From the Journals

Aggression toward health care providers common during pandemic


 

Verbal and physical violence against health care personnel in Latin America has been highly prevalent during the COVID-19 pandemic, according to a new survey.

After an aggressive event or abuse occurred, 56% of providers considered changing their care tasks, and more than a third considered quitting their profession.

“Aggression of any sort against health care providers is not a new social phenomenon, and it has existed as far as medicine and health care is reported in literature. However, the phenomenon of aggression against health care providers during the pandemic grew worse,” senior study author Adrian Baranchuk, MD, a professor of medicine at Queen’s University, Kingston, Ont., told this news organization.

The study was published online in Current Problems in Cardiology

Survey snapshot

Dr. Baranchuk and colleagues, with the support of the Inter-American Society of Cardiology, developed a survey to characterize the frequency and types of abuse that frontline health professionals faced. They invited health care professionals from Latin America who had provided care since March 2020 to participate.

Between January and February 2022, 3,544 participants from 19 countries took the survey. Among them, 70.8% were physicians, 16% were nurses, and 13.2% were other health team members, such as administrative staff and technicians. About 58.5% were women, and 74.7% provided direct care to patients with COVID-19.

Overall, 54.8% of respondents reported acts of aggression. Of this group, 95.6% reported verbal abuse, 11.1% reported physical abuse, and 19.9% reported other types of abuse, including microaggressions.

About 13% of respondents reported experiencing some form of aggression daily, 26.4% experienced abuse weekly, and 38.8% reported violence a few times per month. Typically, the incidents involved patients’ relatives or both the patients and their relatives.

Nearly half of those who reported abuse experienced psychosomatic symptoms after the event, and 12% sought psychological care.

Administrative staff were 3.5 times more likely to experience abuse than other health care workers. Doctors and nurses were about twice as likely to experience abuse.

In addition, women, younger staff, and those who worked directly with COVID-19 patients were more likely to report abuse.

‘Shocking results’

Dr. Baranchuk, a native of Argentina, said people initially celebrated doctors and nurses for keeping communities safe. In several countries across Latin America, for instance, people lit candles, applauded at certain hours, and posted support on social media. As pandemic-related policies changed, however, health care providers faced unrest as people grew tired of wearing masks, maintaining social distance, and obeying restrictions at public spaces such as clubs and restaurants.

“This fatigue toward the social changes grew, but people didn’t have a specific target, and slowly and gradually, health care providers became the target of frustration and hate,” said Dr. Baranchuk. “In areas of the world where legislation is more flexible and less strict in charging individuals with poor or unacceptable behavior toward members of the health care team, aggression and microaggression became more frequent.”

“The results we obtained were more shocking than we expected,” Sebastián García-Zamora, MD, the lead study author and head of the coronary care unit at the Delta Clinic, Buenos Aires, said in an interview.

Dr. García-Zamora, also the coordinator of the International Society of Electrocardiology Young Community, noted the particularly high numbers of reports among young health care workers and women.

“Unfortunately, young women seem to be the most vulnerable staff to suffering violence, regardless of the work they perform in the health system,” he said. “Notably, less than one in four health team members that suffered workplace violence pursued legal action based on the events.”

The research team is now conducting additional analyses on the different types of aggression based on gender, region, and task performed by the health care team. They’re trying to understand who is most vulnerable to physical attacks, as well as the consequences.

“The most important thing to highlight is that this problem exists, it is more frequent than we think, and we can only solve it if we all get involved in it,” Dr. García-Zamora said.

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