Work-related aggression and violence committed by patients and its psychological influence on doctors

J Occup Health. 2011;53(5):356-64. doi: 10.1539/joh.11-0108-oa. Epub 2011 Aug 9.


Objectives: To determine the incidence rate of work-related aggression and violence (WRAV) against doctors and investigate risk factors and psychological influences of WRAV doctors.

Methods: We sent a self-administered questionnaire on WRAV committed by patients and their associates to 1,148 doctors in Nara Prefecture, Japan. We calculated the incidence rate of WRAV using the number of incidents encountered during the previous 12 mo and the doctor's average weekly working hours. Risk factors for the incidence WRAV were analyzed by Poisson regression, and the influence of WRAV on the symptoms of post-traumatic stress disorder (PTSD) was evaluated by multiple logistic regression analysis.

Results: A total of 758 (66.0%) doctors returned the questionnaire. The incidence rate of WRAV was 0.20 [95% CI: 0.17-0.24]×10(-3) per practice hour. Adjusted incidence rate ratios of WRAV were significantly increased among doctors 1) with a shorter career (11.0; 95% CI: 5.0-24.2), 2) working in a region with the lowest average taxable income (1.6; 1.1-2.4), and 3) whose specialties were dermatology (3.8; 2.3-6.3), psychiatry (2.7; 1.3-5.6) and ophthalmology (1.9; 1.2-3.2). Of 289 subjects who had encountered WRAV at least once during their career, 26 doctors (8.2%) had symptoms suggestive of PTSD due to the most severe incident.

Conclusions: Doctors encountered WRAV at an incidence rate of 0.20×10(-3) per practice hour, and some of them might develop PTSD. Countermeasures are required to maintain sound health and safe workplaces for doctors.

MeSH terms

  • Adult
  • Aged
  • Aggression / psychology*
  • Dermatology / statistics & numerical data
  • Female
  • Humans
  • Japan / epidemiology
  • Logistic Models
  • Male
  • Middle Aged
  • Ophthalmology / statistics & numerical data
  • Physician-Patient Relations*
  • Physicians / psychology*
  • Poisson Distribution
  • Poverty Areas
  • Psychiatry / statistics & numerical data
  • Risk Factors
  • Severity of Illness Index
  • Stress Disorders, Post-Traumatic / epidemiology
  • Stress Disorders, Post-Traumatic / psychology*
  • Surveys and Questionnaires
  • Violence / psychology*
  • Violence / statistics & numerical data
  • Workplace / psychology*
  • Workplace / statistics & numerical data