José Antonio Ruiz-Hernández

Patients' aggressive behaviours towards nurses: development and psychometric properties of the hospital aggressive behaviour scale‐ users

AIM This article is to report the development and psychometric testing of the Hospital Aggressive Behaviour Scale - Users. BACKGROUND Workplace violence is present in many work spheres, but in the healthcare sector, nurses in particular are at more risk due to the close contact they maintain with users and clients and the special characteristics of this relationship. DESIGN Using qualitative and quantitative methodology, an instrument was applied to a sample of 1,489 nurses from 11 public hospitals. Data collection was carried out in 2010 and 2011. RESULTS Exploratory factor analysis yielded a 10-item instrument distributed in two factors (non-physical violence and physical violence), which was validated by means of confirmatory factor analysis. Both the resulting questionnaire and the factors identified present high internal consistency and adequate external validity, analysed by means of statistically significant correlations between the Hospital Aggressive Behaviour Scale and job satisfaction, burnout components, and psychological well-being. CONCLUSIONS The results indicate that, in nursing personnel, higher exposure to user violence leads to lower job satisfaction, more emotional exhaustion and more cynicism, and to a lower level of psychological well-being. The instrument developed in this study may be very useful in the sphere of assessment and prevention of psychosocial risks for the early detection of the problem of user violence in its two facets.

Vertical and Lateral Workplace Bullying in Nursing: Development of the Hospital Aggressive Behaviour Scale

Healthcare staff is one of the professional groups that suffers the highest exposure to sources of occupational stress such as hostility from coworkers and superiors. In order to contribute to the assessment of bullying behaviors in the healthcare sector and to obtain a brief and manageable instrument for the assessment of this psychosocial risk, we developed the Hospital Aggressive Behaviour Scale–version Co-workers-Superiors (HABS-CS). By means of thorough qualitative analysis, an initial pool of 166 items was obtained, which were reviewed according to precise criteria until concluding with a total of 57 items, which were administered to a sample of 1,484 healthcare professionals from 11 public hospitals. The analyses concluded with the selection of 17 items distributed in two subscales. The internal 5-factor structure is the result of exploratory and confirmatory factor analysis conducted in two samples. Both the resulting questionnaire and the factors identified present adequate psychometric properties: high-internal consistency (Cronbach’s α of .86) and adequate criterion validity, analyzed by means of significant correlations between the HABS-CS and job satisfaction, burnout components, and psychological well-being. This instrument may be of great utility for the assessment and prevention of psychosocial risks.

Profile of partner aggressors as a function of risk of recidivism

Partner aggressors present psychopathological, criminal, and sociodemographic characteristics that have been used for classification in typologies. The goal of the present work was to identify profile of aggressors as a function of the risk of recidivism, and assess whether there correspondence with type of offenders proposed by Holtzworth–Munroe and Stuart. The sample was made up of 90 men condemned for partner violence, of whom 50 were serving a prison sentence, and 40 mandatory community intervention/programs. The risk of recidivism was assessed with the SARA - Spousal Assault Risk Assessment Guide, completed with information obtained from prison records, clinical interviews for the assessment of personality disorders, and self-reports. The results reveal three profile of aggressors according to their risk of recidivism, related to the above-mentioned classification: high-risk aggressors coincide with the Dysphoric/Borderline (DB) type, medium-risk aggressors with the low-level antisocial type (LLA), and the low-risk group with the type of aggressors family only (FO). The implications are discussed in the penitentiary intervention of these results.

User Violence and Nursing Staff Burnout The Modulating Role of Job Satisfaction

Exposure to patient violence in health staff can lead to the onset of burnout in these workers. The main goal of this investigation is to study how exposure to this kind of violence affects onset of burnout and to appraise the role of job satisfaction as a modulating variable. A descriptive, cross-sectional study was carried out using a self-administered anonymous questionnaire with the nursing staff of all the public hospitals of the Region of Murcia (Spain), obtaining a sample of 1,489 health professionals. From the results obtained, we underline the modulating role of extrinsic job satisfaction in the relationship between nonphysical violence and emotional exhaustion, and the protective effect of job satisfaction on the impact of nonphysical violence and the level of cynicism. No effects of job satisfaction in the relationship between physical violence and burnout were observed. We therefore conclude that experiencing nonphysical aggression has a lower impact on the psychological health of workers who are satisfied with their job, and interventions aimed at increasing these workers’ extrinsic job satisfaction are highly recommended.

Influence of attitudes, impulsivity, and parental styles in adolescents’ externalizing behavior

Diverse works have associated externalizing problem behavior with impulsivity, parental styles, and attitudes toward violence. The aim of this study is to analyze the association between these variables and externalizing behavior. A cross-sectional correlational design was used with a sample of 252 adolescents, aged between 12 and 15 years, from the general population. The results obtained indicate a significant association of externalization with high impulsivity, ingrained attitudes toward violence, and inconsistent parental styles, as well as gender and age differences. These results are discussed in relation with the influence of gender stereotypes and their implications in the development of attitudes toward violence.

Evaluation of the users violence in primary health care: Adaptation of an instrument

Background/Objetivo: According to the World Health Organization, one out of every four violent workplace acts takes place in the health setting. The aims of the study are to study the prevalence of workplace violence in primary healthcare (PHC) professionals by adapting the Healthcare-workers Aggresive Behaviour Scale-Users (HABS-U), to establish the frequency of exposure to hostile indicators and to determine which professional group is most exposed. Method: Study through qualitative and quantitative methodology in PHC professionals of the Region of Murcia (Spain). In the qualitative phase in-depth interviews were conducted and during the quantitative phase the instrument was used to 574 professionals of 39 PHC centres. Results: The resulting scale shows excellent psychometric properties and correlates significantly with job satisfaction, burnout components, the factors of empathy and psychological well-being. There was a 90.2% prevalence of user violence, and non-medical personnel were found to be the professional group most exposed. Conclusion: The distribution of user violence is not homogeneous among the different professional groups of PHC. The adaptation of the scale may be useful for detection of user violence, as well as to evaluate the efficacy of intervention programs.