Mental distress and job satisfaction in Palestinian nurses exposed to workplace aggression: a cross-sectional study

Abstract Background Nurses who are exposed to workplace aggression from patients, patient relatives, or colleagues are at risk for mental health disorders and job dissatisfaction. The aim of this study was to assess the prevalence of exposure to workplace aggression and the association between mental distress and job satisfaction in nurses working in the Hebron district of the occupied Palestinian territory. Methods In this cross-sectional study, nurses were recruited to answer a questionnaire covering sociodemography and workplace aggression (WHO questionnaire), including exposure to physical and verbal aggression and bullying. We assessed mental distress with the General Health Questionnaire (GHQ-30) and job satisfaction with the Generic Job Satisfaction scale. Associations between workplace aggression and mental distress and satisfaction were estimated from χ 2 tests and linear regression analyses using Stata/IC10. The study was approved by the ministry of health. Written informed consent was provided by all participants. Findings In 2012, we recruited 372 registered nurses from the Hebron governorate. 28 (8%) nurses were excluded, and the final sample (n=344) included 213 (62%) women and 131 (38%) men. The prevalence of aggression of any kind was 27%. 17 (5%) nurses had been exposed to physical aggression, 83 (24%) had been exposed to verbal aggression, and 25 (7%) had been exposed to bullying. Men reported a higher prevalence of bullying than women (12% of men vs 5% of women). The prevalence of exposure to physical aggression, verbal aggression, and bullying was highest in young nurses. After adjusting for covariates, nurses exposed to verbal aggression reported 2·9 units (95% CI 0·02 to 5·6; p=0·04) more mental distress than non-exposed nurses. Bullying was associated with a 2·6 unit (95% CI −5·1 to −0·14) reduction in job satisfaction score. Interpretation Nearly a third of nurses in this study reported exposure to some sort of aggression. Nurses exposed to verbal aggression reported more distress than nurses who had never been exposed to verbal aggression. Bullying was associated with reduced job satisfaction. Because the study had a cross-sectional design and both exposure and outcomes were measured using self-report, the results should be interpreted with caution. Funding The Norwegian Programme for Development, Research and Education (NUFU pro x1 50/2002 and NUFUSM-2008/10232) and The National Norwegian State Education Loan Funds.