Violence exposure and resulting psychological effects suffered by psychiatric visiting nurses in Japan. Issue 8 (24th August 2017) - Fujimoto, H.
Accessible Summary: What is known on the subject?: There is a developing body of research on violence in healthcare workplaces. Although psychiatric visiting nurses (PVNs) are an important group of professionals who provide medical services for people with mental disorders live in the community, little is known about the experiences and characteristics of violence exposure among PVNs, or the characteristics and work situations of PVNs related to violence exposure. What this study adds to existing knowledge?: Approximately 40% of participants were exposed to violence during the previous 12 months; approximately 50% had been exposed during their PVN careers in PVN settings. The most frequent violence was verbal abuse. Longer career length as a PVN and greater number of visits per month were both positively associated with verbal abuse during the previous 12 months. Twenty‐eight of the 34 participants (83%) who completed the IES‐R‐J survey had some residual psychological distress, and two (6%) had a potentially high risk of posttraumatic stress disorder. What are the implications for practice?: In devising policies and strategies against violence, PVN organizations and administrators should consider the characteristics of the violence, especially verbal abuse, as well as the characteristics and work situations of PVNs that are related to verbal abuse. Furthermore, they might provide relevant information on violence in PVN settings within their violence‐prevention manuals or education. It would be important to provide support and to construct a safe workplace environment for PVNs who are experiencing residual psychological distress. Abstract: Introduction: Psychiatric visiting nurses (PVNs) play a crucial role by providing medical services for community‐living individuals with mental disorders in Japan. However, little is known about violence towards PVNs. Aim: This cross‐sectional study investigated violence during visits and the resulting psychological effects for PVNs. Methods: PVNs were assessed using a violence exposure questionnaire and the Impact of Event Scale‐Revised (IES‐R‐J); a measure of posttraumatic distress. Result: Thirty‐eight (41%) of 94 participants had experienced violence during the previous 12 months and 49 (53%) over their entire career. The most frequent violence was verbal abuse. Career length as a PVN and number of visits per month were significantly positively associated with verbal abuse during the previous 12 months. The IES‐R‐J scores indicated 28 of the 34 participants who completed the questionnaire exhibited psychological distress for the most traumatic violence during their career and two had a potentially high risk of posttraumatic stress disorder. Discussion and Implications: Policies and strategies aimed at reducing violence in PVN settings should be developed according to characteristics of the violence, as well as the characteristics and work situation of PVNs. Furthermore, the provision of support and a safe workplace environment would be important for PVNs with residual psychological distress.