Date of Award

2025-08-31

Degree Name

PhD Nursing

Dissertation Committee

Cynthia D. Connelly, PhD, RN, FAAN, Chairperson; Christine Nibbelink, PhD, RN, Committee Member; Jennifer Barrows, PhD, RN, Committee Member

Keywords

Nursing, Pediatrics, Workplace Violence

Abstract

Background: Healthcare-related workplace violence has steadily increased. According to the U.S. Bureau of Labor Statistics (2020), from 2011 to 2018, workplace violence within healthcare settings increased from 6.4 to 10.4 incidents for every 10,000 full-time employees. Since then, the prevalence of workplace violence only continues to rise, adversely affecting healthcare professionals. Of the four types of workplace violence, Type II is most frequently reported within healthcare settings and refers to aggression and violence exhibited by patients and their families. Despite the increasing prevalence, there remains a paucity of research in relation to Type II workplace violence in pediatrics.

Purpose: The purpose of this study was to describe nurses’ perceptions of factors influencing patient and family aggressive and violent behaviors in a pediatric healthcare setting.

Lines of Inquiry: The lines of inquiry were to describe patient and family aggressive and violent behaviors encountered by participants and their perception of factors influencing patient and family aggression and violence.

Methods: This study employed a qualitative descriptive design to understand factors influencing Type II workplace violence within a free-standing pediatric healthcare setting. Purposive sampling was utilized to select participants meeting the established inclusion criteria. Semi-structured interviews and follow-up interviews were conducted along with a member-checking focus group. Thematic analysis was done to arrive at the findings.

Findings: Thirteen pediatric nurses participated in this study. Participants reported encountering varying forms of physical and verbal aggression and violence from patients and families. The following six themes describe participants’ perception of factors influencing patient and family aggression and violence: (1) loss of control, (2) medical and mental health diagnoses and psychosocial histories, (3) ineffective communication, (4) spectrum of staff acceptance and tolerance of aggressive behaviors, (5) staff interactions with patients and families, and (6) enforcement of patient cares and organizational policies.

Implications: Several factors can influence patient and family aggression and violence. This study identified six themes, adding to the body of literature related to Type II healthcare-related workplace violence. Trends and opportunities for early intervention strategies and resource allocation, along with opportunities for additional research related to Type II workplace violence in pediatrics were identified.

Document Type

Dissertation: Open Access

Department

Nursing

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