Violence and Abuse towards Staff by Patients and the Public in General Practice: A Scoping Review

Problem

Violence and abuse in healthcare settings is a growing concern. Staff are more likely to experience violence initiated by patients and the public than by their own colleagues. General practice may be more exposed to such behaviours than hospitals. Such experiences can negatively impact staff wellbeing, job satisfaction and turnover intention. It is important to better understand the extent and the nature of these experiences as well as possible preventive and support strategies in order to reduce their occurrence and impact. Though evidence on workplace violence in healthcare settings has been synthesised, the majority of reviews focus on hospitals and rarely consider primary care, in particular, general practice. In addition, these reviews have not focused on specifically patient or public-initiated violence and abuse towards staff. This scoping review addresses these research gaps.

The aim of the scoping review is to synthesise evidence on:

1. The extent, characteristics and impact of violence and abuse towards staff in general practice as initiated by patients and the public.

2. Practices in violence prevention and associated staff support in general practice

Approach

This review follows the Joanna Briggs Institute scoping review guidelines. The protocol was registered on Open Science Framework on 21st August 2023. Five bibliographic databases, one grey literature source, Google, and Google Scholar were searched in September 2023. Primary studies in any language were included. Citation screening involved two reviewers working independently. Data have been charted.

Findings

The search strategy yielded 35,823 citations, 16,303 of which were duplicates. Of the remaining 19,519 citations, 55 citations met the inclusion criteria and four were unobtainable. Preliminary findings are that 34 studies reported the rate of staff experience of violence and abuse by patients or the public. Eight studies include staff from various healthcare settings, not exclusive to general practice, or include staff-on-staff violence and abuse. Ten studies reported possible correlates, six studies explored possible causes, and 18 reported impacts of this type of violence. Only five studies explored participants’ suggestions on future preventative or support strategies. Within the above-mentioned studies, nine were qualitative and two adopted mixed methods studies that explored staff perspectives in greater depth.

Consequences

Current research primarily focuses on the extent of this issue. Impacts of this type of violence and abuse include staff stress / depression, injury, and turnover intention. Further research on risk factors, wider impacts and possible preventative and support strategies is needed. It will benefit from taking a systemic approach to understanding this issue and formulating strategies or responses.