Violence against healthcare workers during COVID-19 vaccination campaign

Abstract Background Violence against healthcare workers (HCWs) has gained increasing attention in recent years, both because it is on the rise and because there is growing concern about these incidents, which are classified as sentinel events by the Italian Ministry of Health. Since little is known about the actual burden of this phenomenon, especially during the stressful COVID-19 vaccination campaign, we decided to explore the problem in our region. Methods Between January and March 2022, in the 1.2 million-inhabitant Friuli Venezia Giulia region (Italy), we conducted an anonymous online survey to collected data on episodes of violence and their consequences for HCWs. Data from validated tools assessing characteristics of violent episodes and post-trauma impact were analyzed in conjunction with socio-demographic data of respondents. Results 200 HCWs participated in the survey, most of whom were women (72%), worked as nurses (107) or doctors (71), and had a mean age of 47 years. More than half of them (59%) reported at least one episode of violence, mainly in the form of a verbal assault (64%); there were no differences between victims. In 72 cases, these incidents affected the HCW’s private life, mainly disturbing sleep or concentration (68%). Most HCWs stated that inadequate communication was a trigger for the violence (97%). Although 80% of HCWs would readily report any violent incident, to improve the situation they called for certainty of action against the perpetrator (87%), more organizational support (85%), standard procedures (75%) and self-defense courses (75%). Conclusions Violence in COVID-19 vaccination campaign appears to be common and to affect both the personal and professional lives of HCWs. Improvements at the institutional and personal level could help to address this problem that affects the health workforce. Key messages • Given the growing public debate, violence in healthcare settings is an important issue that needs to be addressed in the coming years. • Assessing workplace violence and its associated risk factors will help focus on the strategies that can be usefully employed to prevent it in the future.


Background:
Studying the relationship between work-related stress and sick leave is valuable in taking actions for workers' health. This study aimed to analyse the association between work-related stress, measured with the Work Stress Questionnaire (WSQ), and registered sick leave among primary health care patients in Sweden.

Methods:
The prospective longitudinal study included 232 patients who were non-sick-listed, employed, aged 18-64 years and sought care for mental and/or physical health complaints. Logistic regression analysis was performed with questionnaire data on work-related stress from baseline together with sick leave data from a national register for the following 12 months. Results: High stress due to indistinct organization and conflicts was reported by 21% (n = 49), while 45% (n = 105) reported high stress due to individual demands and commitment. During 12 months 36% (n = 83) were on sick leave for 15 days or more. The odds of being on sick leave was twice as high for patients perceiving high stress due to indistinct organization and conflicts, high stress due to individual demands and commitment, low influence at work, or high interference between work and leisure time. Perceiving high stress due to both indistinct organization and conflicts as well as individual demands and commitment quadrupled the odds of sick leave, OR 4.15 (95% CI 1.84; 9.38).

Conclusions:
Work-related stress and sick leave were prevalent among the patients. Primary health care can therefore be a suitable arena for addressing these issues. Perceiving work-related stressors and stress within one or multiple areas increased the odds of registered sick leave by two to four times. Hence, a wide spectrum of factors needs to be considered, to capture the dynamic interaction between the individual and the work environment.

Key messages:
Work-related stress is associated with future sick leave for primary health care patients. Early identification of patients with work-related stress is important for the primary health care.

Background:
Violence against healthcare workers (HCWs) has gained increasing attention in recent years, both because it is on the rise and because there is growing concern about these incidents, which are classified as sentinel events by the Italian Ministry of Health. Since little is known about the actual burden of this phenomenon, especially during the stressful COVID-19 vaccination campaign, we decided to explore the problem in our region.

Methods:
Between January and March 2022, in the 1.2 millioninhabitant Friuli Venezia Giulia region (Italy), we conducted an anonymous online survey to collected data on episodes of violence and their consequences for HCWs. Data from validated tools assessing characteristics of violent episodes and post-trauma impact were analyzed in conjunction with socio-demographic data of respondents.

Results:
200 HCWs participated in the survey, most of whom were women (72%), worked as nurses (107) or doctors (71), and had a mean age of 47 years. More than half of them (59%) reported at least one episode of violence, mainly in the form of a verbal assault (64%); there were no differences between victims. In 72 cases, these incidents affected the HCW's private life, mainly disturbing sleep or concentration (68%). Most HCWs stated that inadequate communication was a trigger for the violence (97%). Although 80% of HCWs would readily report any violent incident, to improve the situation they called for certainty of action against the perpetrator (87%), more organizational support (85%), standard procedures (75%) and self-defense courses (75%). 15th Violence in COVID-19 vaccination campaign appears to be common and to affect both the personal and professional lives of HCWs. Improvements at the institutional and personal level could help to address this problem that affects the health workforce.

Key messages:
Given the growing public debate, violence in healthcare settings is an important issue that needs to be addressed in the coming years. Assessing workplace violence and its associated risk factors will help focus on the strategies that can be usefully employed to prevent it in the future.

Background:
Active labour market programmes, such as vocational training, have become widely adopted measures to increase job seekers' employment opportunities, but evidence of their effectiveness in later employment is mixed. Individuals who enter training differ greatly in their socioeconomic background, health, and labour market history, which can affect the effectiveness of these programmes. There is still uncertainty, for example, on how vocational labour market training works for individuals with prior health problems.

Methods:
We use nationally representative Finnish register data on 88,283 individuals aged 25-59 who participated in vocational labour market training in 2008-2013, 23,715 of whom had sickness absence lasting at least 10 weekdays (including Saturday) three years prior to the training and 64,568 of whom did not. To adjust for the differences in sociodemographic and work-related factors between these groups, we will conduct propensity score matching. We will analyze work participation three years before and after the training among those with sickness absence and those without using a difference-in-difference analysis.

Results:
Our preliminary results show that before training the work participation rate was similar in those with sickness absence history (58.5 %) and those without (58.1 %). After training, those with a sickness absence history had slightly lower work participation than those without (54.6% versus 59.6 %). The differences in work participation between these groups increased slightly over time after training.

Conclusions:
Vocational labour market training does not necessarily work equally well for everyone in terms of enhancing employment, and job seekers with work disability history should be offered either extra support or another type of unemployment service. However, these are our pre-matching results, and they cannot be causally interpreted. Next, we will conduct the propensity score matching and difference-in-difference analysis.

Key messages:
Having a sickness absence history prior to vocational labour market training is associated with lower work participation after training compared to participants without a sickness absence history.
The main advantage of the study is the use of a quasiexperimental study design to test the effectiveness of vocational training, using rich nationally representative register data with long follow-up.