One of the stressors for man is his type of job and working conditions. Violence in the workplace is also part of the occupational hazard [1]. Violence literally means drought, bitterness and hardship [2]. Indeed, violence is a pattern of behavior that is imposed by fear, intimidation, and harmful and abusive behavior to exercise power and control over a close individual [3]. The World Health Organization divides violence into four categories: physical, verbal, racial, and sexual [5, 4].
An overview of databases shows that workplace violence in health centers is not specific to a specific stratum or location [7]. Statistics published in Europe show that 70-80% of nurses, emergency workers and physicians experience one or more types of workplace violence annually [10].
Despite relevant studies, the true dimensions of violence in health, education, and health centers have not yet been elucidated, and the current face of violence appears to be only the tip of a huge iceberg [28]. In most studies, only the patient's perspective has focused on the issue of violence in the health care setting, and few studies have investigated violence against health care workers [30, 29].
The aim of this study was to determine the prevalence of workplace violence against medical emergency technicians in Hamadan province and its relationship with individual and occupational variables.

 

This descriptive cross-sectional study was conducted in the first half of the year 2018 to survey the staffs of emergency, urban and road medical emergency bases in Hamadan province. Hamadan province has 9 cities including Hamadan, Kabudarahang, Faminin, Rosen, Bahar, Nahavand, Asadabad, Tuyserkan and Malayer with 21 urban bases, 31 road bases and an air base with 332 emergency medical personnel. The sampling method was stratified-random sampling. From among 332 Emergency Personnel of Hamadan province, 137 operational unit technicians who met the inclusion criteria were selected according to the number of employees in each base.
Inclusion criteria included willingness to participate in the study and at least one year of operational experience in emergency medical bases. Individuals who did not wish to cooperate were excluded. Based on a similar study in which the prevalence of violence was 0.838 [10] and with a confidence level of 95%, the minimum sample size was calculated to be 120, with a minimum probability of 10%, the required sample was estimated to be 137. In this study, the standard questionnaire of workplace violence, designed by the International Labor Office and the WHO and the International Council of Nurses was used to collect data [34].
Data were analyzed using SPSS 16 (SPSS Inc., Chicago, IL., USA). Descriptive statistical methods including percent and frequency and analytical statistical methods such as Chi-square, Mann-Whitney and Kruskal-Wallis tests were used. Significance level was 0.05 in all cases.

 

Psychological violence (72.2%), Physical violence (22.6%), racial and religious harassment (4.5%) and sexual harassment (0.7%) were the most prevalent type of violence, respectively (Table 1). Technicians' response to violence was frequent, including aggressive calls to calm (48.1%), urgent coworkers (10.9%), reporting to superiors (10.2%), no specific action (8.7%) and self-defence (7.2%) (Table 2). There was a significant relationship between job status and workplace violence (P<0.05) (Table 3). Marital status, educational level, employment status, type of job shift, employment, direct contact with patients / injured, specific drug use and disease, participation in a training course, experiencing a personal crisis during the last six months, was not related to workplace violence (P<0.05) (Table 4). Also, there was no statistically significant relationship between workplace violence and direct dealing with patients, patient age and gender (P<0.05) (Table 5).
 

Table 1. Distribution of Absolute and Relative Frequency of Research Units by Types of Violence


Table 2. Emergency medical technicians' response to workplace violence


Table 3. Investigation of the relationship between workplace violence against emergency medical technicians and work-related factors


Table 4. Investigating the Relationship between Workplace Violence Against Emergency Medical Technicians and Drug Use, Illness, Crisis Experience, and Attendance


Table 5. Relationship between workplace violence against emergency medical technicians and patient-related factors

In the present study, the factors affecting workplace violence against medical emergency technicians in Hamadan province were investigated. The results showed that the highest rate of workplace violence against emergency medical personnel is related to psychological violence (verbal harassment) and 77.2% of the respondents experienced this type of violence during the last year. Studies of workplace violence against emergency medical technicians have reported psychological violence, including verbal violence, as reported in Maghami et al. (65%) [36] and Rahmani et al. [71%]. In foreign studies, such as the study by Rodriguez Borrego et al. [38] and El-Gilany et al. [39], the frequency of violence was 75.1% and 91%, respectively. The results show that the prevalence of psychological violence (verbal harassment) is slightly higher among emergency medical staff in Hamadan province, which can have devastating effects on them, such as reduced work morale, anger, reduced self-esteem, absenteeism, job change and disability [40].

 

There was a high prevalence of psychological violence against the staff; therefore, planners must identify the related factors in order to plan for preventing these violations.

 

The authors of the article consider it necessary to express their gratitude to the Emergency Medical Staff of Hamadan Province and the officials of the relevant units who contributed to this project. This article is taken from the Master's thesis with the specific recognition of the Ethics Committee of Hamadan University of Medical Sciences, IR.UMSHA.REC.1397.50. The authors also thank the Vice-Chancellor for Research and Technology of Hamadan University of Medical Sciences for the approval of the project and the financial and administrative support of this research in the form of project number 970218802.

 

The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.