Patient and visitor violence in general hospitals: A systematic review of the literature

Patient and visitor violence (PVV) is a complex occupational hazard for health care staff working in general hospitals. In order to reduce the deficit of information regarding this kind of PVV, a systematic literature review that describes and summarizes the current scientific knowledge on this topic was conducted. The literature search identified 84 studies. These were analyzed for research quality and those with good or moderate research quality were selected (n=31). In most studies, a retrospective self reported cross-sectional design and a broad definition of violence were employed. Additionally, most of the questionnaires applied were developed by the researchers and utilized different retrospective time frames. Unfortunately, information about the validity of the questionnaires was often lacking. Results of this review suggest that PVV is a serious problem for health care staff in general hospitals, especially those working in medical and surgical units. Workplace characteristics and the interaction between patients and staff are important contextual factors that can contribute to the development of violent incidents. Because the studies reviewed employed different methodologies, instruments, and definitions, comparison was difficult. We, therefore, recommend that future research use clearer conceptual frameworks and unique instruments. (C) 2008 Elsevier Ltd. All rights reserved.