Understanding and Improving Workplace Violence Prevention Practices among Nursing Students: A Cross-Sectional Study in a Private College, Malaysia.

Authors

  • Muhamad Naqib Shariff Faculty of Medicine, Universiti Kuala Lumpur Royal College of Medicine Perak, Malaysia.
  • Davinder Singh Bagher Singh Faculty of Medicine, Universiti Kuala Lumpur Royal College of Medicine Perak, Malaysia.
  • Hussain Saadi Faculty of Medicine, Universiti Kuala Lumpur Royal College of Medicine Perak, Malaysia.

DOI:

https://doi.org/10.70672/670xzr22

Keywords:

Workplace violence, Nursing education, Perception and practice, Violence prevention, Clinical training

Abstract

Background: Workplace violence (WPV) is a growing concern in healthcare settings, with nursing students at heightened risk due to their frontline roles during clinical placements. Although several studies have explored WPV among healthcare workers, research focusing on prevention practices among nursing students in Malaysia remains limited. This study aimed to assess nursing students’ perception and practice of WPV prevention and identify associated factors. Methods: A cross-sectional survey was conducted among 245 nursing students enrolled at a private nursing college in Perak, Malaysia. Data were collected using a validated structured questionnaire assessing WPV perception and practice across multiple domains. Descriptive and inferential analyses were performed using chi-square tests and logistic regression to determine predictors of good perception and practice. Results: Most participants demonstrated moderate perception and high practice of WPV prevention. Binary logistic regression revealed that bachelor-level students (aOR = 114.5, p = 0.03) and those with ≥ 6 months of clinical experience (aOR = 1.89, p = 0.046) were more likely to exhibit good perception towards WPV prevention. Multinomial regression confirmed these associations, indicating that educational level and clinical experience independently predicted good perception. No significant predictors were found for practice outcomes. Conclusion: Academic preparation and clinical exposure play crucial roles in shaping nursing students’ perception of WPV prevention. Integrating structured WPV prevention training into the nursing curriculum and strengthening institutional support mechanisms are essential to enhance awareness, preparedness, and safety culture among future nurses.

References

[1]. World Health Organization. Framework guidelines for addressing workplace violence in the health sector. Geneva: WHO; 2022.

[2]. International Labour Organization. Framework guidelines for addressing workplace violence in the health sector. Geneva: ILO; 2020.

[3]. Aelameddin T, Arabi M, Saleh M, Salameh B. Workplace violence against nurses in healthcare settings: A systematic review. J Nurs Manag. 2015. 23(6):764–74.

[4]. Halim M, et al. Workplace violence among nurses: Prevalence, consequences, and preventive strategies. J Clin Nurs. 2022;31(9–10):1251–61.

[5]. Al-Omari H. Physical and verbal workplace violence against nurses in Jordan. Int Nurs Rev. 2015;62(1):111–8.

[6]. Woodhead EL, Northrop L, Edelstein B. Stress, social support, and burnout among long-term care nursing staff. J Appl Gerontol. 2022;41(3):769–79.

[7]. Cheung T, Yip PS. Workplace violence towards nurses in Hong Kong: Prevalence and correlates. BMC Public Health. 2017;17:196.

[8]. Wang P, et al. Effects of workplace violence on Chinese nurses’ mental health and sleep quality: The mediating role of perceived social support. J Nurs Manag. 2022;30(4):892–902.

[9]. Papa A, Venella J. Workplace violence in healthcare: Strategies for prevention. J Emerg Nurs. 2013;39(5):477–9.

[10]. Spector PE, Zhou ZE, Che XX. Nurse exposure to physical and nonphysical violence, bullying, and sexual harassment: A quantitative review. Int J Nurs Stud. 2014;51(1):72–84.

[11]. Mohamad Yazid NH, Adibah N, Shahida S, Syazwani AR, Norlina H, Nur Sabrina O, et al. Development and validation of a workplace violence questionnaire among healthcare workers in Malaysia. BMC Public Health. 2023;23:1792.

[12]. Bambi S, Foà C, De Felippis C, Lucchini A, Guazzini A, Rasero L. Workplace incivility, lateral violence and bullying among nurses. A review about their prevalence and related factors. Acta Biomed. 2019;90(4):51–79.

[13]. Wolf LA, Delao AM, Perhats C, Clark PR, Moon MD, Zavotsky KE. Workplace violence and emergency nurses: A narrative review. Adv Emerg Nurs J. 2014;36(4):315–26.

[14]. Bandura A. Social-cognitive theory. In: Pervin L, John O, editors. An introduction to theories of personality. New York: Psychology Press; 2014. p. 341–60.

[15]. Xiao Y, Wang J, Chen S, et al. Workplace violence against nurses in Chinese hospitals: A cross-sectional survey. BMJ Open. 2021;11:e045872.

[16]. Cheung T, Yip PS. Workplace violence towards nurses in Hong Kong: Prevalence and correlates. BMC Public Health. 2017;17(1):196.

[17]. Wang PX, Wang MZ, Hu GX, Wang ZM. Study on the relationship between workplace violence and psychological health in nurses. Zhonghua Lao Dong Wei Sheng Zhi Ye Bing Za Zhi. 2022. 40(6):427–32.

[18]. Halim NA, Mamat NH, Rahman HA, et al. Workplace violence among healthcare workers in Malaysia: A cross-sectional study. Med J Malaysia. 2022. 77(3):285–92.

[19]. Halim NA, Mamat NH, Rahman HA, et al. Barriers to reporting workplace violence in Malaysian healthcare settings. Malays J Med Sci. 2022. 29(4):69–78.

[20]. Venella J, Papa A. Addressing barriers to workplace violence prevention in healthcare. J Emerg Nurs. 2013. 39(2):153–7.

[21]. Mitchell R. Safety protocols and workplace violence prevention in nursing. J Nurs Manag. 2021;29(5):1124–31.

[22]. Dafny M, Chammas G, Peterman T. Environmental safety and violence prevention in healthcare. Aust Health Rev. 2024. 48(1):35–42.

[23]. Al-Omari H. Physical and verbal workplace violence against nurses in Jordan. Middle East Journal of Nursing. 2015. 9(3):35–44.

[24]. Hamdan M, Abu Hamra A. Workplace violence towards workers in the emergency departments of Palestinian hospitals: a cross-sectional study. Human Resources for Health. 2017. 15(1):5.

[25]. Çelik SŞ, Çelik Y, Ağırbaş İ, Uğurluoğlu Ö. Verbal and physical abuse against nurses in Turkey. International Nursing Review. 2008. 54(4):359–66.

[26]. Campbell JC, Messing JT, Kub J, Agnew J, Fitzgerald S, Fowler B, et al. Workplace violence: prevalence and risk factors in the safe at work study. Journal of Occupational and Environmental Medicine. 2011. 53(1):82–9.

[27]. Ferri P, Silvestri M, Artoni C, Di Lorenzo R. Workplace violence in different settings and among various health professionals in an Italian general hospital: a cross-sectional study. Psychology Research and Behavior Management. 2016. 9:263–75.

[28]. Wang Y, Han P, Dai H, Fang L, Yang H, Yang X, et al. Workplace violence against healthcare workers in China: a national cross-sectional survey. BMJ Open. 2022. 12:e062465.

[29]. Shields M, Wilkins K. Factors related to on-the-job abuse of nurses by patients. Statistics Canada Health Reports. 2009. 20(2):7–19.

[30]. Bandura A. Social Foundations of Thought and Action: A Social Cognitive Theory. Englewood Cliffs, NJ: Prentice Hall; 1986.

[31]. Zimmerman BJ. Self-regulated learning and academic achievement: an overview. Educational Psychologist. 1990. 25(1):3–17.

[32]. Papa A, Venella J. Workplace violence in healthcare: strategies for advocacy. Online Journal of Issues in Nursing. 2013. 18(1):5.

[33]. Park M, Cho S-H, Hong H-J. Prevalence and perpetrators of workplace violence by nursing unit and the relationship between violence and the perceived work environment. Journal of Nursing Scholarship. 2015. 47(1):87–95.

[34]. Alshehry AS, Alquwez N, Almazan JU, Namis IM, Alfuqaha OA, Cruz JP. Workplace incivility and its influence on professional quality of life among nurses from multicultural backgrounds: a cross-sectional study. Journal of Clinical Nursing. 2021. 30(7–8):1074–84.

[35]. Shibiti R. Student nurses’ perceptions of violence in a clinical setting: a qualitative study. Curationis. 2017. 40(1):1–8.

[36]. Edward K-L, Stephenson J, Ousey K, Lui S, Warelow P, Giandinoto J-A. A systematic review and meta-analysis of factors that relate to aggression perpetrated against nurses by patients/relatives or staff. Journal of Clinical Nursing. 2014. 23(7–8):1079–91.

[37]. Magnavita N, Heponiemi T. Workplace violence against nursing students and nurses: an Italian experience. Journal of Nursing Scholarship. 2011. 43(2):203–10.

[38]. Baby M, Glue P, Carlyle D. ‘Violence is not part of our job’: a thematic analysis of psychiatric mental health nurses’ experiences of patient assaults from a New Zealand perspective. Issues in Mental Health Nursing. 2018;39(7):554–61.

[39]. Kling RN, Yassi A, Smailes E, Lovato CY, Koehoorn M. Evaluation of a violence risk assessment system (the alert system) for reducing violence in an acute hospital: a before and after study. BMC Health Services Research. 2011. 11:52.

[40]. Cheung T, Yip PSF. Depression, anxiety and symptoms of stress among Hong Kong nurses: a cross-sectional study. International Journal of Environmental Research and Public Health. 2017. 14(8):924.

[41]. Wei C-Y, Chiou S-T, Chien L-Y, Huang N. Workplace violence against nurses: prevalence and association with hospital characteristics. International Journal of Nursing Studies. 2024. 137:104436.

[42]. Estryn-Behar M, van der Heijden B, Camerino D, Fry C, Le Nezet O, Conway PM, et al. Violence risks in nursing—results from the European ‘NEXT’ study. Occupational Medicine. 2008. 58(2):107–14.

[43]. Gong Y, Han T, Yin X, Yang G, Zhuang R, Chen Y, et al. Prevalence of anxiety and depressive symptoms and related risk factors among physicians in China: a cross-sectional study. PLoS One. 2014. 9(7):e103242.

[44]. Woodhead EL, Northrop L, Edelstein B. Violence in the workplace: exploring nursing students’ perceptions of safety. Journal of Nursing Education and Practice. 2022. 12(5):53–61.

[45]. OSHA. Guidelines for Preventing Workplace Violence for Healthcare and Social Service Workers. Washington, DC: Occupational Safety and Health Administration; 2016.

[46]. ILO. Framework Guidelines for Addressing Workplace Violence in the Health Sector. Geneva: International Labour Organization; 2020.

[47]. Gillespie GL, Gates DM, Miller M, Howard PK. Workplace violence in healthcare settings: risk factors and protective strategies. Rehabilitation Nursing. 2013. 38(1):31–43.

[48]. Arnetz JE, Hamblin L, Ager J, Luborsky M, Upfal MJ, Russell J, et al. Underreporting of workplace violence: comparison of self-report and actual documentation of hospital incidents. Workplace Health & Safety. 2015. 63(5):200–10.

[49]. Pompeii LA, Schoenfisch AL, Lipscomb HJ, Dement JM, Smith CD, Upadhyaya M. Physical assault, physical threat, and verbal abuse perpetrated against hospital workers by patients or visitors in six U.S. hospitals. American Journal of Industrial Medicine. 2013. 56(11):1262–72.

[50]. Hwang J-I, Park H-A, Lee S-K, Kim J-A. Work-related violence and burnout in nurses. Journal of Korean Academy of Nursing Administration. 2006. 12(4):589–98.

Downloads

Published

31-10-2025

Issue

Section

Original Articles

How to Cite

Shariff, M. N., Davinder Singh Bagher Singh, & Hussain Saadi. (2025). Understanding and Improving Workplace Violence Prevention Practices among Nursing Students: A Cross-Sectional Study in a Private College, Malaysia. Asian Journal of Medicine & Health Sciences, 8(2). https://doi.org/10.70672/670xzr22