Aggressions on healthcare workers: prevalence, underreporting, motives, and consequences

Workplace violence in healthcare sector has a significant impact on the health of healthcare professionals, the functioning of the system, and the economy; however, there is a high and variable level of underreporting, as well as few studies on its possible causes and consequences. Furthermore, the literature focuses on specific, and only healthcare professions, hindering a comprehensive view. This study aimed to calculate the prevalence of violence against workers, estimate its underreporting, and analyze its possible reasons and effects. The prevalence of aggressions in a large Spanish public hospital and its associated centers was calculated using official reports. An ad hoc survey was conducted to compare these data and explore associated factors, inviting all professionals (N=5,472) to participate. A classification tree analysis was conducted to study the association between underreporting and its possible causes, including level of awareness of the reporting procedure, type of aggression suffered, and eleven other possible reasons. Participation was obtained from 16.45% (n=900), and the results confirmed an 83.1% underreporting rate (survey prevalence of 16.9% vs. official prevalence of 1.6%). The main reasons cited were related to a lack of knowledge of basic concepts about aggressions, the reporting procedure and its usefulness in prevention, as well as the type of aggression and incorrect subjective beliefs. These results have significant repercussions on the veracity of official data, which are inconsistent, highly variable, and ignore the consequences for workers health. This hampers prevention and has significant economic consequences and impacts the analysis of the burden caused by aggressions.