Predictors of Work-Related Violence Against Nurses Working at a Tertiary Hospital in Kisumu, Kenya.

Predictors of Work-Related Violence Against Nurses Working at a Tertiary Hospital in Kisumu, Kenya. | 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 Predictors of Work-Related Violence Against Nurses Working at a Tertiary Hospital in Kisumu, Kenya. Anne Owira Atogo, Zablon Nyaberi, John Arudo This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-4724448/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background Workplace violence (WPV) is any act in which a person is abused, threatened, intimidated or assaulted in their work environment. It could involve physical, verbal or written threatening behaviour or physical attacks. Workplace violence against nurses is increasingly becoming a major problem globally. Because of the nature of their work, nurses are at increased risk of workplace violence. Objective To assess workplace violence against nurses at Jaramogi Oginga Odinga Teaching and Referral Hospital. Materials and methods It employed a cross-sectional study design among 184 nurses randomly selected from Jaramogi Oginga Odinga Teaching and Referral Hospital in Kisumu-Kenya. Data was collected using a self-administered questionnaire that asked questions regarding their sociodemographic characteristics, nature of their work, experience with workplace violence and institutional factors that could be associated with workplace violence. The data obtained was analysed descriptively (in the form of frequencies and proportions for categorical variable and inferentially as mean with corresponding standard deviation) and inferentially. Pearson chi-square test was adopted to assess statistically significant association between predictors of WPV and violence occurrence. Odds ratios were computed at 95% confidence interval. Results This study enrolled 184 nurses with a mean age of 37 (± 9.5) years, of whom 62% were female. Majority (88%; n = 162) of the nurses enrolled were at the operational level with 2 (1.1%) being supervisors and 20 (10.9%) being in senior management. Workplace violence was reported by 70% of the respondents, with 41.8% of them saying they were verbally abused. Among those physically abused, 71.8% were assaulted by the relatives of the patients with 28.2% being injured because of the incident. Bullying by co-workers was noted among 24 (13.0%) of the respondents while 41 (22.3%) reported sexual harassment. 96.2% had not received any training on WPV prevention in the last twelve months. Working in the general surgery department (p < 0.001) and lack of safety measures (p = 0.020) predicted WPV. Conclusion the study reports that working in general surgical wards and lack of institutional measures against violence are the major predictors of workplace violence among nurses. There is need to understand institutional processes, procedures and operations that reduce the likelihood of workplace violence in other hospital departments and apply these findings to the general surgery unit where there was a higher prevalence of workplace violence. Nursing Workplace violence WPV Nurses Kisumu Kenya Figures Figure 1 INTRODUCTION Workplace violence is any act or threat of physical violence, harassment, intimidation or threatening disruptive behaviour that occurs at place of work 1,2 . Workplace violence in hospitals refers to violent or aggressive incidents that occur in healthcare settings. According to the Health and Safety Executive (HSE), workplace violence is defined as “any incident in which a person is abused, threatened, or assaulted in circumstances relating to their work.” This workplace violence could include but is not limited to a carer bitten by a person with learning disabilities during normal care, an irate visitor verbally abusing a ward manager due to perceived inadequate treatment, a nurse facing verbal abuse and threats from a patient refusing prescribed medication or a catering assistant being hit by a confused elderly patient. Because of the busy and routine nature of hospitals, there is a high prevalence of workplace violence 3–5 . This can further be attributed to high flow and work-intensive departments such as the emergency departments, surgical and medical wards 6 . Workplace Violence (WPV) is a significant issue within the healthcare sector that has been on the rise over the past decade, with a notable increase during the COVID-19 pandemic. This alarming trend is commonly witnessed in emergency departments, where incidents of violence have doubled compared to pre-pandemic levels. Workplace Violence not only impacts the patient’s quality of care, but also affects the well-being of healthcare employees. Organizational interventions aimed at addressing WPV have shown varying degrees of success, with many failing to produce sustained improvements. This is often due to a tendency by healthcare organizations to oversimplify the causes of violence, leading to interventions that primarily focus on individual-level responses like staff education and security modifications 7 . However, these approaches are insufficient in tackling the full spectrum of factors contributing to WPV. Violence against nurses in their workplace is a major global problem that has received increased attention in recent years 1 . Work-related violence is defined as any act in which a person is abused, threatened, intimidated or assaulted in their work environment 8 . It includes threatening behaviour, verbal or written threats, harassment, verbal abuse and physical attacks 9 . Violence and threats of violence are an emerging problem in jobs where workers are in constant contact with clients, the public and co-workers. Unfortunately, it has been reported that health care workers experience the highest rate of WPV as compared to other sectors often because nurses on the frontline are more at risk of workplace assault than other health professionals. 10 The nature of nursing work exposes them to increased risk of work-related violence. High rates of both physical and nonphysical violent events have been reported among nurses working in nursing homes, emergency departments, psychiatric and geriatric departments. 11 Being male, working at night and working in an environment with more colleagues have been associated with workplace violence against nurses. 12 Globally violence against health care workers; of who nurses form the highest number is a growing problem and can severely impact on the health care system. 13 Work-related violence against healthcare professionals is a problem that is occurring with increased frequency in many parts of the world. Because of the nature of their work, nurses are prone to workplace violence more than any other category of healthcare workers. 14 Workplace violence has a negative impact on the physical and psychological wellbeing of health care personnel 3 . It has been shown a relationship between workplace violence and stress. This study assessed workplace violence against nurses. Specifically, it assessed individual and institutional factors influencing workplace violence. It also explored determinants of workplace violence as well as evaluated the effect of workplace violence on nurses’ mental well-being. MATERIALS AND METHODS This cross-sectional descriptive study was conducted among nurses with a minimum of one-year experience working at the Jaramogi Oginga Odinga Teaching and Referral Hospital in Kisumu-Kenya. Data was collected using a self-administered questionnaire that asked questions regarding their sociodemographic characteristics, nature of their work, experience with workplace violence and institutional factors that could be associated with workplace violence. The data obtained was analysed descriptively (in the form of frequencies and proportions for categorical variable and inferentially as mean with corresponding standard deviation) and inferentially. Pearson chi-square test was adopted to assess statistically significant association between predictors of WPV and violence occurrence. Odds ratios were computed at 95% confidence interval. We obtained ethical approval from the institutional research and ethics committees of Masinde Muliro University of Science and Technology (MMUST) and the Jaramogi Oginga Odinga Teaching and Referral Hospital/ (JOOTRH). Additionally, a research license was obtained from the National Commission for Science, technology and Innovations (NACOSTI). Lastly, a written informed consent was obtained from all participants prior to enrolment. RESULTS We enrolled 184 nurses, majority of whom were female (62.0%), aged 25–34 years (48.9%), married (81.0%), attained a diploma level of education (57.6%) and all professed the Christian faith (Table 1 ). Table 1 Sociodemographic Characteristics (N = 184 ) Variables Categories n % Gender Male 70 38.0 Female 114 62.0 Age group in years 25–34 90 48.9 35–44 49 26.6 45–55 30 16.3 ≥ 55 15 8.2 Mean age ± SD (Range) 37.0 ± 9.5 (25.0–59.0); Median = 35.0 Marital status Single 27 14.7 Married 149 81.0 Separated 5 2.7 Widowed 3 1.6 Level of training Certificate 16 8.7 Diploma 106 57.6 Degree 62 33.7 Religion Christian 184 100.0 Majority (88%) of the nurses interviewed were operational nurses with about one in ten (10.9%) being senior managers. Mean number of years worked was 10.8 ± 9.9 and ranged from 1 to 35. The mean number staff per workstation was 5 with a range of 1–18. Nearly half (48.9%) worked in general surgery while 28.8% were in general medicine. Majority (96.7%) worked in shifts with less than three-quarters (71.7%) working in adult setting. Slightly more than half (51.1%) worked with male patients compared to 36.4% who worked in mixed gender setting (Table 2 ). Table 2 Nurses’ Individual characteristics Variables Categories n % Job position Senior Management 20 10.9 Supervisor 2 1.1 Operational nurse 162 88.0 Mean number of years of experience in health sector ± SD (Range) 10.8 ± 9.9 (1.0–35.0) Mean number of staff (Range) 5 (1–18) Where spends most of the times in workplace Accident and emergency 15 8.1 Ambulatory, ICU, Specialized unit 8 4.4 General surgery 90 48.9 General medicine 53 28.8 Other 18 9.8 Work in shifts Yes 178 96.7 No 6 3.3 Patients / Clients work with Newborn 2 1.1 Infants 8 4.4 Children 39 21.2 Adolescents 3 1.6 Adults 132 71.7 Sex of patients work with Male 94 51.1 Female 23 12.5 Male / Female 67 36.4 Seven in ten nurses reported experiencing some form of workplace violence, with 41.8% of them saying they were verbally abused. Among those physically abused, 71.8% were assaulted by the relatives of the patients with 28.2% being injured because of the incident. Bullying by co-workers was noted among 24 (13.0%) of the respondents while 41 (22.3%) reported sexual harassment (Fig. 1 ). Availability of workplace safety measures and effectiveness in management of workplace violence significantly reduced the likelihood of WPV occurrence. Nurses who believed in the institutional safety measures were significantly less likely to experience WPV (OR: 0.2; 95% CI: 0.11–0.41; p < 0.001) as shown on Table 3 . Table 3 Institutional predictors of workplace violence Predictor OR (95% CI) p-value Presence of safety measures 0.3 (0.13, 0.84) 0.020 WPV measures 0.2 (0.11, 0.41) < 0.001 Effectiveness in WPV management 0.3 (0.18, 0.65) 0.009 Working in general surgery 9.7 (3.60, 27.01) < 0.001 Effect of workplace violence on nurses’ mental well-being was assessed using the GHQ-28 instrument scores which included assessment on somatic symptoms, anxiety / insomnia, social dysfunction and severe depression. A score of 24 and higher was considered as presence of mental illness while a score of < 24 was considered as normal status of well-being. Nurses who had experienced workplace violence were 10.8 times more likely to have presented with symptoms of mental illness (OR: 10.8; 95% CI: 5.22–22.48; p < 0.0001) than those who had not. Those who had experienced physical (OR: 4.7; 95% CI: 1.72–12.62; p = 0.001), verbal abuse (OR: 3.9; 95% CI: 2.00–7.89; p < 0.0001), bullied (OR: 14.9; 95% CI: 1.97–113.41; p = 0.0007) or sexual violence (OR: 6.7; 95% CI: 2.26–19.76; p = 0.0001) had higher odds of having manifested with symptoms of mental illness (Table 4 ). Table 4 Test of Association between the participants’ characteristics and barriers to contraceptive use Independent variable OR (95% CI:) p-value Experienced workplace violence 10.8 (5.22, 22.48) < 0.0001 Physical violence 4.7 (1.72, 12.62) 0.001 Verbal abuse 3.9 (2.00, 7.89) < 0.0001 Bullied 14.9 (1.97, 113.41) 0.0007 Sexual violence 6.7 (2.26, 19.76) 0.0001 DISCUSSION This study defined work-related violence as self-reported experiences of physical attack, verbal abuse, bullying or sexual harassment which occurred in the workplace over the past 12-months (from the time of data collection). Based on this, 70% of the participants reported some form of work-related violence. This overall one-year prevalence of work-related violence is close to that reported in Kenya at 76.8%. 15 This finding is higher than the global prevalence estimated to be between 51.7 to 66.7%. 16 Lower proportions have also been reported in other African countries such as Ethiopia 17 at 26.7%, Ghana 18 at 52.7% and Gambia 19 at 62.1%. The high prevalence of workplace violence in the current study could be attributed to the fact that workplace violence is rising in the healthcare industry due to heavy workloads, increasing work pressures, work-related stress, interpersonal conflict, economic disruptions and social uncertainty 20 . This workplace violence within healthcare settings exacerbates in the event of a crisis or disaster involving groups of people overwhelmed with their work and exhibit panic attacks, uncertainties, shock and worries. Additionally, the hospital is located in densely populated area, and is the main teaching and referral hospital in Kisumu County. The hospital receives high number of patients daily which may be overwhelming to the staff. Thus, the daily large number of patients may lead to long waiting periods with the tendency of making patients and their relatives irritable. 21 This study noted that younger nurses below 35 years were more predisposed to workplace violence compared to their older counterparts, a relationship that was statistically significant. This finding is comparable to that conducted in Canada’s Alberta and British Columbia in Canada where the authors noted that younger nurses were more predisposed to workplace violence because of their age and inadequate experience. Furthermore, younger nurses were noted to acknowledge violence more readily than their older counterparts who may accept a level of violence as an occupational hazard. 22 In contrast, a study conducted in the emergency departments at general hospitals within Basra city of Iraq, the authors 23 reported a significantly higher proportionate increase in the proportion of workplace violence with advancement in age. This phenomenon was noted by the authors as a reverse pattern in contrast to previously published studies. Secondly, nurses with certificate or diploma level of training experience less likelihood of workplace violence compared to those with at least bachelor’s degree in nursing. The current study also found a statistically significant association between physical violence and the rank of the nurse/midwife. The study revealed that staff nurses were most frequently physically assaulted than other ranks. This finding could be because of their lack of experience in dealing with potentially violent patients 21 . Nurses who attain higher education and work for at least 5 years are less exposed to physical violence than their younger and less experienced colleagues 18 . There was a statistically significant association between those working in general surgery and workplace violence with the odds being ten times higher than those working in other departments. Settings like accident and emergency, psychiatry, geriatric care, and nursing homes have been recurrently found exposed to higher frequency of violent episodes, but also general care departments like medical/surgical wards and community care are increasingly reported to be vulnerable to the occurrence of harassment and aggression 24 . Anecdotal data indicate that majority of healthcare professionals (such as nurses) who work in general hospital wards attend to patients with varying medical and surgical conditions are exposed to workplace violence compared to their colleagues in other wards 5 (Jakobsson et al., 2020). In a systematic review conducted in Switzerland, the authors 25 noted that there was a high prevalence of violence meted upon nurses by patients and visitors in general surgery units of public hospitals. This study also revealed a statistically significant relationship between working in medical, surgical, psychiatric and emergency units with physical violence. Results from a study conducted by Hahn et al., (2011),about half of the nurses had experienced verbal abuse while one-quarter reported to have been subjected to physical violence. The high prevalence of work-place violence was reported more in the medical and surgical wards as well as the intensive care units. Medical, surgical and emergency units are units usually have severely ill patients who need nursing care and regular monitoring 6 . This phenomenon creates unnecessary anger and anxiety leading to violence on the part of patients 6,26,27 . Furthermore, nurses working with male patients were about three times more likely to have experienced workplace violence compared to those working with female or patients of both sexes. This favourably compares with a study conducted in Northwest Ethiopia 17 where results revealed that working in a male ward was independently associated with workplace violence. Nurses working in male wards were about eight times more likely to experience violence compared to those working in female wards. The authors attributed this phenomenon to the fact that males are more aggressive as compared to females. Availability of workplace safety measures and effectiveness in management of workplace violence significantly negatively influenced prevalence of workplace violence. Nurses who were of the view that the institution had safety measures were 80% unlikely to have experienced workplace violence. Equally where there was effective management of workplace violence, the nurses were 70% less likely to have reported workplace violence. From the findings of this study, nurses who had experienced workplace violence had a ten-fold likelihood of presenting with symptoms related to mental illness compared to those who had not. Furthermore, nurses who had experienced physical, verbal abuse, bullying or sexual violence increasingly manifested symptoms of mental illness. Overally, all participants who experienced any one form of workplace violence had a greater risk of mental disorders compared with those who had not. These findings are consistent with those reported in previous studies which noted that workplace violence can have serious short- and long-term implications for the mental health and well-being of those exposed. 28 This was also noted in a cross-sectional study conducted in Palestinian hospitals where it was reported that violence led to psychological effects as about 30% of the exposed revealed fear, anxiety, hopelessness, and feelings of guilt. Additionally, majority of those who had been exposed to violence indicated intention to quit work which possibly could complicate job retention and lead to shortages of qualified personnel. 6 Furthermore, in a previous study conducted in Palestine, the authors noted that understaffing, job stress, low job satisfaction are among possible factors that might lead to aggression towards colleagues and co-workers in Palestinian hospitals. Furthermore, victims of co-worker violence reported a loss of confidence in their clinical abilities, and this subsequently influenced their mental wellbeing 26 . This is because, the violence meted upon healthcare workers represents a complex and dangerous occupational hazard – such as mental health challenges. In a study conducted in Italy, 14 workplace violence was associated with job burnout and mental fatigue that may reduce productivity, presence at work and work engagement and may negatively affect the therapeutic relationship between providers and patients. CONCLUSIONS AND RECOMMENDATIONS This study reports a high rate of workplace violence among approximately three-quarters of the nurses at Jaramogi Oginga Odinga Teaching and Referral Hospital (JOOTRH). Nurses aged below 35 years, with advance training and working in the general surgery and male wards were at increased risk of workplace violence against nurses compared to those who were older, with less training and working in other wards. Availability of workplace safety protection measures significantly reduced the likelihood of workplace violence. Other institutional factors that reduced the likelihood of workplace violence were availability of training opportunities and effectiveness in management of workplace violence against nurses. There is need to understand institutional processes, procedures and operations that reduce the likelihood of workplace violence in other hospital departments and apply these findings to the general surgery unit where there was a higher prevalence of workplace violence. Nurses in these violence prone departments should be availed for psychotherapy and other necessary interventions to help them overcome the trauma associated with workplace violence. 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DOI:10.1186/1472-6963-12-469. Tee S, Üzar Özçetin YS, Russell-Westhead M. Workplace violence experienced by nursing students: A UK survey. Nurse Educ Today 2016; 41 : 30–5. De Puy J, Romain-Glassey N, Gut M, Pascal W, Mangin P, Danuser B. Clinically assessed consequences of workplace physical violence. Int Arch Occup Environ Health 2015; 88 : 213–24. Additional Declarations The authors declare no competing interests. Cite Share Download PDF Status: Posted 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. 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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-4724448","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":325695985,"identity":"270d9b61-8a07-44de-92f2-61a12a5fb781","order_by":0,"name":"Anne Owira Atogo","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA1klEQVRIiWNgGAWjYFACxgYIzQ6iDSyI1ZIApHkOgLRIEGsTSIsEiGAgQgu/RHLbh58/bOz6JZ9f3fCjQIKBv707Aa8WyRmJzTN7EtKSZ87OKbvZA3SYxJmzG/BqMbid2MzAk3A42eB2TtoNHqAWA4lcwloY/4C03DyTdvMPsVqYgbbYGdxgP3abKFsk5z9sZpZJS0uQ7Mlhuy1jIMFD0C/8PMcfM76xsbHnZz/+7OabPzZy/O29+LXAQGIDA48BiMFDlHIQsAemmAdEqx4Fo2AUjIKRBQCYVEdWOBm63QAAAABJRU5ErkJggg==","orcid":"https://orcid.org/0000-0002-3807-1416","institution":"Masinde Muliro University of Science and Technology.","correspondingAuthor":true,"prefix":"","firstName":"Anne","middleName":"Owira","lastName":"Atogo","suffix":""},{"id":325697010,"identity":"43a83d07-fe7a-4156-b43a-d2fbeb9e499d","order_by":1,"name":"Zablon Nyaberi","email":"","orcid":"","institution":"Masinde Muliro University of Science and Technology.","correspondingAuthor":false,"prefix":"","firstName":"Zablon","middleName":"","lastName":"Nyaberi","suffix":""},{"id":325697011,"identity":"490e13fa-9b79-4fd6-82ca-73322c548613","order_by":2,"name":"John Arudo","email":"","orcid":"https://orcid.org/0000-0002-7557-4717","institution":"Masinde Muliro University of Science and Technology.","correspondingAuthor":false,"prefix":"","firstName":"John","middleName":"","lastName":"Arudo","suffix":""}],"badges":[],"createdAt":"2024-07-11 13:26:43","currentVersionCode":1,"declarations":{"humanSubjects":true,"vertebrateSubjects":false,"conflictsOfInterestStatement":false,"humanSubjectEthicalGuidelines":true,"humanSubjectConsent":true,"humanSubjectClinicalTrial":false,"humanSubjectCaseReport":false,"vertebrateSubjectEthicalGuidelines":false},"doi":"10.21203/rs.3.rs-4724448/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-4724448/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":60341885,"identity":"26d99a6c-ae0f-4dfb-8de4-b864dfbc9037","added_by":"auto","created_at":"2024-07-15 18:46:41","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":29865,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003ePrevalence of Workplace Violence\u003c/strong\u003e\u003c/p\u003e","description":"","filename":"1.png","url":"https://assets-eu.researchsquare.com/files/rs-4724448/v1/fc51a5e7879d5338b6aa8dbf.png"},{"id":60343766,"identity":"a0c463ce-3e14-4d06-bf65-938c52df3fcf","added_by":"auto","created_at":"2024-07-15 19:18:42","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":454221,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-4724448/v1/5fa918c0-9e44-4200-b6f5-47835fbb1f81.pdf"}],"financialInterests":"The authors declare no competing interests.","formattedTitle":"\u003cp\u003e\u003cstrong\u003ePredictors of Work-Related Violence Against Nurses Working at a Tertiary Hospital in Kisumu, Kenya.\u003c/strong\u003e\u003c/p\u003e","fulltext":[{"header":"INTRODUCTION","content":"\u003cp\u003eWorkplace violence is any act or threat of physical violence, harassment, intimidation or threatening disruptive behaviour that occurs at place of work\u003csup\u003e1,2\u003c/sup\u003e. Workplace violence in hospitals refers to violent or aggressive incidents that occur in healthcare settings. According to the Health and Safety Executive (HSE), workplace violence is defined as \u0026ldquo;any incident in which a person is abused, threatened, or assaulted in circumstances relating to their work.\u0026rdquo; This workplace violence could include but is not limited to a carer bitten by a person with learning disabilities during normal care, an irate visitor verbally abusing a ward manager due to perceived inadequate treatment, a nurse facing verbal abuse and threats from a patient refusing prescribed medication or a catering assistant being hit by a confused elderly patient. Because of the busy and routine nature of hospitals, there is a high prevalence of workplace violence \u003csup\u003e3\u0026ndash;5\u003c/sup\u003e. This can further be attributed to high flow and work-intensive departments such as the emergency departments, surgical and medical wards\u003csup\u003e6\u003c/sup\u003e. Workplace Violence (WPV) is a significant issue within the healthcare sector that has been on the rise over the past decade, with a notable increase during the COVID-19 pandemic. This alarming trend is commonly witnessed in emergency departments, where incidents of violence have doubled compared to pre-pandemic levels. Workplace Violence not only impacts the patient\u0026rsquo;s quality of care, but also affects the well-being of healthcare employees. Organizational interventions aimed at addressing WPV have shown varying degrees of success, with many failing to produce sustained improvements. This is often due to a tendency by healthcare organizations to oversimplify the causes of violence, leading to interventions that primarily focus on individual-level responses like staff education and security modifications \u003csup\u003e7\u003c/sup\u003e. However, these approaches are insufficient in tackling the full spectrum of factors contributing to WPV.\u003c/p\u003e \u003cp\u003eViolence against nurses in their workplace is a major global problem that has received increased attention in recent years\u003csup\u003e1\u003c/sup\u003e. Work-related violence is defined as any act in which a person is abused, threatened, intimidated or assaulted in their work environment\u003csup\u003e8\u003c/sup\u003e. It includes threatening behaviour, verbal or written threats, harassment, verbal abuse and physical attacks\u003csup\u003e9\u003c/sup\u003e. Violence and threats of violence are an emerging problem in jobs where workers are in constant contact with clients, the public and co-workers. Unfortunately, it has been reported that health care workers experience the highest rate of WPV as compared to other sectors often because nurses on the frontline are more at risk of workplace assault than other health professionals.\u003csup\u003e10\u003c/sup\u003e The nature of nursing work exposes them to increased risk of work-related violence. High rates of both physical and nonphysical violent events have been reported among nurses working in nursing homes, emergency departments, psychiatric and geriatric departments.\u003csup\u003e11\u003c/sup\u003e Being male, working at night and working in an environment with more colleagues have been associated with workplace violence against nurses.\u003csup\u003e12\u003c/sup\u003e\u003c/p\u003e \u003cp\u003eGlobally violence against health care workers; of who nurses form the highest number is a growing problem and can severely impact on the health care system.\u003csup\u003e13\u003c/sup\u003e Work-related violence against healthcare professionals is a problem that is occurring with increased frequency in many parts of the world. Because of the nature of their work, nurses are prone to workplace violence more than any other category of healthcare workers.\u003csup\u003e14\u003c/sup\u003e Workplace violence has a negative impact on the physical and psychological wellbeing of health care personnel\u003csup\u003e3\u003c/sup\u003e. It has been shown a relationship between workplace violence and stress.\u003c/p\u003e \u003cp\u003eThis study assessed workplace violence against nurses. Specifically, it assessed individual and institutional factors influencing workplace violence. It also explored determinants of workplace violence as well as evaluated the effect of workplace violence on nurses\u0026rsquo; mental well-being.\u003c/p\u003e"},{"header":"MATERIALS AND METHODS","content":"\u003cp\u003eThis cross-sectional descriptive study was conducted among nurses with a minimum of one-year experience working at the Jaramogi Oginga Odinga Teaching and Referral Hospital in Kisumu-Kenya. Data was collected using a self-administered questionnaire that asked questions regarding their sociodemographic characteristics, nature of their work, experience with workplace violence and institutional factors that could be associated with workplace violence. The data obtained was analysed descriptively (in the form of frequencies and proportions for categorical variable and inferentially as mean with corresponding standard deviation) and inferentially. Pearson chi-square test was adopted to assess statistically significant association between predictors of WPV and violence occurrence. Odds ratios were computed at 95% confidence interval. We obtained ethical approval from the institutional research and ethics committees of Masinde Muliro University of Science and Technology (MMUST) and the Jaramogi Oginga Odinga Teaching and Referral Hospital/ (JOOTRH). Additionally, a research license was obtained from the National Commission for Science, technology and Innovations (NACOSTI). Lastly, a written informed consent was obtained from all participants prior to enrolment.\u003c/p\u003e"},{"header":"RESULTS","content":"\u003cp\u003eWe enrolled 184 nurses, majority of whom were female (62.0%), aged 25\u0026ndash;34 years (48.9%), married (81.0%), attained a diploma level of education (57.6%) and all professed the Christian faith (Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e).\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\u003e\u003cb\u003eSociodemographic Characteristics (N\u0026thinsp;=\u0026thinsp;184\u003c/b\u003e)\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"4\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVariables\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCategories\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003en\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003e%\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eGender\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e70\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e38.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e114\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e62.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003eAge group in years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e25\u0026ndash;34\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e90\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e48.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e35\u0026ndash;44\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e49\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e26.6\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e45\u0026ndash;55\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e30\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e16.3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026ge;\u0026thinsp;55\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e15\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e8.2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eMean age\u0026thinsp;\u0026plusmn;\u0026thinsp;SD (Range)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e37.0\u0026thinsp;\u0026plusmn;\u0026thinsp;9.5 (25.0\u0026ndash;59.0); Median\u0026thinsp;=\u0026thinsp;35.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003eMarital status\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSingle\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e27\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e14.7\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMarried\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e149\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e81.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSeparated\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\u003e2.7\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eWidowed\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.6\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eLevel of training\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCertificate\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\u003e8.7\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eDiploma\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e106\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e57.6\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eDegree\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e62\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e33.7\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eReligion\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eChristian\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e184\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e100.0\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\u003eMajority (88%) of the nurses interviewed were operational nurses with about one in ten (10.9%) being senior managers. Mean number of years worked was 10.8\u0026thinsp;\u0026plusmn;\u0026thinsp;9.9 and ranged from 1 to 35. The mean number staff per workstation was 5 with a range of 1\u0026ndash;18. Nearly half (48.9%) worked in general surgery while 28.8% were in general medicine. Majority (96.7%) worked in shifts with less than three-quarters (71.7%) working in adult setting. Slightly more than half (51.1%) worked with male patients compared to 36.4% who worked in mixed gender setting (Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e).\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\u003eNurses\u0026rsquo; Individual characteristics\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"4\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVariables\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCategories\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003en\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003e%\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eJob position\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSenior Management\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\u003e10.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSupervisor\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\u003e1.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eOperational nurse\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e162\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e88.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eMean number of years of experience in health sector\u0026thinsp;\u0026plusmn;\u0026thinsp;SD (Range)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e10.8\u0026thinsp;\u0026plusmn;\u0026thinsp;9.9 (1.0\u0026ndash;35.0)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eMean number of staff (Range)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e5 (1\u0026ndash;18)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"4\" rowspan=\"5\"\u003e \u003cp\u003eWhere spends most of the times in workplace\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAccident and emergency\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e15\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e8.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAmbulatory, ICU, Specialized unit\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\u003e4.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eGeneral surgery\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e90\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e48.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eGeneral medicine\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e53\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e28.8\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\u003e18\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e9.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eWork in shifts\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e178\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e96.7\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\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\u003e3.3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"4\" rowspan=\"5\"\u003e \u003cp\u003ePatients / Clients work with\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNewborn\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\u003e1.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eInfants\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\u003e4.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eChildren\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e39\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e21.2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAdolescents\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.6\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAdults\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e132\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e71.7\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eSex of patients work with\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e94\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e51.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e23\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e12.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMale / Female\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e67\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e36.4\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\u003eSeven in ten nurses reported experiencing some form of workplace violence, with 41.8% of them saying they were verbally abused. Among those physically abused, 71.8% were assaulted by the relatives of the patients with 28.2% being injured because of the incident. Bullying by co-workers was noted among 24 (13.0%) of the respondents while 41 (22.3%) reported sexual harassment (Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003eAvailability of workplace safety measures and effectiveness in management of workplace violence significantly reduced the likelihood of WPV occurrence. Nurses who believed in the institutional safety measures were significantly less likely to experience WPV (OR: 0.2; 95% CI: 0.11\u0026ndash;0.41; p\u0026thinsp;\u0026lt;\u0026thinsp;0.001) as shown on Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eInstitutional predictors of workplace violence\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"3\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePredictor\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eOR (95% CI)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003ep-value\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePresence of safety measures\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e0.3 (0.13, 0.84)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e0.020\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWPV measures\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e0.2 (0.11, 0.41)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEffectiveness in WPV management\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e0.3 (0.18, 0.65)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.009\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWorking in general surgery\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e9.7 (3.60, 27.01)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\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\u003eEffect of workplace violence on nurses\u0026rsquo; mental well-being was assessed using the GHQ-28 instrument scores which included assessment on somatic symptoms, anxiety / insomnia, social dysfunction and severe depression. A score of 24 and higher was considered as presence of mental illness while a score of \u0026lt;\u0026thinsp;24 was considered as normal status of well-being. Nurses who had experienced workplace violence were 10.8 times more likely to have presented with symptoms of mental illness (OR: 10.8; 95% CI: 5.22\u0026ndash;22.48; p\u0026thinsp;\u0026lt;\u0026thinsp;0.0001) than those who had not. Those who had experienced physical (OR: 4.7; 95% CI: 1.72\u0026ndash;12.62; p\u0026thinsp;=\u0026thinsp;0.001), verbal abuse (OR: 3.9; 95% CI: 2.00\u0026ndash;7.89; p\u0026thinsp;\u0026lt;\u0026thinsp;0.0001), bullied (OR: 14.9; 95% CI: 1.97\u0026ndash;113.41; p\u0026thinsp;=\u0026thinsp;0.0007) or sexual violence (OR: 6.7; 95% CI: 2.26\u0026ndash;19.76; p\u0026thinsp;=\u0026thinsp;0.0001) had higher odds of having manifested with symptoms of mental illness (Table\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab4\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eTest of Association between the participants\u0026rsquo; characteristics and barriers to contraceptive use\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"3\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eIndependent variable\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eOR (95% CI:)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003ep-value\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eExperienced workplace violence\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e10.8 (5.22, 22.48)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.0001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePhysical violence\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e4.7 (1.72, 12.62)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVerbal abuse\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e3.9 (2.00, 7.89)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.0001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBullied\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e14.9 (1.97, 113.41)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.0007\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSexual violence\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e6.7 (2.26, 19.76)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.0001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e"},{"header":"DISCUSSION","content":"\u003cp\u003eThis study defined work-related violence as self-reported experiences of physical attack, verbal abuse, bullying or sexual harassment which occurred in the workplace over the past 12-months (from the time of data collection). Based on this, 70% of the participants reported some form of work-related violence. This overall one-year prevalence of work-related violence is close to that reported in Kenya at 76.8%.\u003csup\u003e15\u003c/sup\u003e This finding is higher than the global prevalence estimated to be between 51.7 to 66.7%.\u003csup\u003e16\u003c/sup\u003e Lower proportions have also been reported in other African countries such as Ethiopia\u003csup\u003e17\u003c/sup\u003e at 26.7%, Ghana\u003csup\u003e18\u003c/sup\u003e at 52.7% and Gambia\u003csup\u003e19\u003c/sup\u003e at 62.1%. The high prevalence of workplace violence in the current study could be attributed to the fact that workplace violence is rising in the healthcare industry due to heavy workloads, increasing work pressures, work-related stress, interpersonal conflict, economic disruptions and social uncertainty\u003csup\u003e20\u003c/sup\u003e. This workplace violence within healthcare settings exacerbates in the event of a crisis or disaster involving groups of people overwhelmed with their work and exhibit panic attacks, uncertainties, shock and worries. Additionally, the hospital is located in densely populated area, and is the main teaching and referral hospital in Kisumu County. The hospital receives high number of patients daily which may be overwhelming to the staff. Thus, the daily large number of patients may lead to long waiting periods with the tendency of making patients and their relatives irritable.\u003csup\u003e21\u003c/sup\u003e\u003c/p\u003e \u003cp\u003eThis study noted that younger nurses below 35 years were more predisposed to workplace violence compared to their older counterparts, a relationship that was statistically significant. This finding is comparable to that conducted in Canada\u0026rsquo;s Alberta and British Columbia in Canada where the authors noted that younger nurses were more predisposed to workplace violence because of their age and inadequate experience. Furthermore, younger nurses were noted to acknowledge violence more readily than their older counterparts who may accept a level of violence as an occupational hazard.\u003csup\u003e22\u003c/sup\u003e In contrast, a study conducted in the emergency departments at general hospitals within Basra city of Iraq, the authors\u003csup\u003e23\u003c/sup\u003e reported a significantly higher proportionate increase in the proportion of workplace violence with advancement in age. This phenomenon was noted by the authors as a reverse pattern in contrast to previously published studies.\u003c/p\u003e \u003cp\u003eSecondly, nurses with certificate or diploma level of training experience less likelihood of workplace violence compared to those with at least bachelor\u0026rsquo;s degree in nursing. The current study also found a statistically significant association between physical violence and the rank of the nurse/midwife. The study revealed that staff nurses were most frequently physically assaulted than other ranks. This finding could be because of their lack of experience in dealing with potentially violent patients\u003csup\u003e21\u003c/sup\u003e. Nurses who attain higher education and work for at least 5 years are less exposed to physical violence than their younger and less experienced colleagues\u003csup\u003e18\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003eThere was a statistically significant association between those working in general surgery and workplace violence with the odds being ten times higher than those working in other departments. Settings like accident and emergency, psychiatry, geriatric care, and nursing homes have been recurrently found exposed to higher frequency of violent episodes, but also general care departments like medical/surgical wards and community care are increasingly reported to be vulnerable to the occurrence of harassment and aggression \u003csup\u003e24\u003c/sup\u003e. Anecdotal data indicate that majority of healthcare professionals (such as nurses) who work in general hospital wards attend to patients with varying medical and surgical conditions are exposed to workplace violence compared to their colleagues in other wards\u003csup\u003e5\u003c/sup\u003e(Jakobsson et al., 2020). In a systematic review conducted in Switzerland, the authors\u003csup\u003e25\u003c/sup\u003e noted that there was a high prevalence of violence meted upon nurses by patients and visitors in general surgery units of public hospitals. This study also revealed a statistically significant relationship between working in medical, surgical, psychiatric and emergency units with physical violence. Results from a study conducted by Hahn et al., (2011),about half of the nurses had experienced verbal abuse while one-quarter reported to have been subjected to physical violence. The high prevalence of work-place violence was reported more in the medical and surgical wards as well as the intensive care units. Medical, surgical and emergency units are units usually have severely ill patients who need nursing care and regular monitoring \u003csup\u003e6\u003c/sup\u003e. This phenomenon creates unnecessary anger and anxiety leading to violence on the part of patients \u003csup\u003e6,26,27\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003eFurthermore, nurses working with male patients were about three times more likely to have experienced workplace violence compared to those working with female or patients of both sexes. This favourably compares with a study conducted in Northwest Ethiopia \u003csup\u003e17\u003c/sup\u003e where results revealed that working in a male ward was independently associated with workplace violence. Nurses working in male wards were about eight times more likely to experience violence compared to those working in female wards. The authors attributed this phenomenon to the fact that males are more aggressive as compared to females.\u003c/p\u003e \u003cp\u003eAvailability of workplace safety measures and effectiveness in management of workplace violence significantly negatively influenced prevalence of workplace violence. Nurses who were of the view that the institution had safety measures were 80% unlikely to have experienced workplace violence. Equally where there was effective management of workplace violence, the nurses were 70% less likely to have reported workplace violence.\u003c/p\u003e \u003cp\u003eFrom the findings of this study, nurses who had experienced workplace violence had a ten-fold likelihood of presenting with symptoms related to mental illness compared to those who had not. Furthermore, nurses who had experienced physical, verbal abuse, bullying or sexual violence increasingly manifested symptoms of mental illness. Overally, all participants who experienced any one form of workplace violence had a greater risk of mental disorders compared with those who had not. These findings are consistent with those reported in previous studies which noted that workplace violence can have serious short- and long-term implications for the mental health and well-being of those exposed.\u003csup\u003e28\u003c/sup\u003e\u003c/p\u003e \u003cp\u003eThis was also noted in a cross-sectional study conducted in Palestinian hospitals where it was reported that violence led to psychological effects as about 30% of the exposed revealed fear, anxiety, hopelessness, and feelings of guilt. Additionally, majority of those who had been exposed to violence indicated intention to quit work which possibly could complicate job retention and lead to shortages of qualified personnel.\u003csup\u003e6\u003c/sup\u003eFurthermore, in a previous study conducted in Palestine, the authors noted that understaffing, job stress, low job satisfaction are among possible factors that might lead to aggression towards colleagues and co-workers in Palestinian hospitals. Furthermore, victims of co-worker violence reported a loss of confidence in their clinical abilities, and this subsequently influenced their mental wellbeing \u003csup\u003e26\u003c/sup\u003e. This is because, the violence meted upon healthcare workers represents a complex and dangerous occupational hazard \u0026ndash; such as mental health challenges. In a study conducted in Italy,\u003csup\u003e14\u003c/sup\u003e workplace violence was associated with job burnout and mental fatigue that may reduce productivity, presence at work and work engagement and may negatively affect the therapeutic relationship between providers and patients.\u003c/p\u003e"},{"header":"CONCLUSIONS AND RECOMMENDATIONS","content":"\u003cp\u003eThis study reports a high rate of workplace violence among approximately three-quarters of the nurses at Jaramogi Oginga Odinga Teaching and Referral Hospital (JOOTRH). Nurses aged below 35 years, with advance training and working in the general surgery and male wards were at increased risk of workplace violence against nurses compared to those who were older, with less training and working in other wards. Availability of workplace safety protection measures significantly reduced the likelihood of workplace violence. Other institutional factors that reduced the likelihood of workplace violence were availability of training opportunities and effectiveness in management of workplace violence against nurses.\u003c/p\u003e \u003cp\u003eThere is need to understand institutional processes, procedures and operations that reduce the likelihood of workplace violence in other hospital departments and apply these findings to the general surgery unit where there was a higher prevalence of workplace violence. Nurses in these violence prone departments should be availed for psychotherapy and other necessary interventions to help them overcome the trauma associated with workplace violence. Overally, experiencing various forms of WPV significantly affected the wellbeing of the nurses enrolled.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eAl-Qadi MM. 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Clinically assessed consequences of workplace physical violence. \u003cem\u003eInt Arch Occup Environ Health\u003c/em\u003e 2015; \u003cstrong\u003e88\u003c/strong\u003e: 213\u0026ndash;24.\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":true,"hideJournal":true,"highlight":"","institution":"Masinde Muliro University of Science and Technology","isAcceptedByJournal":false,"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":"Workplace violence, WPV, Nurses, Kisumu, Kenya","lastPublishedDoi":"10.21203/rs.3.rs-4724448/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-4724448/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cb\u003eBackground\u003c/b\u003e\u003c/p\u003e \u003cp\u003eWorkplace violence (WPV) is any act in which a person is abused, threatened, intimidated or assaulted in their work environment. It could involve physical, verbal or written threatening behaviour or physical attacks. Workplace violence against nurses is increasingly becoming a major problem globally. Because of the nature of their work, nurses are at increased risk of workplace violence.\u003c/p\u003e\u003cp\u003e\u003cb\u003eObjective\u003c/b\u003e\u003c/p\u003e \u003cp\u003eTo assess workplace violence against nurses at Jaramogi Oginga Odinga Teaching and Referral Hospital.\u003c/p\u003e\u003cp\u003e\u003cb\u003eMaterials and methods\u003c/b\u003e\u003c/p\u003e \u003cp\u003eIt employed a cross-sectional study design among 184 nurses randomly selected from Jaramogi Oginga Odinga Teaching and Referral Hospital in Kisumu-Kenya. Data was collected using a self-administered questionnaire that asked questions regarding their sociodemographic characteristics, nature of their work, experience with workplace violence and institutional factors that could be associated with workplace violence. The data obtained was analysed descriptively (in the form of frequencies and proportions for categorical variable and inferentially as mean with corresponding standard deviation) and inferentially. Pearson chi-square test was adopted to assess statistically significant association between predictors of WPV and violence occurrence. Odds ratios were computed at 95% confidence interval.\u003c/p\u003e\u003cp\u003e\u003cb\u003eResults\u003c/b\u003e\u003c/p\u003e \u003cp\u003eThis study enrolled 184 nurses with a mean age of 37 (\u0026plusmn;\u0026thinsp;9.5) years, of whom 62% were female. Majority (88%; n\u0026thinsp;=\u0026thinsp;162) of the nurses enrolled were at the operational level with 2 (1.1%) being supervisors and 20 (10.9%) being in senior management. Workplace violence was reported by 70% of the respondents, with 41.8% of them saying they were verbally abused. Among those physically abused, 71.8% were assaulted by the relatives of the patients with 28.2% being injured because of the incident. Bullying by co-workers was noted among 24 (13.0%) of the respondents while 41 (22.3%) reported sexual harassment. 96.2% had not received any training on WPV prevention in the last twelve months. Working in the general surgery department (p\u0026thinsp;\u0026lt;\u0026thinsp;0.001) and lack of safety measures (p\u0026thinsp;=\u0026thinsp;0.020) predicted WPV.\u003c/p\u003e\u003cp\u003e\u003cb\u003eConclusion\u003c/b\u003e\u003c/p\u003e \u003cp\u003ethe study reports that working in general surgical wards and lack of institutional measures against violence are the major predictors of workplace violence among nurses. There is need to understand institutional processes, procedures and operations that reduce the likelihood of workplace violence in other hospital departments and apply these findings to the general surgery unit where there was a higher prevalence of workplace violence.\u003c/p\u003e","manuscriptTitle":"Predictors of Work-Related Violence Against Nurses Working at a Tertiary Hospital in Kisumu, Kenya.","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-07-15 18:46:36","doi":"10.21203/rs.3.rs-4724448/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":"17560aa3-7c18-4f23-b1a4-ad8ccede4ee1","owner":[],"postedDate":"July 15th, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[{"id":34599968,"name":"Nursing"}],"tags":[],"updatedAt":"2024-07-15T18:46:36+00:00","versionOfRecord":[],"versionCreatedAt":"2024-07-15 18:46:36","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-4724448","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-4724448","identity":"rs-4724448","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}