Workplace Violence Against Doctors in Khartoum State, Sudan, 2020
Background: Workplace violence against healthcare workers and especially doctors are now clearly taken as a rapidly rising health problem in Sudan with great political and legal concerns. The current study was aimed at exploring the prevalence of verbal and physical workplace violence, the major factors associated with it, and its consequences reported by medical staff in Khartoum, Sudan government hospitals in 2020.
Methods: This cross-sectional study utilized self-administered questionnaires to collect data on aspects of workplace violence against doctors working in the government hospitals of Khartoum, Sudan. A nine-item self-reported workplace violence scale was used. An online survey of self-reported work-related violence exposure during the preceding 12 months was sent to conveniently selected doctors. In total, 387 doctors completed the questionnaire in 2020. Data were analyzed using the SPSS version 26.
Results: One hundred and ninety five (50%) respondents reported they were victims of violence in the previous 12 months; 92% of them experienced nonphysical violence; while female doctors were more likely to experience this type of violence (67%), younger respondents <30 years of age were more likely to encounter violent episodes. Results show an association between exposure to physical violence and working at an emergency department. The assailants were mostly males in the age group of 19–35 years (70.2%), most of them were under no influence (60.8%).
Conclusion: Approximately one in every two doctors had experienced some degree of violence, either physical or nonphysical or both, and it was negatively reflected on their psychological status as well as their work performance.
 Violence. (n.d.). In Oxford Dictionary on Lexico.com. Retrieved from: https://www.lexico.com/definition/ violence
 USLegal, Inc. (n.d.). In Workplace Violence Law and Legal Definition. Retrieved from: https://definitions. uslegal.com/w/workplace-violence/
 FitzGerald, D. and Reid, A. (2012). Frequency and consequences of violence in community pharmacies in Ireland. Occupational Medicine, vol. 62, no. 8, pp. 632–663.
 Papa, A. and Venella, J. (2013). Workplace violence in healthcare: strategies for advocacy. Online Journal of Issues in Nursing, vol. 18, no. 1, manuscript 5.
 WHO. (2002). Framework Guidelines for Addressing Workplace Violence in the Health Sector. Geneva, Switzerland: International labour Office (ILO), International Council for Nurses (ICN), World Health Organization (WHO), Public services international (PSI). Retrieved from: who.int/violence_injury_prevention/violence/activities/work-place/en/
 Dahal, K. (2008). Angry relatives attack doctors and hospitals in Nepal. BMJ, vol. 337, p. a1946.
 Li, Z., Yan, C. M., Shi, L., et al. (2017). Workplace violence against medical staff of Chinese children’s hospitals: a cross-sectional study. PLoS ONE, vol. 12, no. 6, p. e0179373.
 Chen, S., Lin, S., Ruan, Q., et al. (2016). Workplace violence and its effect on burnout and turnover attempt among Chinese medical staff. Archives of Environmental & Occupational Health, vol. 71, no. 6, p. 3307.
 Muzyk, A., Lentz, K., Green, C., et al. (2017). Emphasizing bloom’s affective domain to reduce pharmacy students’ stigmatizing attitudes. American Journal of Pharmaceutical Education, vol. 81, no. 2, p. 35.
 US Department of Labor. (n.d.). OSHA Fact Sheet. Retrieved from: www.osha.gov/OshDoc/ data_General_Facts/factsheet-workplace-violence.pdf
 di Martino, V. (2003). Workplace Violence in the Health Sector: Relationship Between Work Stress and Workplace Violence in the Health Sector. Geneva: ILO/ICN/WHO/PSI. Retrieved from: https://www.who. int/violence_injury_prevention/violence/interpersonal/WVstresspaper.pdf
 Burnham, G. M., Lafta, R., and Doocy, S. (2009). Doctors leaving 12 tertiary hospitals in Iraq, 2004–2007. Social Science & Medicine, vol. 69, pp. 172–177.
 O’Hanlon, M. E. and Campbell, J. H. (October 1, 2007). Iraq Index. The Brookings Institution. Retrieved from: http:/www.brookings.edu/fp/saban/iraq/index.pdf
 Boafo, I. (2016). Ghanaian nurses’ emigration intentions: the role of workplace violence. International Journal of Africa Nursing Sciences, vol. 5, pp. 29–35.
 Kapoor, M. C. (2017). Violence against the medical profession. Journal of Anaesthesiology Clinical Pharmacology, vol. 33, pp. 145–147.
 Tian, Y., Yue, Y., Wang, G., et al. (2020). Workplace violence against hospital healthcare workers in China: a national WeChat-based survey. BMC Public Health, vol. 20, article 582.
 di Martino, V. (2002). Workplace Violence in the Health Sector: Country Case Studies – Brazil, Bulgaria, Lebanon, Portugal, South Africa, Thailand and an additional Australian study. Retrieved from: https: //www.who.int/violence_injury_prevention/injury/en/WVsynthesisreport.pdf
 Mento, C., Silvestri, M., Bruno, A., et al. (2020). Workplace violence against healthcare professionals: a systematic review. Aggression and Violent Behavior, vol. 51, p. 101381.
 Sun, T., Gao, L., Li, F., et al. (2017). Workplace violence, psychological stress, sleep quality and subjective health in Chinese doctors: a large cross-sectional study. BMJ Open, vol. 7, no. 12, p. e017182.
 Gong, Y., Han, T., Yin, X., et al. (2014). Prevalence of depressive symptoms and work-related risk factors among nurses in public hospitals in southern China: a cross-sectional study. Scientific Reports, vol. 4, p. 7109.
 Xu, T., Magnusson Hanson, L. L., Lange, T., et al. (2018). Workplace bullying and violence as risk factors for type 2 diabetes: a multicohort, study and meta-analysis. Diabetologia, vol. 61, no. 1, pp. 75–83.
 Xu, T., Magnusson Hanson, L. L., Lange, T., et al. (2019). Workplace bullying and workplace violence as risk factors for cardiovascular disease: a multi-cohort study. European Heart Journal, vol. 40, no. 14, pp. 1124–1134.
 Kitaneh, M. and Hamdan, M. (2012). Workplace violence against physicians and nurses in Palestinian public hospitals: a cross-sectional study. BMC Health Services Research, vol. 12, no. 1.
 ILO/ICN/WHO/PSI. (2002). Workplace Violence in the Health Sector - Country Case Studies Research Instrument – Survey Questionnaire. Geneva, Switzerland: ILO/ICN/WHO/PSI Joint Programme on Workplace Violence in the Health Sector.
 Gerberich, S., Church, T., McGovern, P., et al. (2004). An epidemiological study of the magnitude and consequences of work related violence: the Minnesota Nurses’ Study. Occupational and Environmental Medicine, vol. 61, no. 6, pp. 495–503.
 Abbas, M. A., Fiala, L. A., Abdel Rahman, A. G., et al. (2010). Epidemiology of workplace violence against nursing staff in Ismailia Governorate, Egypt. Journal of the Egyptian Public Health Association, vol. 85, no. 1–2, pp. 29–43.
 Algwaiz, W. M. and Alghanim, S. A. (2012). Violence exposure among health care professionals in Saudi public hospitals: a preliminary investigation. Saudi Medical Journal, vol. 33, pp. 76–82.
 Abodunrin, O. L., Adeoye, O. A., Adeomi, A. A., et al. (2014). Prevalence and forms of violence against health care professionals in a South-Western city, Nigeria. Sky Journal of Medicine and Medical Sciences, vol. 2, no. 8, pp. 067–072.
 Fernandes, C. M., Bouthillette, F., Raboud, J. M., et al. (1999). Violence in the emergency department: a survey of health care workers. CMAJ, vol. 161, no. 10, pp. 1245–1248.
 Alameddine, M., Kazzi, A., El-Jardali, F., et al. (2011). Occupational violence at Lebanese emergency departments: prevalence, characteristics and associated factors. Journal of Occupational Health, vol. 9, pp. 455–464.
 Deeb, M. (2003). Workplace Violence in the Health Sector – Lebanon Country Case Study. Geneva, Switzerland: ILO/ICN/WHO/PSI Joint Programme on Workplace Violence in the Health Sector.
 AbuAlRub, R. F., Khalifa, M. F., and Habbib, M. B. (2007). Workplace violence among Iraqi hospital nurses. Journal of Nursing Scholarship, vol. 39, no. 3, pp. 281–288.
 El-Gilany, A. H., El-Wehady, A., and Amr, M. (2010). Violence against primary health care workers in Al-Hassa, Saudi Arabia. Journal of Interpersonal Violence, vol. 25, no. 4, pp. 716–734.
 Gillespie, G. L., Gates, D. M., Miller, M., et al. (2010). Workplace violence in healthcare settings: risk factors and protective strategies. Rehabilitation Nursing, vol. 35, no. 5, pp. 177–184.
 Abdellah, R. and Salama, K. (2017). Prevalence and risk factors of workplace violence against health care workers in emergency department in Ismailia, Egypt. Pan African Medical Journal, vol. 26, p. 21.
 Imran, N., Jawaid, M., Haider, I. I., et al. (2010). Bullying of junior doctors in Pakistan: a cross-sectional survey. Singapore Medical Journal, vol. 51, no. 7, p. 592.
 Ayranci, U., Yenilmez, C., Balci, Y., et al. (2006). Identification of violence in Turkish health care settings. Journal of Interpersonal Violence, vol. 21, no. 2, pp. 276–296.
 Landau, S. and Bendalak, Y. (2007). Personnel exposure to violence in hospital emergency wards: a routine activity approach. Aggressive Behavior, vol. 34, no. 1, pp. 88–103.
 Ahmed, F., Khizar Memon, M., and Memon, S. (2018). Violence against doctors, a serious concern for healthcare organizations to ponder about. Annals of Medicine and Surgery, vol. 25, pp. 3–5.
 Swain, C. G., and Greenwood, R. (2014). Patient aggression experienced by staff in a New Zealand public hospital setting. The New Zealand Medical Journal, vol. 127, no. 1394, pp. 10–18.
 Erkol, H., Gökdoğan, M. R., Erkol, Z., et al. (2007). Aggression and violence towards health care providers–a problem in Turkey? Journal of Forensic and Legal Medicine, vol. 14, no. 7, pp. 423–428.
 Ryan, J. A. and Poster, E. C. (1989). The assaulted nurse: short-term and long-term responses. Archives of Psychiatric Nursing, vol. 3, no. 6, pp. 323–331.
 Adib, S. M., Al-Shatti, A. K., Kamal, S., et al. (2002). Violence against nurses in healthcare facilities in Kuwait. International Journal of Nursing Studies, vol. 39, no. 4, pp. 469–478.