of publication bias of studies of the prevalence of verbal incivility Figure 9− Funnel plot of publication bias of studies of the prevalence of physical incivility Figure 10 − Funnel plot of publication bias of studies of the prevalence of sexual incivility Figure 11 . Funnel plot of publication bias of studies of the prevalence mobbing The results of heterogeneity of the studies are presented in Table 2 . Since there was an expressive heterogeneity among the studies, the subgroups were analysed. The results demonstrated that the greatest and smallest prevalence rates of incivility pertained to the verbal and sexual aspects. The prevalence of incivility was higher in the studies that used random sampling than other studies, in psychiatric wards than other wards, and more so in developing countries than developed countries. The accumulation curve of the studies is displayed in Figs. 7 , 8 , 9 , 10 , and 11 . The meta-regression test indicated a correlation between publication date and prevalence of incivility, so that its prevalence has decreased over the recent decades (Fig. 12 ). Discussion This systematic review and meta-analysis assessed the prevalence of incivility and violence in nurses using 61 studies. The findings of the study showed a higher than average rate of incivility among nurses. The highest rate belonged to violence and verbal abuse, experienced by almost all nurses during their work experience. Moreover, the prevalence of incivility as mental violence was greater than physical violence and threat. The least rate belonged to sexual violence. The search process showed that studies targeting nurses were more numerous than those targeting other health professions and that the number of studies on other health professions was significantly smaller than the studies on nurses. The number of studies on nursing students was greater than the studies on other groups. The studies showed a higher prevalence of incivility among nurses than other healthcare staff. It appears that the more time the staff spends with patients and other individuals, the greater the rate of incivility will be [ 19 ]. The study by Li et al. (2018) suggested that although the rate of violence against physicians and nurses is high, the rate of incivility towards nurses is higher than that among physicians [ 20 ]. Taylor et al. asserted that more than 80% of nurses render their workplace as unsafe and that the prevalence of verbal and physical threat is high among nurses [ 21 ]. A study conducted by Duncan study reported incivility towards nurses higher than 46% and stated that one-third of nurses have been exposed to physical violence. This study reported that 100% of ER nurses have been exposed to verbal violence and more than 80% to physical violence [ 22 ]. Meta-regression based on publication date indicated that the rate of incivility and violence has decreased over time. One of the reasons that the prevalence of violence has decreased in recent years can be attributed to increased nurses’ awareness of their professional rules and regulations and legal mitigation and pursuit. Awareness of rules and law enables nurses to defend their own rights and therefore diminishing incivility. Nonetheless, the rate of prevalence of verbal violence has not decreased tangibly. The study by Pompeii et al. (2015) and Hsieh et al. (2017) revealed that the greatest rate of incivility belonged to violence and verbal threat [ 23 ]. It appears that poor communication skills, devoting insufficient time, and lack of prompt sharing of information may foster the incidence of verbal incivility. The findings of the study showed that most primary studies were carried out on general hospitals and nurses in various wards; yet, the prevalence of incivility and violence was greater in psychiatric wards than other wards. Furthermore, the incidence of physical incivility was greater in these wards compared to other types of incivility. Verbal incivility was more frequent in the ER and ICU wards compared to other behaviors because ER patients are experiencing a critical situation and it is highly important to settle their situation as quickly and efficiently as possible. The nature and sensitivity of ER means that any shortcoming in organisational and manpower factors would lead to disastrous consequences. Chaotic situation, unpredictable situations, stressful atmospheres, limitations in therapeutic processes for evaluating the effect of therapeutic interventions and care given may predispose ER staff to verbal incivility. Some studies report that nurses in pediatrics, ER, mental health inpatient units, neurology and neurosurgery departments are more frequently exposed to violence. This may result in diminishing intent young nurses to work in such environments [ 24 ]. Our findings suggested the greater prevalence of incivility in developing countries; yet, the prevalence of verbal, physical, and sexual incivility was higher in developed countries. Decreasing reports of sexual violence in these countries may be attributed to cultural reasons. The variety and great number of studies in different countries show that most clinical environments are exposed to the prevalence of incivility and violence among healthcare providers and caregivers. Still, the findings of the study demonstrated that the Asian countries, especially Iran and Taiwan, had the greatest number of studies in this field. This may be attributed to personal factors as well as heavy workload, shortage of manpower, low skills for team work, or lack of management programs for healthcare violence [ 21 ]. Publication bias in studies of sexual harassment can be due to socio-cultural factors. Physical and psychological problems, decreased motivation and commitment to the workplace, consequently leaving work are the consequences of sexual harassment. Organisational factors such as social support and workplace reporting systems, as well as the vulnerability of people such as race, marital status, age, etc. can affect the reporting of this event. Studies show that the atmosphere of the organisation, the sensitivity of the organisation, its support in reducing sexual harassment and encouraging reporting of sexual harassment are effective [ 25 ]. Incivility not only creates a hostile milieu for nurses, but forms a dangerous environment for patients leading to diminished patient satisfaction [ 8 ]. Clark and Springer concluded that inappropriate behaviors may predispose the incidence of medical and nursing errors and poor patient outcomes [ 9 ]. On the other hand, legal mitigation by victims in hostile environments may impose some costs on hospitals. Additionally, work leave, nurse transfer, the spread of hostile environments can affect employment in the organisation and the nurse victims may seek legal consultation possibly affecting the financial affairs, reputation, and credibility of the center [ 8 ]. Consequently, incivility is associated with overwhelming costs of healthcare, increased compensatory payments related to tension with the staff, increased number of legal pursuits, and reduced quality of care given to patients [ 26 ]. The results of studies demonstrate that incivility is the most important factor in nurses’ occupational satisfaction [ 24 ] resulting in reduced responsibility, reduced commitment, increased work leave in nurses that finally influences quality of care, costs and organisational reputation both directly and indirectly. The personnel that experience incivility in workplace deliberately reduce the quality of their work leading to diminished efficacy [ 27 , 28 ]. However, some parameters such as social support, organisational support, presence of transparent rules, enhanced communicative skills, increased level of skills and power in nurses can attenuate the rate of incivility [ 21 ]. In many cases, nurses cannot persue the problems due to absence of centers, committees for managing and recording the incident violence, or due to individuals’ request for pursuit of the problem. Finally, studies report that many nurses stated that there is no site or place in the organisation to report incivility and they are puzzled where to turn to in such conditions. So, many of incivility cases remain unreported. Specifically, junior nurses that experience higher rates of incivility cannot take any appropriate measures in these conditions due to lack of support by coworkers, organisation and poor communication skills. Hence, the incidence of such behaviors is substantiated in the organisational culture. Limitations Of The Study One limitation was inaccessibility of full texts of some papers that was resolved through communicating with the author(s). In addition, the use of different and diverse terms to assess the extent of non-civil behavior has made the studies heterogeneous in this area. Nurses' perceptions of the concept of non-civic behavior were very different. Conclusion The findings of this systematic review and meta-analysis showed that there was a higher than average rate of incivility among nurses. Given the wide range of studies regarding various time, setting, and environments, it appears, that planners and policy-makers should develop programs to decrease violence and increase workplace safety. The healthcare managers and supervisors are aware that disruptive and threatening behavior is a serious problem in the healthcare system. Verbal abuse, refusing to contribute to determined duties and physical threats induce failure of teamwork, interaction and the cooperation required for care provision. Given the highly significant role of nurses in care giving, they deserve to have a safe work environment, similar to other workplaces. Consequently, nursing managers ought to identify the risk factors in the workplace and pay due attention to nurses’ concerns in this regard. Finally, future studies should focus on identification and implementation of effective evidence-based interventions based on organisational culture. Systematic review and meta-analysis findings showed that the prevalence of incivility behaviors among nurses was the higher than average rate. Given the high prevalence of non-verbal behavior and its non-reduction in recent years, nursing managers should identify risk factors in the workplace, especially in the emergency department. Verbal, physical, sexual, and psychological abuse leads to failure in teamwork, interaction and collaboration to provide care to the patient. Given the crucial role nurses play in caring for themselves, they, like other workplaces, have the right to a safe environment. Considering that creating a responsive and supportive organisational environment can help prevent and reduce non-civil behavior and even encourage staff to report a variety of behaviors. To support and plan for empowering and educating nurses to deal with violence and report violence created. Studies should also be designed and implemented to identify and evaluate evidence-based interventions and organisational culture. Abbreviations Not applicable Declarations There is no conflict of interest to disclose. We did not have the funds. All authors, were in close collaboration and responsible for critical revisions of the manuscript. Ethics approval and consent to participate In this study consent to participate not applicable. The research was approved by the organisational ethics committee of Shahid Beheshti University of Medical Sciences (no. IR.SBMU.REC.1398.143 ). Availability of data and materials The authors declare that data supporting the findings of this study are available within the article and its supplementary information files. Acknowledgements The authors would like to acknowledge the efforts of Dr. Mahmoud Yousefifard for their diligent and thoughtful editing of the manuscript. Conflict of interest There is no conflict of interest in this study. Competing interests The authors have no competing interests to declare. Authors' Contribution SM and FA did the planning and design of the study. Electronic search in databases was done by SM, and AB rechecked search terms and syntaxes. GR, contributed significant text and native translation. All authors, FA, SM, AB, GR, were in close collaboration and responsible for critical revisions of the manuscript. All authors read and approved the final manuscript. Funding statement This research received no specific grant from any funding agency in the public, commercial or not-for-profit sectors. References Oxford English Dictionary. http://www.oxforddictionaries.com/us/definition/american_english/civility 2016. Gopalkrishnan P. Workplace incivility and employee strain in reactions: The moderating effects of perceived organisational support and job insecurity. Bowling Green: Bowling Green State University; 2011. Björkqvist K, ÖstermanK, Hjelt-Bäck M. Aggression among university employees. Aggressive behavior.1994; 20(3):173–84. https://doi.org/10.1002/1098-2337(1994)20:33.0.CO;2-D Andersson LM, Pearson CM. Tit for tat? The spiraling effect of incivility in the workplace. Academy of management review. 1999;24(3):452–71. 10.5465/AMR.1999.2202131 . Hosseinpour-Dalenjan L, Atashzadeh-Shoorideh F, Hosseini M, Mohtashami J. The correlation between nurses’ work engagement and workplace incivility. Iranian Red Crescent Medical Journal. 2017; 19(4). doi: 10.5812/ircmj.45413 . Hershcovis MS, Barling J. Towards a relational model of workplace aggression. United Kingdom: Edward Elgar; 2007. Lim S, Cortina LM, Magley VJ. Personal and workgroup incivility: Impact on work and health outcomes. J Appl Psychol. 2008;93(1):95–107. https://doi.org/10.1037/0021-9010.93.1.95 . Hoffman RL, Chunta K. Workplace incivility: promoting zero tolerance in nursing. J Radiol Nurs. 2015;34(4):222–7. http://dx.doi.org/10.1016/j.jradnu.2015.09.004 . Clark CM, Springer PJ. Academic nurse leaders’ role in fostering a culture of civility in nursing education. J Nurs Educ. 2010;49(6):319–25. DOI: 10.3928/01484834-20100224-01 . Azami M, Moslemirad M, YektaKooshali MH, Rahmati S, Soleymani A, Shamloo MBB, et al. Workplace violence against Iranian nurses: a systematic review and meta-analysis. Violence victims. 2018;33(6):1148–75. doi: 10.1891/0886-6708.33.6.1148 . Dalvand S, Gheshlagh RG, Najafi F, Zahednezhad H, Sayehmiri K, Eghtedari M, et al. The Prevalence of Workplace Violence against Iranian Nurses: A Systematic Review and Meta-Analysis. Shiraz E Medical Journal.2108; 19(9). DOI: 10.5812/semj.65923 . D'ambra AM, Andrews DR. Incivility, retention and new graduate nurses: an integrated review of the literature. J Nurs Manag. 2014;22(6):735–42. doi: 10.1111/jonm.12060 . Epub 2013 Aug 9. Edward K, Ousey K, Warelow P, Lui S. Nursing and aggression in the workplace: a systematic review. British Journal of Nursing. 2014;23(12):653–9. https://doi.org/10.12968/bjon.2014.23.12.653 . Hawkins N, Jeong S, Smith T. New graduate registered nurses’ exposure to negative workplace behaviour in the acute care setting: An integrative review. International journal of nursing studies. 2019;93:41–5. DOI: 10.1016/j.ijnurstu.2018.09.020 . Zhu Z, Xing W, Lizarondo L, Guo M, Hu Y. Nursing students’ experiences with faculty incivility in the clinical education context: a qualitative systematic review and meta-synthesis. BMJ open.019; 9(2):e024383. DOI: 10.1136/bmjopen-2018-024383 . Hodgins M, MacCurtain S, Mannix-McNamara P. Workplace bullying and incivility: a systematic review of interventions. International Journal of Workplace Health Management. 2014;7(1):54–72. DOI 10.1108/IJWHM-08-2013-0030 . Stroup DF, Berlin JA, Morton SC, Olkin I, Williamson GD, Rennie D, et al. Meta-analysis of observational studies in epidemiology: a proposal for reporting. Meta-analysis Of Observational Studies in Epidemiology (MOOSE) group. JAMA. 2000;283(15):2008–12. DOI: 10.1001/jama.283.15.2008 . Hoy D, Brooks P, Woolf A, Blyth F, March L, Bain C, et al. Assessing risk of bias in prevalence studies: modification of an existing tool and evidence of interrater agreement. J Clin Epidemiol. 2012;65(9):934–9. https://doi.org/10.1016/j.jclinepi.2011.11.014 . Phillips JP. Workplace violence against health care workers in the United States. New England journal of medicine. 2016;374(17):1661–9. DOI: 10.1056/NEJMra1501998 . Li P, Xing K, Qiao H, Fang H, Ma H, Jiao M, et al. Psychological violence against general practitioners and nurses in Chinese township hospitals: incidence and implications. Health Qual Life Outcomes. 2018;16(1):117. https://doi.org/10.1186/s12955-018-0940-9 . Taylor JL, Rew L. A systematic review of the literature: workplace violence in the emergency department. Journal of clinical nursing. 2011;20(7-8):1072–85. doi: 10.1111/j.1365-2702.2010.03342.x . Duncan S, Estabrooks CA, Reimer M. Violence against nurses. Alberta RN. 2000;56(2):13. Pompeii LA, Schoenfisch AL, Lipscomb HJ, Dement JM, Smith CD, Upadhyaya M. Physical assault, physical threat, and verbal abuse perpetrated against hospital workers by patients or visitors in six US hospitals. Am J Ind Med. 2015;58(11):1194–204. http://dx.doi.org/10.1002/ajim.22489 . Martinez AJS. Managing workplace violence with evidence-based interventions: a literature review. Journal of psychosocial nursing mental health services. 2016;54(9):31–6. DOI: 10.3928/02793695-20160817-05 . 10.1037/1076-8998.13.2.152 Bergman ME, Henning JB. Sex and ethnicity as moderators in the sexual harassment phenomenon: A revision and test of Fitzgerald et al.(1994). Journal of Occupational Health Psychology. 2008; 13(2):152. https://doi.org/10.1037/1076-8998.13.2.152 . Montalvo L. Civility and Incivility Between Nurses and Administrators: A Model to Drive Successful Health Care Outcomes in the Department of Veterans Affairs: University of Maryland University College; 2013. Spence Laschinger HK, Finegan J, Wilk P. New graduate burnout: The impact of professional practice environment, workplace civility and empowerment. Nursing Economic. 2009a;27(6):377–83. Spence Laschinger HK, Leiter M, Day A, Gilin D. Workplace empowerment, incivility, and burnout: impact on staff nurse recruitment and retention outcomes. J Nurs Manag. 2000b;17(3):302–11. DOI: 10.1111/j.1365-2834.2009.00999.x . Cite Share Download PDF Status: Published Journal Publication published 03 Nov, 2021 Read the published version in Journal of Medical Ethics and History of Medicine → Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-35232","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research article","associatedPublications":[],"authors":[{"id":690807,"identity":"23e4baff-2cb5-4cbd-abf2-eb9c402cb576","order_by":0,"name":"Foroozan Atashzadeh-Shoorideh","email":"","orcid":"","institution":"Shaheed Beheshti University of Medical Sciences","correspondingAuthor":false,"prefix":"","firstName":"Foroozan","middleName":"","lastName":"Atashzadeh-Shoorideh","suffix":""},{"id":690808,"identity":"2add2d1a-52f4-4f61-a54f-835b9c8db493","order_by":1,"name":"Soolmaz Moosavi","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA+UlEQVRIiWNgGAWjYPACCRDBeABIyDEw8BCvhQGkxZhYLQxwLYkNhLTotjcf/vCzzYJBvr35wKEbNXXpG46fPfjgA4OdnG4Ddi1mZ46lSfa2STAYnDmWcDjnGFvuhjN5yYYzGJKNzQ7g0HIjx4yB5wxQi0SOweEcNp7cDQdyzKR5GA4kbsOtxfjjH6AW+RkgLf8k0g3OvyGoxUCapwIYYkDG4dw2gwSDG4RsAfpFWqZCggfsl9y+BMOZN94YG84wwOOX482HP74xqJMDhtjBxznf6uT5zucYPvhQYSeHSwsMIOJCAazSAL9yVCDfQIrqUTAKRsEoGAkAAI2cXrgGrcgWAAAAAElFTkSuQmCC","orcid":"https://orcid.org/0000-0002-2095-283X","institution":"Shaheed Beheshti University of Medical Sciences","correspondingAuthor":true,"prefix":"","firstName":"Soolmaz","middleName":"","lastName":"Moosavi","suffix":""},{"id":690809,"identity":"4883ca69-9b9d-4e87-8736-ac9a505221d2","order_by":2,"name":"Abbas Balouchi","email":"","orcid":"","institution":"Tehran University of Medical Sciences","correspondingAuthor":false,"prefix":"","firstName":"Abbas","middleName":"","lastName":"Balouchi","suffix":""},{"id":690810,"identity":"7f8602d2-657d-4173-b923-aa2267cf6668","order_by":3,"name":"Georgina Riley","email":"","orcid":"","institution":"London South Bank University","correspondingAuthor":false,"prefix":"","firstName":"Georgina","middleName":"","lastName":"Riley","suffix":""}],"badges":[],"createdAt":"2020-06-12 04:57:32","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-35232/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-35232/v1","draftVersion":[],"editorialEvents":[{"content":"https://doi.org/10.18502/jmehm.v14i15.7670","type":"published","date":"2021-11-03T05:41:05+00:00"}],"editorialNote":"","failedWorkflow":false,"files":[{"id":1375133,"identity":"f5f851e7-c35d-4049-9684-b60c5483cdd9","added_by":"auto","created_at":"2020-06-19 19:05:01","extension":"jpg","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":74291,"visible":true,"origin":"","legend":"The search flowchart for articles in databases based on the PRISMA 2009 checklist","description":"","filename":"Figure1.jpg","url":"https://assets-eu.researchsquare.com/files/rs-35232/v1/Figure1.jpg"},{"id":1375134,"identity":"1084b410-8654-4a75-b4db-7a2657cfcc5c","added_by":"auto","created_at":"2020-06-19 19:05:01","extension":"jpg","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":140867,"visible":true,"origin":"","legend":"Forest plot based on the population studied the prevalence of incivility in the range of 95% confidence interval","description":"","filename":"Figure2.jpg","url":"https://assets-eu.researchsquare.com/files/rs-35232/v1/Figure2.jpg"},{"id":1375135,"identity":"f68e1b3e-8909-421f-90d4-ce468b44ea46","added_by":"auto","created_at":"2020-06-19 19:05:01","extension":"jpg","order_by":3,"title":"Figure 3","display":"","copyAsset":false,"role":"figure","size":111843,"visible":true,"origin":"","legend":"Forest plot based on the population studied the prevalence of verbal incivility in the range of 95% confidence interval","description":"","filename":"Figure3.jpg","url":"https://assets-eu.researchsquare.com/files/rs-35232/v1/Figure3.jpg"},{"id":1375136,"identity":"219f6c48-ca36-4de4-9086-ba4a66c42a1a","added_by":"auto","created_at":"2020-06-19 19:05:01","extension":"jpg","order_by":4,"title":"Figure 4","display":"","copyAsset":false,"role":"figure","size":109170,"visible":true,"origin":"","legend":"Forest plot based on the population studied the prevalence of physical incivility in the range of 95% confidence interval","description":"","filename":"Figure4.jpg","url":"https://assets-eu.researchsquare.com/files/rs-35232/v1/Figure4.jpg"},{"id":1375137,"identity":"8a45d959-ec46-4689-a17e-f0823b4c20c9","added_by":"auto","created_at":"2020-06-19 19:05:02","extension":"jpg","order_by":5,"title":"Figure 5","display":"","copyAsset":false,"role":"figure","size":78823,"visible":true,"origin":"","legend":"Forest plot based on the population studied the prevalence of sexual incivility in the range of 95% confidence interval","description":"","filename":"Figure5.jpg","url":"https://assets-eu.researchsquare.com/files/rs-35232/v1/Figure5.jpg"},{"id":1375138,"identity":"91018709-2132-4a02-a944-ca6e337975fc","added_by":"auto","created_at":"2020-06-19 19:05:02","extension":"jpg","order_by":6,"title":"Figure 6","display":"","copyAsset":false,"role":"figure","size":55176,"visible":true,"origin":"","legend":"Forest plot based on the population studied the prevalence of mobbing in the range of 95% confidence interval","description":"","filename":"Figure6.jpg","url":"https://assets-eu.researchsquare.com/files/rs-35232/v1/Figure6.jpg"},{"id":1375139,"identity":"0c4444be-67a3-4263-a598-b31760707935","added_by":"auto","created_at":"2020-06-19 19:05:02","extension":"jpg","order_by":7,"title":"Figure 7","display":"","copyAsset":false,"role":"figure","size":33032,"visible":true,"origin":"","legend":"Funnel plot of publication bias of studies of the prevalence of incivility ","description":"","filename":"Figure7.jpg","url":"https://assets-eu.researchsquare.com/files/rs-35232/v1/Figure7.jpg"},{"id":1375140,"identity":"506b1470-dcf5-4f3d-8627-95d9bc831e28","added_by":"auto","created_at":"2020-06-19 19:05:02","extension":"jpg","order_by":8,"title":"Figure 8","display":"","copyAsset":false,"role":"figure","size":30268,"visible":true,"origin":"","legend":"Funnel plot of publication bias of studies of the prevalence of verbal incivility","description":"","filename":"Figure8.jpg","url":"https://assets-eu.researchsquare.com/files/rs-35232/v1/Figure8.jpg"},{"id":1375141,"identity":"3390dbcb-3d50-4575-bce2-befd0f0bb989","added_by":"auto","created_at":"2020-06-19 19:05:02","extension":"jpg","order_by":9,"title":"Figure 9","display":"","copyAsset":false,"role":"figure","size":30452,"visible":true,"origin":"","legend":"Funnel plot of publication bias of studies of the prevalence of physical incivility","description":"","filename":"Figure9.jpg","url":"https://assets-eu.researchsquare.com/files/rs-35232/v1/Figure9.jpg"},{"id":1375142,"identity":"3ce07a11-5c14-4928-89f2-330236a30034","added_by":"auto","created_at":"2020-06-19 19:05:03","extension":"jpg","order_by":10,"title":"Figure 10","display":"","copyAsset":false,"role":"figure","size":25987,"visible":true,"origin":"","legend":"Funnel plot of publication bias of studies of the prevalence of sexual incivility","description":"","filename":"Figure10.jpg","url":"https://assets-eu.researchsquare.com/files/rs-35232/v1/Figure10.jpg"},{"id":1375143,"identity":"ee1ec5aa-7496-4422-8ecd-54069fefbbd5","added_by":"auto","created_at":"2020-06-19 19:05:03","extension":"jpg","order_by":11,"title":"Figure 11","display":"","copyAsset":false,"role":"figure","size":26783,"visible":true,"origin":"","legend":"Funnel plot of publication bias of studies of the prevalence mobbing","description":"","filename":"Figure11.jpg","url":"https://assets-eu.researchsquare.com/files/rs-35232/v1/Figure11.jpg"},{"id":1375144,"identity":"119c9219-99ba-49e2-b35c-3b0535953cd1","added_by":"auto","created_at":"2020-06-19 19:05:03","extension":"jpg","order_by":12,"title":"Figure 12","display":"","copyAsset":false,"role":"figure","size":37330,"visible":true,"origin":"","legend":"Metaregression of Prevalence of incivility based on year of publication","description":"","filename":"Figure12.jpg","url":"https://assets-eu.researchsquare.com/files/rs-35232/v1/Figure12.jpg"},{"id":19271575,"identity":"5d0f5ba5-983c-4592-8539-3d9dc2f99191","added_by":"auto","created_at":"2022-03-16 05:41:13","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1044451,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-35232/v1/c9ad1137-203b-4fe9-88eb-729244c3fd90.pdf"}],"financialInterests":"","formattedTitle":"Incivility towards nurses: A Systematic Review and Meta-analysis","fulltext":[{"header":"Background","content":" \u003cp\u003eCivility is defined as being polite and kind in mood and speech. Civil behavior refers to polite behavior toward others and ensuring that their dignity is maintained. On the contrary, incivility is defined as the negative behavior of insulting others or violating the common norms of behavior in the workplace [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]. Incivility is a new concept in the psychology of occupational health [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e] with most of the related literature being published at the beginning of the current century. In recent years, the increasing number of publications on this topic indicates that incivility occurs more frequently in the work environment compared to other extreme behaviors. A study by Bjorkqvist et al. (1994) showed that 32% of the participants had experienced incivility [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eIncivility was first defined by Anderson \u0026amp; Pearson (1999) as \u0026ldquo;negative behaviors with low-intensity and unclear intention that damages the targeted person\u0026rdquo; [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e]. Nonetheless, terms such as lateral violence, disruptive behavior, abuse, conflict, bullying, and aggression are used to describe incivility. These behaviors occur frequently in healthcare environments, lead to numerous negative consequences and can lead to more severe violence [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e, \u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eUncivil behaviors include verbal abuse, nonverbal abuse, sexual harassment, and passive aggressive behavior. Verbal abuse involves shouting, raising a voice, in a hostile manner or threatening a person verbally overt scolding or criticism, the use of insulting and disgracing words, disrespectful tones, impoliteness, sarcastic behavior, threatening, and humiliation [\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e]. Nonverbal abuse includes raising the eyebrows, tightening the eyes, scowling, creating physical distance, excluding one from conversations, and/or invading someone\u0026rsquo;s privacy [\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eSexual harassment includes inappropriate behaviors that could be construed to have sexual intention, inappropriate sexual jokes, words that are sexual in nature, unwanted sexual advances, requests for sex, and accidental sexual contact [\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e]. Passive aggressive behaviors in the workplace can be as destructive as uncivil behaviors. Passive aggressive behaviors include lack of support for colleagues, planning to defeat the work opponent, refusing to communicate with an individual, impatience with other people\u0026rsquo;s questions, and manifesting a negative attitude, all of which affect colleagues\u0026rsquo; confidence [\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eStudies on incivility in the work environment suggest that it is often produced by emotionally annoying interactions due to inappropriate demonstration of anger and anguish, being overworked, tension, lack of communication, heavy workload, occupational insecurity, organisational change, poor work organisation, differences in social power, and reciprocal relation of duties [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]. These variables, as stressors, may lead to depression and negative physical symptoms. Experience of incivility in the work environment is negatively correlated with psychosomatic health [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e] and is recognised as the prerequisite for many aggressive behaviors and violence in work environment [\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eGenerally, creation and maintenance of a safe work environment forms one part of the nursing role. Disruptive behaviors negatively affect patient outcomes and nursing performance. Nurses should support patients through dealing with disruptive behavior to create and maintain a safe environment for giving quality care.\u003c/p\u003e \u003cp\u003eSeveral studies examined prevalence of incivility in nurses in specific countries or regions, however, no studies have estimated the overall prevalence of nurses\u0026rsquo; incivility globally and only a few included meta-analysis. A review of previous studies showed that few studies have focused on incivility. Aazami et al.\u0026rsquo;s study (2018) investigated Iranian incivility towards nurses. The researcher in this study searched the databases \u0026ldquo;Magiran, Barakat Knowledge Network System, IranDoc, Regional Information Center for Science and Technology (RICST), Scientific Information Database (SID), Iranian National Library, PubMed/Medline, Cochrane Library, Scopus, Science Direct, ISI Web of Knowledge, CINAHL, and Google Scholar\u0026rdquo; up to 2017. In 26 studies, the rate of prevalence of variables under study including violence and verbal, physical, sexual, and racial threat in the work environment were 80.8%, 24.8%, 6.14%, and 44%, respectively [\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eThe systematic review by Dalvand et al. (2018) was carried out to assess violence in Iranian nurses\u0026rsquo; work place. In addition, 22 studies were extracted from databases \u0026ldquo;IranMedex, Google Scholar, MagIran, SID, Scopus, Web of Science, PubMed, and Science Direct\u0026rdquo; and evaluated. The results showed that 74% of nurses are exposed to verbal violence and 28% to physical violence. Previous research showed high prevalence of workplace violence toward nurses [\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eThe systematic review by D\u0026rsquo;ambra \u0026amp; Andrews (2013) was aimed at assessing the effect of incivility on recently-graduated nurses. The researchers searched CINAHL, PsychInfo, and MEDLINE-EBSCOhost to extract English papers published during 2002\u0026ndash;2012. Sixteen papers were extracted indicating that incivility in workplace is an important predictor of low job satisfaction among beginner nurses [\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eThe systematic review by Edward et al. (2017) was conducted on the correlation between workplace violence and nurses\u0026rsquo; anxiety. The databases \u0026ldquo;PsychInfo and MEDLINE-CINAHL\u0026rdquo; were searched up to 2013 and 53 papers were selected to be reviewed. The results demonstrated that nurses in emergency wards are more frequently exposed to verbal violence than other wards. The most frequent time of exposure to violence was at the point of direct care of patients and violence was either by the patients or by their attendants. Nurses did not report the violence due to various organizational reasons [\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eThe review study of sources by Hawkins et al. (2018) assessed beginner nurses\u0026rsquo; experiences with negative behaviors. The databases \u0026ldquo;CINAHL, MEDLINE, ProQuest, JBI, and Scopus\u0026rdquo; were searched for the 2007\u0026ndash;2017 and eight qualitative and eight quantitative studies were assessed. The findings suggested that between 3% and 57% of the nurses experienced negative behaviors leading to depression, anxiety and work leave among nurses [\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eThe systematic review by Zhu et al. (2019) aimed to explore incivility experience in nursing students. The databases \u0026ldquo;CINAHL, PubMed (MEDLINE), ProQuest Central, ProQuest Education Journals, ProQuest XML-Dissertations and Theses, Web of Science, Embase, EBSCO Discovery Service and PsycINFO\u0026rdquo; were searched for studies published during 1990\u0026ndash;2018. The results showed that nursing students experienced incivility during their clinical training and the importance of the manager's role in reducing these behaviors [\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eFinally, the systematic review by Hodgins et al. (2013), aimed at assessing effective interventions for decreasing violence and incivility in workplace, was searched in \u0026ldquo;ASIA, Emerald, Ovid, JSTOR Web of Science, EBSCO: Academic Search Complete, Embase, Medline, Social Care Online, Science Direct, and Scopus\u0026rdquo;. Twelve studies were investigated. The results revealed that weak interpersonal communication was one of the most important causes of incivility. Training and awareness of incivility and violence can be effective in reducing the incidence of these behaviors [\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e]. Consequently, our systematic review and meta-analysis answered the following question: What is the rate of incivility in Iranian nurses\u0026rsquo; workplace?\u003c/p\u003e "},{"header":"Methods","content":"\u003cp\u003e\u003cstrong\u003eDesign of the Study\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis systematic review was conducted on observational studies concerning the prevalence of incivility towards nurses\u0026rsquo; workplace. To achieve the goals, the guideline \u0026ldquo;Meta-analysis of observational studies in epidemiology (MOOSE)\u0026rdquo; was used [17].\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eInclusion Criteria\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAll observational studies (descriptive and analytical) focusing on investigation of the rate of prevalence of incivility towards nurses were selected, regardless of the sampling method they had used. Letters-to-the-editor, protocols, review studies, case series, case reports and studies with sample volumes less than 25 were excluded from the study. In addition, the studies that had used researcher-made instruments to examine incivility, repetitious studies, and non-reporting of prevalence incivility were excluded from the study. There were no limitations in the language of the studies, and free-of-charge translators like ImTranslator, Bing, Google Translate, and Applied Languages were used to translate papers into other languages.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eSearch Strategy\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eIn this study, the databases \u0026ldquo;Medline (via PubMed), Embase, Scopus, Web of Science, IranDoc, and Magiran\u0026rdquo; were searched for works published during January 1, 1996 to December 31, 2019. Moreover, the studies related to these, dissertations and conference papers were searched. The search strategy is given in Medline following Script:\u003c/p\u003e\n\u003cp\u003e(((Incivility[Title/Abstract] OR Uncivil Behavior*[Title/Abstract] OR Workplace Incivility[Title/Abstract] OR Rudeness[Title/Abstract] OR Bullying[Title/Abstract] OR abuse[Title/Abstract] OR lateral violence[Title/Abstract] OR horizontal violence[Title/Abstract] OR relational aggression[Title/Abstract] OR workplace violence[Title/Abstract] OR negative act*[Title/Abstract] OR negative behavior*[Title/Abstract] OR disruptive behavior*[Title/Abstract] OR horizontal hostility[Title/Abstract])) OR incivility[MeSH Terms])) AND (Nurs*[Title/Abstract] OR Personnel Nurs*[Title/Abstract] OR Registered Nurs*[Title/Abstract] OR caregiver*[Title/Abstract])) AND (prevalence [Title/Abstract] OR incidence [Title/Abstract] OR frequency [Title/Abstract] OR occurrence [Title/Abstract] OR burden [Title/Abstract] OR epidemiology [Title/Abstract])\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eData Extraction\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eTwo independent researchers (SM, AB) completed the initial screening of the studies based on titles and abstracts. In the next stage, the two researchers (SM, FA) studied the full texts of papers supposed to have reported consequences in more detail. Then, the relevant papers were outlined in a checklist.\u003c/p\u003e\n\u003cp\u003eData such as study features including author(s), publication date, and type of journal, setting of the study, goals, design, and type of study, sample volume, sampling method, and characteristics of the participants such as age, gender, ward, and work experience were extracted. In all of these stages, any disagreement or conflict between the two researchers was settled by consensus via bilateral debate or by a third party.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eQualitative Assessment\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe selected studies were assessed qualitatively using Hoy\u0026rsquo;s Critical Assessment Checklist that consists of 10 items. Items 1-4 assess external validity (target population, sampling framework, sampling method, and bias of lack of responding), items 5-9 assess internal validity (data collection method, case definition, and instruments), and item 10 evaluates analytical bias [18]. This assessment was completed by two people independently. Any conflict was solved by debate and consensus or finally by third party intervention.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eData Analysis\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eData were analysed by STATA14.0 statistical package (College Station, TX: Stata Corp LLC). The prevalence data of the studies were pooled and using \u0026ldquo;\u003cem\u003emetaprop one\u003c/em\u003e\u0026rdquo; command, a pooled prevalence with a 95% confidence interval (95% CI) was reported. I\u003csup\u003e2\u003c/sup\u003e was used for assessing heterogeneity. Subgroup analysis and meta-regression were used for finding the potential sources of heterogeneity. The funnel plot was used to assess the small study effect (Publication bias).\u003c/p\u003e"},{"header":"Results","content":" \u003cdiv id=\"Sec10\" class=\"Section2\"\u003e \u003ch2\u003eDescription of the Studies\u003c/h2\u003e \u003cp\u003eFirstly, 6876 studies were identified from the electronic databases. After duplicate studies were removed and those not meeting inclusion criteria, finally 61 studies are covered in this review. The number of the extracted studies in terms of databases was as follows: PubMed: 1391, Web of Science: 225, Scopus: 3190, and EMBASE: 2070. After omitting 3451 repetitious studies, 3425 studies entered the screening phase and 3235 irrelevant studies were excluded. Next, 189 studies entered the full text reading stage, of which 128 studies were excluded due to differences in participants (69 cases) and study design (60 cases) so that finally, 61 studies entered the study (Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003eFigure\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e. The search flowchart for articles in databases based on the PRISMA 2009 checklist\u003c/p\u003e \u003cp\u003eThe 61 studies were conducted between 1997 to 2019 used 30801 participants. Characteristics of the selected works are given in Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e. The largest and smallest participants of the studies were 3835 and 80, respectively. Most studies pertained to Asian countries (n\u0026thinsp;=\u0026thinsp;34) followed by America (n\u0026thinsp;=\u0026thinsp;15), Africa (n\u0026thinsp;=\u0026thinsp;8), and Europe (n\u0026thinsp;=\u0026thinsp;4). Among the Asian countries, Iran and Taiwan (n\u0026thinsp;=\u0026thinsp;5) had the greatest number of studies. The number of studies was 30 in developed and 31 in developing countries. 19 studies used random sampling, 5 studies census sampling and 15 studies convenient sampling. Seven studies have not explained the sampling method clearly. 45 studies used cross-sectional design and 16 studies were descriptive. The minimal rate of response was 3% and the maximal rate was 100%. Three studies had not reported response rate. 6 studies were performed on psychiatrics, 6 on emergency care, and 2 on ICU. Most studies (n\u0026thinsp;=\u0026thinsp;47) involved general hospitals and all wards. The most frequently used instruments were \u0026ldquo;Workplace Violence in the Health Sector\u0026rdquo; established with the cooperation of the International Labor Organization (ILO), the WHO, the ICN, and the PSI in 2003 (27 cases) and \u0026ldquo;Negative Acts Questionnaire\u0026rdquo; (eight cases).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eStudies included in the systematic review (N\u0026thinsp;=\u0026thinsp;61)\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"8\"\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eID\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAuthor\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eYear\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eCountry\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eDesign\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003eInstrument\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003eSample. Size\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c8\"\u003e \u003cp\u003eQuality assessment\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSauer\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2016\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eUnited states\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003edescriptive survey\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eNegative Acts Questionnaire\u0026ndash;Revised (NAQR)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e2250\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eLow risk\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eHeydari\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2015\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eIran\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003edescriptive, cross -sectional\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003ePerceived workplace civility climate scale (PWCC)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e200\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eLow risk\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eBudin\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2013\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eUnited states\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003edescriptive survey\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eVerbal Abuse Scale (VAS) developed by Manderino and Banton\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e2007\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eLow risk\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eLu\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2019\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eChina\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003ecross-sectional\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eworkplace violence scale developed by Chen ZH's group\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e2124\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eLow risk\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eTsukamoto\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2019\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eBrazil\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003ecross-sectional\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eAssessing violence in work suffered or witnessed by nursing staff developed by Bordignon and Monteiro\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e242\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eLow risk\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eJaradat\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2018\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003ePalestine\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003ecross-sectional\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eWorkplace Violence in the Health Sector by ILO/ICN/WHO/PSI/2003\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e372\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eLow risk\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCheung\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2017\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eHong Kong\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003ecross-sectional\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eWorkplace Violence in the Health Sector by ILO/ICN/WHO/PSI/2003\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e16082\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eLow risk\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eBoafo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2015\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eGhana\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003ecross-sectional\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eWorkplace Violence in the Health Sector by ILO/ICN/WHO/PSI/2003\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e1021\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eLow risk\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAlkorashy\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2016\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eSaudi Arabia\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003ecross-sectional\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eWorkplace Violence/ Abuse conducted by the Massachusetts Nurses Association Congress\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e500\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eLow risk\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFute\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2014\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eEthiopia\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003ecross-sectional\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eWorkplace Violence in the Health Sector by ILO/ICN/WHO/PSI/2003\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e660\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eLow risk\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e11\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eBaran Aksakal\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2011\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eTurkey\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003ecross-sectional\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eWorkplace Violence in the Health Sector by ILO/ICN/WHO/PSI/2003\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e650\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eLow risk\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e12\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAbou-ElWafa\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2015\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eEgypt\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003ecross-sectional comparative\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eWorkplace Violence in the Health Sector by ILO/ICN/WHO/PSI/2003\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e286\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eLow risk\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e13\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eBambi\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2014\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eItaly\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003ecross-sectional\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eLH questionnaire developed by Alspach\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e1504\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eLow risk\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e14\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eGali\u0026aacute;n-Mu\u0026ntilde;oz\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2013\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eSpain\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003edescriptive study\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eHABS-U scale (Hospital Aggressive Behavior Scale-User)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e200\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eLow risk\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e15\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eLemelin\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2003\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eCanada\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003edescriptive\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eWorkplace Violence Events Questionnaire by Anderson (2002)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e300\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eLow risk\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e16\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eManderino\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1997\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eUnited states\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003edescriptive-correlational design\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eVerbal Abuse Scale (VAS)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e300\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eLow risk\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e17\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eChen\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2012\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eTaiwan\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003edescriptive-correlational design\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eWorkplace Violence in the Health Sector by ILO/ICN/WHO/PSI/2003\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e1004\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eLow risk\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e18\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSuhaila\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2012\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eMalaysia\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003ecross-sectional\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eUtara Sexual Harassment Questionnaire (USHQ) by Sabitha\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e455\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eLow risk\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e19\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eKhademloo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2013\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eIran\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003ecross-sectional\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eStaff Observation Scale Revised (SOAS-R) by Nijman and colleagues\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e440\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eLow risk\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e20\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFallahi Khoshknab\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2011\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eIran\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003ecross-sectional\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eWorkplace Violence in the Health Sector by ILO/ICN/WHO/PSI/2003\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e200\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eLow risk\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e21\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eBerry\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2011\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eUnited states\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003edescriptive cross-sectional survey\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eNegative Acts Questionnaire\u0026ndash;Revised (NAQR)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e5000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eLow risk\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e22\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAhmed\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2012\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eJordan\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003ecross-sectional descriptive\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eWorkplace Violence in the Health Sector by ILO/ICN/WHO/PSI/2003\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e500\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eLow risk\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e23\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePai\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2011\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eTaiwan\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003ecross-sectional descriptive\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eWorkplace Violence in the Health Sector by ILO/ICN/WHO/PSI/2003\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e700\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eLow risk\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e24\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAbuAlRub\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2008\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eJordan\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003edescriptive\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eWorkplace Violence in the Health Sector by ILO/ICN/WHO/PSI/2003\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e496\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eLow risk\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e25\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eHsieh\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2016\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eTaiwan\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003ecross-sectional\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eNegative Acts Questionnaire\u0026ndash;Revised (NAQR)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e550\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eLow risk\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e26\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eHampton\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2018\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eUnited states\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003ecross-sectional descriptive\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eNegative Acts Questionnaire\u0026ndash;Revised (NAQR)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e175\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eLow risk\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e27\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eZhao\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2015\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eChina\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003emulti-stage cross-sectional\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eWorkplace Violence Scale (WVS) \u003csup\u003edeveloped by Schat (Schat \u0026amp; Kelloway, 2003\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e1013\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eLow risk\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e28\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNoorana Zahra\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2018\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eIndonesia\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003ecross-sectional descriptive\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eWorkplace Violence in the Health Sector by ILO/ICN/WHO/PSI/2003\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e245\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eLow risk Low risk\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e29\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eZhang\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2014\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eChina\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003ecross-sectional descriptive\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eWorkplace Violence in the Health Sector by ILO/ICN/WHO/PSI/2003\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e4123\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eLow risk\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e30\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eKaratza\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2013\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eGreece\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003ecross-sectional descriptive\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eNegative Acts Questionnaire\u0026ndash;Revised (NAQR)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e1000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eLow risk\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e31\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eJafree\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2013-4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003ePakistan\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003ecross-sectional descriptive\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eWorkplace Violence in the Health Sector by ILO/ICN/WHO/PSI/2003\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e804\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eLow risk\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e32\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eRidenour\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2015\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eUnited states\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003ecross-sectional descriptive\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eNegative Acts Questionnaire\u0026ndash;Revised (NAQR)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e284\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eLow risk\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e33\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eEstes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2013\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eUnited states\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eanonymous mail survey\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eOrganizational deviance scale developed by Bennett and Robinson (2000)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e1524\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eLow risk\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e34\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eEsmaeilpour\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2011\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eIran\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003ecross-sectional descriptive\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eWorkplace Violence in the Health Sector by ILO/ICN/WHO/PSI/2003\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e196\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eLow risk\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e35\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFujishiro\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2011\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003ePhilippines\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003ecross-sectional\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e(ANA's) 2001 Health and Safety Survey\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e1000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eLow risk\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e36\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAbbas\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2010\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eEgypt\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003ecross-sectional\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eWorkplace Violence in the Health Sector by ILO/ICN/WHO/PSI/2003\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e1600\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eLow risk\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e37\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eShiao\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2010\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eTaiwan\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003ecross-sectional\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eRosenberg et al. (1992) and the National Crime Victimization Survey (NCVS) (Warchol\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e1228\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eLow risk\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e38\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYildirim\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2009\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eTurkey\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003ecross-sectional\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eNurses\u0026rsquo; Perception of Bullying In the Workplace, Developed By Dilek \u0026amp; Aytolan (2008)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eLow risk\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e39\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eJoubert\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2005\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eSouth Africa.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003ecross-sectional\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eVerbal Abuse Scale developed by Manderino\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e120\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eLow risk\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e40\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eHonarvar\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2017-8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eIran\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003ecross-sectional\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eWorkplace Violence in the Health Sector by ILO/ICN/WHO/PSI/2003\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e420\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eLow risk\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e41\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYun\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2012\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eKorea\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003ecross-sectional\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eNegative Act Questionnaire-Revised (NAQ-R)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e170\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eLow risk\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e42\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMaio\u0026nbsp;T\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2015\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eAzorean Island\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003edescriptive-correlational design\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eNegative Act Questionnaire-Revised (NAQ-R)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eLow risk\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e43\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eJiao\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2013\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eChina\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003ecross-sectional\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eWorkplace Violence in the Health Sector by ILO/ICN/WHO/PSI/2003\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e700\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eLow risk\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e44\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003epark M, Choi J.S\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2018\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eKorea\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003ecross-sectional\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003efarley wokplace cyberbullying measuremennt\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e260\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eLow risk\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e45\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNiu\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2019\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eTaiwan\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003ecross-sectional\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eWorkplace Violence in the Health Sector by ILO/ICN/WHO/PSI/2003\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e480\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eLow risk\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e46\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eObeidat\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2018\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eAmman\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003ecross-sectional\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eNegative Act Questionnaire-Revised (NAQ-R)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e340\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eLow risk\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e47\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePandey\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2018\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eNepal\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003edescriptive cross-sectional\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eWorkplace Violence in the Health Sector by ILO/ICN/WHO/PSI/2003\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e200\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eLow risk\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e48\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAl-Shamlan\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2015\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eSaudi Arabia\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003ecross-sectional\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eWorkplace Violence in the Health Sector by ILO/ICN/WHO/PSI/2003\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e450\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eLow risk\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e49\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSisawo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2014\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eGambia\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003equantitative and qualitative designs\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eWorkplace Violence in the Health Sector by ILO/ICN/WHO/PSI/2003\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e223\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eLow risk\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e50\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eChang\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2012-3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eKorea\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003ea cross-sectional survey\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eCopenhagen Psychosocial Questionnaire (COPSOQ II)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e391\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eLow risk\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e51\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSauer\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2016\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eUnited States\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003ecross-sectional descriptive\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eNegative Acts Questionnaire\u0026ndash;Revised (NAQR)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e2250\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eLow risk\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e52\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAn\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2014\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eKorea\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003edescriptive correlational\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eNegative Acts Questionnaire-Revised (NAQ-R)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e380\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eLow risk\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e53\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eTiruneh\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2015\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eEthiopia\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003ehospital based cross-sectional\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eWorkplace Violence in the Health Sector by ILO/ICN/WHO/PSI/2003\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e428\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eLow risk\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e54\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFafliora\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2014\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eGreece\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003ecross-sectional\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eWorkplace Violence in the Health Sector by ILO/ICN/WHO/PSI/2003\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e120\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eLow risk\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e55\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eKwok\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2003-4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eHong Kong\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eCross-sectional\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eWorkplace Violence in the Health Sector by ILO/ICN/WHO/PSI/2003\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e1650\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eLow risk\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e56\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eRowe\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2005\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eUnited States\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003edescriptive\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eVerbal Abuse Scale (VAS)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e307\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eLow risk\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e57\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCampbell\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2011\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eunited States\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003ecross-sectional\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eWorkplace Violence in the Health Sector by ILO/ICN/WHO/PSI/2003\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e4165\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eLow risk\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e58\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eHanrahan\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2010\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eunited states\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003ecross-sectional\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003ePractice Environment Scale\u0026ndash;Nursing Work Index (PES-NWI\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e688\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eLow risk\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e59\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMay\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2002\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eunited states\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003edescriptive, comparative\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eHospital Assault Survey for Nurses was developed for this study by Deborah\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e125\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eLow risk\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e60\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eDehghan-Chaloshtari\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2014\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eIran\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003edescriptive\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eWorkplace Violence in the Health Sector by ILO/ICN/WHO/PSI/2003\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e100\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eLow risk\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e61\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCook\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eunited states\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003edescriptive\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eVerbal Abuse Scale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e200\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eLow risk\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003cb\u003eRisk of Bias and\u003c/b\u003e P\u003cb\u003eublication Bias\u003c/b\u003e\u003c/p\u003e \u003cp\u003eThe qualitative assessment of the studies by Hoy et al.\u0026rsquo;s instrument showed low rate of statistical bias in the studies (Table \u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e). As shown in Fig.\u0026nbsp;\u003cspan refid=\"Fig5\" class=\"InternalRef\"\u003e2\u003c/span\u003e,\u003cspan refid=\"Fig6\" class=\"InternalRef\"\u003e3\u003c/span\u003e,\u003cspan refid=\"Fig7\" class=\"InternalRef\"\u003e4\u003c/span\u003e and based on Egger test, there was no publication bias among the studies (P\u0026thinsp;\u0026gt;\u0026thinsp;0.05).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eSubgroup analysis of incivility prevalence\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"6\"\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\" morerows=\"16\" rowspan=\"17\"\u003e \u003cp\u003eTotal\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSubgroup\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eNumber of studies\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003ePrevalence\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003e(95% CI)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003eHeterogeneity %\u003c/p\u003e \u003cp\u003e(p- value)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colspan=\"5\" nameend=\"c6\" namest=\"c2\"\u003e \u003cp\u003e\u003cb\u003eCountry classification\u003c/b\u003e\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eDeveloped\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003e33\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003e52.14\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003e42.77, 61.44\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003e% 99.24 (\u0026lt;\u0026thinsp;0.001)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eDeveloping\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003e19\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003e60.19\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003e49.58, 70.34\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003e% 99.25 (\u0026lt;\u0026thinsp;0.001)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colspan=\"5\" nameend=\"c6\" namest=\"c2\"\u003e \u003cp\u003e\u003cb\u003eInstrument\u003c/b\u003e\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eWHO\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003e22\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003e60.68\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003e50.49, 70.42\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003e99.31 (\u0026lt;\u0026thinsp;0.001) %\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNAQ\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003e11\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003e39.68\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003e26.24, 53.96\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003e98.59 (\u0026lt;\u0026thinsp;0.001) %\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eVerbal scale\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003e5\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003e74.47\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003e48.23, 93.67\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003e98.81 (\u0026lt;\u0026thinsp;0.001) %\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eOther\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003e14\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003e51.16\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003e36.46, 65.76\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003e99.39 (\u0026lt;\u0026thinsp;0.001) %\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colspan=\"5\" nameend=\"c6\" namest=\"c2\"\u003e \u003cp\u003e\u003cb\u003eSetting\u003c/b\u003e\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eGeneral\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003e40\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003e47.47\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003e40.57, 45.42\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003e%99.07 (\u0026lt;\u0026thinsp;0.001)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eEmergency/acute care\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003e8\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003e77.90\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003e59.81, 91.77\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003e% 98.38 (\u0026lt;\u0026thinsp;0.001)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePsychiatric\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003e6\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003e80.50\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003e75.12, 85.37\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003e% 89.53 (\u0026lt;\u0026thinsp;0.001)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colspan=\"5\" nameend=\"c6\" namest=\"c2\"\u003e \u003cp\u003e\u003cb\u003eSampling methods\u003c/b\u003e\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eRandom\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003e27\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003e87.58\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003e52.49, 92.67\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003e%99.36 (\u0026lt;\u0026thinsp;0.001)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eConvenience\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003e20\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003e10.53\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003e53.41,50.64\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003e99.02 (\u0026lt;\u0026thinsp;0.001)%\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNot reported\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003e5\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003e58.42\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003e42.11,52.77\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003e99.59 (\u0026lt;\u0026thinsp;0.001) %\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"15\" rowspan=\"16\"\u003e \u003cp\u003eVerbal\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"5\" nameend=\"c6\" namest=\"c2\"\u003e \u003cp\u003e\u003cb\u003eCountry classification\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eDeveloped\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e14\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e15.70\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e29.57, 58.81\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e98.99% (\u0026lt;\u0026thinsp;0.001)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eDeveloping\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e21\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e15.59\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e49.26, 68.69\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e99.17% (\u0026lt;\u0026thinsp;0.001)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"5\" nameend=\"c6\" namest=\"c2\"\u003e \u003cp\u003e\u003cb\u003eInstrument\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eWHO\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e25\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e75.57\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e49.22, 65.87\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e%98.93 (\u0026lt;\u0026thinsp;0.001)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNAQ\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e76.45\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e70.71, 81.35\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0% (\u0026lt;\u0026thinsp;0.001)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eVerbal scale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e24.96\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e92.77, 98.08\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e%0 (\u0026lt;\u0026thinsp;0.001)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eOther\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e17.74\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e55.98, 88.86\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e99.24% (\u0026lt;\u0026thinsp;0.001)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"5\" nameend=\"c6\" namest=\"c2\"\u003e \u003cp\u003e\u003cb\u003eSetting\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eGeneral\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e25\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e62.69\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e53.48, 71.45\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e%99.15 (\u0026lt;\u0026thinsp;0.001)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eEmergency/acute care\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e74.29\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e47.20, 93.97\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e%98.18 (\u0026lt;\u0026thinsp;0.001)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePsychiatric\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e60.25\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e41.67, 77.43\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e%99.12 (\u0026lt;\u0026thinsp;0.001)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"5\" nameend=\"c6\" namest=\"c2\"\u003e \u003cp\u003e\u003cb\u003eSampling methods\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eRandom\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e18\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e66.22\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e55.28, 76.35\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e% 99.28 (\u0026lt;\u0026thinsp;0.001)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eConvenience\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e60.99\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e49.36, 72.02\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e% 98.09 (\u0026lt;\u0026thinsp;0.001)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNot reported\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e60.29\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e38.19, 80.39\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e99.23 (\u0026lt;\u0026thinsp;0.001)%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"15\" rowspan=\"16\"\u003e \u003cp\u003ePhysical\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"5\" nameend=\"c6\" namest=\"c2\"\u003e \u003cp\u003e\u003cb\u003eCountry classification\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eDeveloped\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e14\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e25.54\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e14, 39.13\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e%99.29 (\u0026lt;\u0026thinsp;0.001)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eDeveloping\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e20\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e21.23\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e15, 32.38\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e%99.17 (\u0026lt;\u0026thinsp;0.001)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"5\" nameend=\"c6\" namest=\"c2\"\u003e \u003cp\u003e\u003cb\u003eInstrument\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eWHO\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e24\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e20.15\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e13.71, 27.46\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e%99.06 (\u0026lt;\u0026thinsp;0.001)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNAQ\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e72.31\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e66.36, 77.57\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e%0 (\u0026lt;\u0026thinsp;0.001)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eVerbal scale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eOther\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e30.58\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e16.28, 47.11\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e% 99.21 (\u0026lt;\u0026thinsp;0.001)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"5\" nameend=\"c6\" namest=\"c2\"\u003e \u003cp\u003e\u003cb\u003eSetting\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eGeneral\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e24\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e20.18\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e14.36, 26.69\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e98.89% (\u0026lt;\u0026thinsp;0.001)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eEmergency/acute care\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e19\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e8.78, 31.91\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e94.91% (\u0026lt;\u0026thinsp;0.001)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePsychiatric\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e51.42\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e24.91, 77.51\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e99.54% (\u0026lt;\u0026thinsp;0.001)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"5\" nameend=\"c6\" namest=\"c2\"\u003e \u003cp\u003e\u003cb\u003eSampling methods\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eRandom\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e20\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e24.54\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e15.52, 34.85\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e99.44% (\u0026lt;\u0026thinsp;0.001)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eConvenience\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e24.12\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e11.01, 40.32\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e99.03% (\u0026lt;\u0026thinsp;0.001)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNot reported\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e22.75\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e7.73,42.68\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e98.83% (\u0026lt;\u0026thinsp;0.001)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"15\" rowspan=\"16\"\u003e \u003cp\u003eSexual\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"5\" nameend=\"c6\" namest=\"c2\"\u003e \u003cp\u003e\u003cb\u003eCountry classification\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eDeveloped\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e20.67\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e9.26, 35.12\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e% 98.91 (\u0026lt;\u0026thinsp;0.001)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eDeveloping\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e13\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e9.57\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e5.41, 14.74\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e% 97.42 (\u0026lt;\u0026thinsp;0.001)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"5\" nameend=\"c6\" namest=\"c2\"\u003e \u003cp\u003e\u003cb\u003eInstrument\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eWHO\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e17\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e10.25\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e6.11, 15.28\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e% 97.97 (\u0026lt;\u0026thinsp;0.001)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNAQ\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eVerbal scale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eOther\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e28.04\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e13.28, 45.73\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e%97.99 (0.00)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"5\" nameend=\"c6\" namest=\"c2\"\u003e \u003cp\u003e\u003cb\u003eSetting\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eGeneral\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e16\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e13.18\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e7.53,20.10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e%98.71 (0.00)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eEmergency/acute care\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e14.09\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e2.71, 31.93\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e%96.85 (0.00)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePsychiatric\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e22.61\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e19.37, 26.02\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e%0 (0.00)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"5\" nameend=\"c6\" namest=\"c2\"\u003e \u003cp\u003e\u003cb\u003eSampling methods\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eRandom\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e14\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e13.48\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e8.23, 19.77\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e%98.02 (0.00)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eConvenience\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e11.63\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.89, 31.42\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e%98.02 (0.00)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNot reported\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e24.63\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e21.43, 27.97\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e%0 (0.00)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMobbing\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo subgroup\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e35.69\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e21.23, 51.60\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e%98.77 (0.00)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePsychological\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo subgroup\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e54.27\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e30.65,76.92\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e% 99.58(0.00)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"6\"\u003eCI: Confidence interval\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003eHowever, there was some publication bias regarding the prevalence of incivility in sexual incivility and mobbing (P\u0026thinsp;\u0026lt;\u0026thinsp;0.05) (Fig.\u0026nbsp;\u003cspan refid=\"Fig8\" class=\"InternalRef\"\u003e5\u003c/span\u003e, \u003cspan refid=\"Fig9\" class=\"InternalRef\"\u003e6\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"No\" id=\"Taba\" border=\"1\"\u003e \u003ccolgroup cols=\"1\"\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003csup\u003e\u003cb\u003eFig.5.\u003c/b\u003e Forest plot based on the population studied the prevalence of sexual incivility in the range of 95% confidence interval\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003csup\u003e\u003cb\u003eFig.6.\u003c/b\u003e Forest plot based on the population studied the prevalence of mobbing in the range of 95% confidence interval\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003c/div\u003e \u003ch2\u003eResults Of Meta-analysis Of The Studies\u003c/h2\u003e \u003cp\u003eBased on the results displayed in Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e, there was high heterogeneity of the studies. Hence, the random effects model with reverse variance was used. In this way, the total prevalence of incivility was 55.10% (95% CI: 48.5, 62.06), the prevalence of verbal, physical, and sexual incivility and mobbing behavior was 61.63% (95% CI: 56, 95, 70), 15.24% (95% CI: 33.17, 70.31), 67.13% (95% CI: 52.8, 77.19), and 69.35% (95% CI: 23.21, 60.51), respectively (Fig.\u0026nbsp;\u003cspan refid=\"Fig10\" class=\"InternalRef\"\u003e7\u003c/span\u003e, \u003cspan refid=\"Fig11\" class=\"InternalRef\"\u003e8\u003c/span\u003e, \u003cspan refid=\"Fig12\" class=\"InternalRef\"\u003e9\u003c/span\u003e, \u003cspan refid=\"Fig13\" class=\"InternalRef\"\u003e10\u003c/span\u003e, and \u003cspan refid=\"Fig14\" class=\"InternalRef\"\u003e11\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"No\" id=\"Tabb\" border=\"1\"\u003e \u003ccolgroup cols=\"1\"\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003csup\u003e\u003cb\u003eFigure 7 \u0026minus;\u003c/b\u003e Funnel plot of publication bias of studies of the prevalence of incivility\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003csup\u003e\u003cb\u003eFigure 8 \u0026minus;\u003c/b\u003e Funnel plot of publication bias of studies of the prevalence of verbal incivility\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003csup\u003e\u003cb\u003eFigure 9\u0026minus;\u003c/b\u003e Funnel plot of publication bias of studies of the prevalence of physical incivility\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003csup\u003e\u003cb\u003eFigure 10 \u0026minus;\u003c/b\u003e Funnel plot of publication bias of studies of the prevalence of sexual incivility\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003csup\u003e\u003cb\u003eFigure 11 .\u003c/b\u003e Funnel plot of publication bias of studies of the prevalence mobbing\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003eThe results of heterogeneity of the studies are presented in Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e. Since there was an expressive heterogeneity among the studies, the subgroups were analysed. The results demonstrated that the greatest and smallest prevalence rates of incivility pertained to the verbal and sexual aspects. The prevalence of incivility was higher in the studies that used random sampling than other studies, in psychiatric wards than other wards, and more so in developing countries than developed countries. The accumulation curve of the studies is displayed in Figs.\u0026nbsp;\u003cspan refid=\"Fig10\" class=\"InternalRef\"\u003e7\u003c/span\u003e, \u003cspan refid=\"Fig11\" class=\"InternalRef\"\u003e8\u003c/span\u003e, \u003cspan refid=\"Fig12\" class=\"InternalRef\"\u003e9\u003c/span\u003e, \u003cspan refid=\"Fig13\" class=\"InternalRef\"\u003e10\u003c/span\u003e, and \u003cspan refid=\"Fig14\" class=\"InternalRef\"\u003e11\u003c/span\u003e. The meta-regression test indicated a correlation between publication date and prevalence of incivility, so that its prevalence has decreased over the recent decades (Fig.\u0026nbsp;\u003cspan refid=\"Fig15\" class=\"InternalRef\"\u003e12\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003c/p\u003e "},{"header":"Discussion","content":" \u003cp\u003eThis systematic review and meta-analysis assessed the prevalence of incivility and violence in nurses using 61 studies. The findings of the study showed a higher than average rate of incivility among nurses. The highest rate belonged to violence and verbal abuse, experienced by almost all nurses during their work experience. Moreover, the prevalence of incivility as mental violence was greater than physical violence and threat. The least rate belonged to sexual violence. The search process showed that studies targeting nurses were more numerous than those targeting other health professions and that the number of studies on other health professions was significantly smaller than the studies on nurses. The number of studies on nursing students was greater than the studies on other groups. The studies showed a higher prevalence of incivility among nurses than other healthcare staff. It appears that the more time the staff spends with patients and other individuals, the greater the rate of incivility will be [\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e]. The study by Li et al. (2018) suggested that although the rate of violence against physicians and nurses is high, the rate of incivility towards nurses is higher than that among physicians [\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eTaylor et al. asserted that more than 80% of nurses render their workplace as unsafe and that the prevalence of verbal and physical threat is high among nurses [\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e]. A study conducted by Duncan study reported incivility towards nurses higher than 46% and stated that one-third of nurses have been exposed to physical violence. This study reported that 100% of ER nurses have been exposed to verbal violence and more than 80% to physical violence [\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eMeta-regression based on publication date indicated that the rate of incivility and violence has decreased over time. One of the reasons that the prevalence of violence has decreased in recent years can be attributed to increased nurses\u0026rsquo; awareness of their professional rules and regulations and legal mitigation and pursuit. Awareness of rules and law enables nurses to defend their own rights and therefore diminishing incivility. Nonetheless, the rate of prevalence of verbal violence has not decreased tangibly. The study by Pompeii et al. (2015) and Hsieh et al. (2017) revealed that the greatest rate of incivility belonged to violence and verbal threat [\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e]. It appears that poor communication skills, devoting insufficient time, and lack of prompt sharing of information may foster the incidence of verbal incivility. The findings of the study showed that most primary studies were carried out on general hospitals and nurses in various wards; yet, the prevalence of incivility and violence was greater in psychiatric wards than other wards. Furthermore, the incidence of physical incivility was greater in these wards compared to other types of incivility. Verbal incivility was more frequent in the ER and ICU wards compared to other behaviors because ER patients are experiencing a critical situation and it is highly important to settle their situation as quickly and efficiently as possible. The nature and sensitivity of ER means that any shortcoming in organisational and manpower factors would lead to disastrous consequences. Chaotic situation, unpredictable situations, stressful atmospheres, limitations in therapeutic processes for evaluating the effect of therapeutic interventions and care given may predispose ER staff to verbal incivility. Some studies report that nurses in pediatrics, ER, mental health inpatient units, neurology and neurosurgery departments are more frequently exposed to violence. This may result in diminishing intent young nurses to work in such environments [\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eOur findings suggested the greater prevalence of incivility in developing countries; yet, the prevalence of verbal, physical, and sexual incivility was higher in developed countries. Decreasing reports of sexual violence in these countries may be attributed to cultural reasons. The variety and great number of studies in different countries show that most clinical environments are exposed to the prevalence of incivility and violence among healthcare providers and caregivers. Still, the findings of the study demonstrated that the Asian countries, especially Iran and Taiwan, had the greatest number of studies in this field. This may be attributed to personal factors as well as heavy workload, shortage of manpower, low skills for team work, or lack of management programs for healthcare violence [\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e].\u003c/p\u003e \u003cp\u003ePublication bias in studies of sexual harassment can be due to socio-cultural factors. Physical and psychological problems, decreased motivation and commitment to the workplace, consequently leaving work are the consequences of sexual harassment. Organisational factors such as social support and workplace reporting systems, as well as the vulnerability of people such as race, marital status, age, etc. can affect the reporting of this event. Studies show that the atmosphere of the organisation, the sensitivity of the organisation, its support in reducing sexual harassment and encouraging reporting of sexual harassment are effective [\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eIncivility not only creates a hostile milieu for nurses, but forms a dangerous environment for patients leading to diminished patient satisfaction [\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e]. Clark and Springer concluded that inappropriate behaviors may predispose the incidence of medical and nursing errors and poor patient outcomes [\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e]. On the other hand, legal mitigation by victims in hostile environments may impose some costs on hospitals. Additionally, work leave, nurse transfer, the spread of hostile environments can affect employment in the organisation and the nurse victims may seek legal consultation possibly affecting the financial affairs, reputation, and credibility of the center [\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eConsequently, incivility is associated with overwhelming costs of healthcare, increased compensatory payments related to tension with the staff, increased number of legal pursuits, and reduced quality of care given to patients [\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e]. The results of studies demonstrate that incivility is the most important factor in nurses\u0026rsquo; occupational satisfaction [\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e] resulting in reduced responsibility, reduced commitment, increased work leave in nurses that finally influences quality of care, costs and organisational reputation both directly and indirectly. The personnel that experience incivility in workplace deliberately reduce the quality of their work leading to diminished efficacy [\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e, \u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e]. However, some parameters such as social support, organisational support, presence of transparent rules, enhanced communicative skills, increased level of skills and power in nurses can attenuate the rate of incivility [\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eIn many cases, nurses cannot persue the problems due to absence of centers, committees for managing and recording the incident violence, or due to individuals\u0026rsquo; request for pursuit of the problem. Finally, studies report that many nurses stated that there is no site or place in the organisation to report incivility and they are puzzled where to turn to in such conditions. So, many of incivility cases remain unreported. Specifically, junior nurses that experience higher rates of incivility cannot take any appropriate measures in these conditions due to lack of support by coworkers, organisation and poor communication skills. Hence, the incidence of such behaviors is substantiated in the organisational culture.\u003c/p\u003e "},{"header":"Limitations Of The Study","content":" \u003cp\u003eOne limitation was inaccessibility of full texts of some papers that was resolved through communicating with the author(s). In addition, the use of different and diverse terms to assess the extent of non-civil behavior has made the studies heterogeneous in this area. Nurses' perceptions of the concept of non-civic behavior were very different.\u003c/p\u003e "},{"header":"Conclusion","content":" \u003cp\u003eThe findings of this systematic review and meta-analysis showed that there was a higher than average rate of incivility among nurses. Given the wide range of studies regarding various time, setting, and environments, it appears, that planners and policy-makers should develop programs to decrease violence and increase workplace safety. The healthcare managers and supervisors are aware that disruptive and threatening behavior is a serious problem in the healthcare system. Verbal abuse, refusing to contribute to determined duties and physical threats induce failure of teamwork, interaction and the cooperation required for care provision. Given the highly significant role of nurses in care giving, they deserve to have a safe work environment, similar to other workplaces. Consequently, nursing managers ought to identify the risk factors in the workplace and pay due attention to nurses\u0026rsquo; concerns in this regard. Finally, future studies should focus on identification and implementation of effective evidence-based interventions based on organisational culture.\u003c/p\u003e \u003cp\u003eSystematic review and meta-analysis findings showed that the prevalence of incivility behaviors among nurses was the higher than average rate. Given the high prevalence of non-verbal behavior and its non-reduction in recent years, nursing managers should identify risk factors in the workplace, especially in the emergency department. Verbal, physical, sexual, and psychological abuse leads to failure in teamwork, interaction and collaboration to provide care to the patient. Given the crucial role nurses play in caring for themselves, they, like other workplaces, have the right to a safe environment. Considering that creating a responsive and supportive organisational environment can help prevent and reduce non-civil behavior and even encourage staff to report a variety of behaviors. To support and plan for empowering and educating nurses to deal with violence and report violence created. Studies should also be designed and implemented to identify and evaluate evidence-based interventions and organisational culture.\u003c/p\u003e "},{"header":"Abbreviations","content":"\u003cp\u003eNot applicable\u003c/p\u003e "},{"header":"Declarations","content":"\u003cp\u003eThere is no conflict of interest to disclose. We did not have the funds. All authors, were in close collaboration and responsible for critical revisions of the manuscript.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEthics approval and consent to participate\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eIn this study consent to participate not applicable. The research was approved by the organisational ethics committee of Shahid Beheshti University of Medical Sciences (no. \u003ca href=\"http://ethics.research.ac.ir/IR.SBMU.REC.1398.143\"\u003eIR.SBMU.REC.1398.143\u003c/a\u003e).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of data and materials\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare that data supporting the findings of this study are available within the article and its supplementary information files.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgements\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors would like to acknowledge the efforts of Dr. Mahmoud Yousefifard\u0026nbsp;for their diligent and thoughtful editing of the manuscript.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConflict of interest\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThere is no conflict of interest in this study.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interests\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;The authors have no competing interests to declare.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors' Contribution\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eSM and FA did the planning and design of the study. Electronic search in databases was done by SM, and AB rechecked search terms and syntaxes. GR, contributed significant text and native translation. All authors, FA, SM, AB, GR, were in close collaboration and responsible for critical revisions of the manuscript. All authors read and approved the final manuscript.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding statement\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis research received no specific grant from any funding agency in the public, commercial or not-for-profit sectors.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e \u003cspan\u003eOxford English Dictionary. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttp://www.oxforddictionaries.com/us/definition/american_english/civility\u003c/span\u003e\u003c/span\u003e 2016.\u003c/span\u003e \u003c/li\u003e \u003cli\u003e \u003cspan\u003eGopalkrishnan P. Workplace incivility and employee strain in reactions: The moderating effects of perceived organisational support and job insecurity. Bowling Green: Bowling Green State University; 2011.\u003c/span\u003e \u003c/li\u003e \u003cli\u003e \u003cspan\u003eBj\u0026ouml;rkqvist K, \u0026Ouml;stermanK, Hjelt-B\u0026auml;ck M. Aggression among university employees. Aggressive behavior.1994; 20(3):173\u0026ndash;84. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1002/1098-2337(1994)20:3\u0026lt;173::AID-AB2480200304\u0026gt;3.0.CO;2-D\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e \u003c/li\u003e \u003cli\u003e \u003cspan\u003eAndersson LM, Pearson CM. Tit for tat? The spiraling effect of incivility in the workplace. Academy of management review. 1999;24(3):452\u0026ndash;71. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.5465/AMR.1999.2202131\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e \u003c/li\u003e \u003cli\u003e \u003cspan\u003eHosseinpour-Dalenjan L, Atashzadeh-Shoorideh F, Hosseini M, Mohtashami J. The correlation between nurses\u0026rsquo; work engagement and workplace incivility. Iranian Red Crescent Medical Journal. 2017; 19(4). doi:\u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.5812/ircmj.45413\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e \u003c/li\u003e \u003cli\u003e \u003cspan\u003eHershcovis MS, Barling J. Towards a relational model of workplace aggression. United Kingdom: Edward Elgar; 2007.\u003c/span\u003e \u003c/li\u003e \u003cli\u003e \u003cspan\u003eLim S, Cortina LM, Magley VJ. Personal and workgroup incivility: Impact on work and health outcomes. J Appl Psychol. 2008;93(1):95\u0026ndash;107. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1037/0021-9010.93.1.95\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e \u003c/li\u003e \u003cli\u003e \u003cspan\u003eHoffman RL, Chunta K. Workplace incivility: promoting zero tolerance in nursing. J Radiol Nurs. 2015;34(4):222\u0026ndash;7. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttp://dx.doi.org/10.1016/j.jradnu.2015.09.004\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e \u003c/li\u003e \u003cli\u003e \u003cspan\u003eClark CM, Springer PJ. Academic nurse leaders\u0026rsquo; role in fostering a culture of civility in nursing education. J Nurs Educ. 2010;49(6):319\u0026ndash;25. DOI:\u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.3928/01484834-20100224-01\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e \u003c/li\u003e \u003cli\u003e \u003cspan\u003eAzami M, Moslemirad M, YektaKooshali MH, Rahmati S, Soleymani A, Shamloo MBB, et al. Workplace violence against Iranian nurses: a systematic review and meta-analysis. Violence victims. 2018;33(6):1148\u0026ndash;75. doi:\u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1891/0886-6708.33.6.1148\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e \u003c/li\u003e \u003cli\u003e \u003cspan\u003eDalvand S, Gheshlagh RG, Najafi F, Zahednezhad H, Sayehmiri K, Eghtedari M, et al. The Prevalence of Workplace Violence against Iranian Nurses: A Systematic Review and Meta-Analysis. Shiraz E Medical Journal.2108; 19(9). DOI: \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.5812/semj.65923\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e \u003c/li\u003e \u003cli\u003e \u003cspan\u003eD'ambra AM, Andrews DR. Incivility, retention and new graduate nurses: an integrated review of the literature. J Nurs Manag. 2014;22(6):735\u0026ndash;42. doi:\u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1111/jonm.12060\u003c/span\u003e\u003c/span\u003e. Epub 2013 Aug 9.\u003c/span\u003e \u003c/li\u003e \u003cli\u003e \u003cspan\u003eEdward K, Ousey K, Warelow P, Lui S. Nursing and aggression in the workplace: a systematic review. British Journal of Nursing. 2014;23(12):653\u0026ndash;9. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.12968/bjon.2014.23.12.653\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e \u003c/li\u003e \u003cli\u003e \u003cspan\u003eHawkins N, Jeong S, Smith T. New graduate registered nurses\u0026rsquo; exposure to negative workplace behaviour in the acute care setting: An integrative review. International journal of nursing studies. 2019;93:41\u0026ndash;5. DOI:\u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1016/j.ijnurstu.2018.09.020\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e \u003c/li\u003e \u003cli\u003e \u003cspan\u003eZhu Z, Xing W, Lizarondo L, Guo M, Hu Y. Nursing students\u0026rsquo; experiences with faculty incivility in the clinical education context: a qualitative systematic review and meta-synthesis. BMJ open.019; 9(2):e024383. DOI: \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1136/bmjopen-2018-024383\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e \u003c/li\u003e \u003cli\u003e \u003cspan\u003eHodgins M, MacCurtain S, Mannix-McNamara P. Workplace bullying and incivility: a systematic review of interventions. International Journal of Workplace Health Management. 2014;7(1):54\u0026ndash;72. DOI \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1108/IJWHM-08-2013-0030\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e \u003c/li\u003e \u003cli\u003e \u003cspan\u003eStroup DF, Berlin JA, Morton SC, Olkin I, Williamson GD, Rennie D, et al. Meta-analysis of observational studies in epidemiology: a proposal for reporting. Meta-analysis Of Observational Studies in Epidemiology (MOOSE) group. JAMA. 2000;283(15):2008\u0026ndash;12. DOI:\u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1001/jama.283.15.2008\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e \u003c/li\u003e \u003cli\u003e \u003cspan\u003eHoy D, Brooks P, Woolf A, Blyth F, March L, Bain C, et al. Assessing risk of bias in prevalence studies: modification of an existing tool and evidence of interrater agreement. J Clin Epidemiol. 2012;65(9):934\u0026ndash;9. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1016/j.jclinepi.2011.11.014\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e \u003c/li\u003e \u003cli\u003e \u003cspan\u003ePhillips JP. Workplace violence against health care workers in the United States. New England journal of medicine. 2016;374(17):1661\u0026ndash;9. DOI:\u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1056/NEJMra1501998\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e \u003c/li\u003e \u003cli\u003e \u003cspan\u003eLi P, Xing K, Qiao H, Fang H, Ma H, Jiao M, et al. Psychological violence against general practitioners and nurses in Chinese township hospitals: incidence and implications. Health Qual Life Outcomes. 2018;16(1):117. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1186/s12955-018-0940-9\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e \u003c/li\u003e \u003cli\u003e \u003cspan\u003eTaylor JL, Rew L. A systematic review of the literature: workplace violence in the emergency department. Journal of clinical nursing. 2011;20(7-8):1072\u0026ndash;85. doi:\u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1111/j.1365-2702.2010.03342.x\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e \u003c/li\u003e \u003cli\u003e \u003cspan\u003eDuncan S, Estabrooks CA, Reimer M. Violence against nurses. Alberta RN. 2000;56(2):13.\u003c/span\u003e \u003c/li\u003e \u003cli\u003e \u003cspan\u003ePompeii LA, Schoenfisch AL, Lipscomb HJ, Dement JM, Smith CD, Upadhyaya M. Physical assault, physical threat, and verbal abuse perpetrated against hospital workers by patients or visitors in six US hospitals. Am J Ind Med. 2015;58(11):1194\u0026ndash;204. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttp://dx.doi.org/10.1002/ajim.22489\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e \u003c/li\u003e \u003cli\u003e \u003cspan\u003eMartinez AJS. Managing workplace violence with evidence-based interventions: a literature review. Journal of psychosocial nursing mental health services. 2016;54(9):31\u0026ndash;6. DOI:\u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.3928/02793695-20160817-05\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e \u003c/li\u003e \u003cli\u003e \u003cdiv class=\"BibBookDOI\"\u003e10.1037/1076-8998.13.2.152\u003c/div\u003e \u003cspan\u003eBergman ME, Henning JB. Sex and ethnicity as moderators in the sexual harassment phenomenon: A revision and test of Fitzgerald et al.(1994). Journal of Occupational Health Psychology. 2008; 13(2):152. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1037/1076-8998.13.2.152\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e \u003c/li\u003e \u003cli\u003e \u003cspan\u003eMontalvo L. Civility and Incivility Between Nurses and Administrators: A Model to Drive Successful Health Care Outcomes in the Department of Veterans Affairs: University of Maryland University College; 2013.\u003c/span\u003e \u003c/li\u003e \u003cli\u003e \u003cspan\u003eSpence Laschinger HK, Finegan J, Wilk P. New graduate burnout: The impact of professional practice environment, workplace civility and empowerment. Nursing Economic. 2009a;27(6):377\u0026ndash;83.\u003c/span\u003e \u003c/li\u003e \u003cli\u003e \u003cspan\u003eSpence Laschinger HK, Leiter M, Day A, Gilin D. Workplace empowerment, incivility, and burnout: impact on staff nurse recruitment and retention outcomes. J Nurs Manag. 2000b;17(3):302\u0026ndash;11. DOI:\u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1111/j.1365-2834.2009.00999.x\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e \u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Incivility, nurse, work environment, mobbing, verbal abuse, violence","lastPublishedDoi":"10.21203/rs.3.rs-35232/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-35232/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e \u003cp\u003eCreation and maintenance of a safe healthy work environment is one part of a nurse\u0026rsquo;s role. Evidence shows there is a presence of negative behaviors like incivility and violence in the nursing profession. This systematic review and meta-analysis determined the rate of incivility towards nurses and the factors affecting it.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e \u003cp\u003eAll observational studies that primarily investigated the rate of incivility towards nurses were selected regardless of sampling method. The electronic databases \u0026ldquo;PubMed, Embase, Web of Sciences, Magiran, IranDoc, and Scopus\u0026rdquo; were searched for studies published during the period of January 1, 1996 to December 31, 2019. The quality of the selected studies was assessed with Hoy\u0026rsquo;s Critical Assessment Checklist. The study was undertaken using the random effects model. Data were analyzed with STATA14.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e \u003cp\u003eData on 61 articles, including data on 30801 individuals that were published during 1997\u0026ndash;2019, entered the study. Prevalence of incivility was 50.10% (95%, CI: 48.05, 62.06).\u003c/p\u003e\u003ch2\u003eConclusion\u003c/h2\u003e \u003cp\u003eGiven the highly important role of nurses in care-giving, they deserve to have a safe working environment similar to other work milieus.\u003c/p\u003e","manuscriptTitle":"Incivility towards nurses: A Systematic Review and Meta-analysis","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2020-06-19 19:05:00","doi":"10.21203/rs.3.rs-35232/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"9cb0b304-2031-4eee-a143-da2d6a2927bd","owner":[],"postedDate":"June 19th, 2020","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"published-in-journal","subjectAreas":[{"id":124770,"name":"Medical Ethics"}],"tags":[],"updatedAt":"2022-03-16T05:41:05+00:00","versionOfRecord":{"articleIdentity":"rs-35232","link":"https://doi.org/10.18502/jmehm.v14i15.7670","journal":{"identity":"journal-of-medical-ethics-and-history-of-medicine","isVorOnly":true,"title":"Journal of Medical Ethics and History of Medicine"},"publishedOn":"2021-11-03 05:41:05","publishedOnDateReadable":"November 3rd, 2021"},"versionCreatedAt":"2020-06-19 19:05:00","video":"","vorDoi":"10.18502/jmehm.v14i15.7670","vorDoiUrl":"https://doi.org/10.18502/jmehm.v14i15.7670","workflowStages":[]},"version":"v1","identity":"rs-35232","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-35232","identity":"rs-35232","version":["v1"]},"buildId":"J0_U0BvcaRcwD8yVFaRlm","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}