Post-trauma symptoms in health workers following physical and verbal aggression

This study investigated the extent and determinants of psychological reactions in UK National Health Service employees in a Community Trust following aggressive incidents at work. For three months, all staff reporting an aggressive incident at work ( N = 318) were sent the Impact of Event Scale-Revised (IES-R) and a questionnaire asking about overall impact, level of expectation and preparedness. A total of 126 questionnaires were returned (40%). Despite the minor physical nature of the incidents, 42% ( n = 53) respondents reported a 'moderate' to 'very great' overall impact with 6.5% ( n = 8) scoring 'moderate' levels of symptomatology on the IES- R. t- tests revealed that verbal aggression had greater impact than physical aggression and resulted in higher IES- R Intrusion scores concerning involuntary and unwanted recollections of the incident. Pearson correlation coefficients showed that severity of response was related to whether the incident was expected and whether the staff member felt prepared for managing aggression. The finding that verbal aggression and apparently minor incidents can result in significant distress is important as verbal aggression is widely experienced in the health service. Increasing staff preparedness and their expectation of incidents may help to reduce the impact. Cognitive theories of traumatic stress suggest that perceived threat and control are important determinants of response and may help to explain why verbal aggression has so much impact.