Workplace violence against emergency department workers in University Malaya Medical Center

Healthcare workers are at higher risk to the exposure of workplace violence by sixteen times compared to any other professional. Emergency Department (ED) are at a greater risk of such events. The objectives of this study were to describe the frequency, the contributing factors and the reporting of...

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Main Author: Satderi, Saidah
Format: Thesis
Language:eng
eng
Published: 2019
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topic HD28-70 Management
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Industrial Management
Satderi, Saidah
Workplace violence against emergency department workers in University Malaya Medical Center
description Healthcare workers are at higher risk to the exposure of workplace violence by sixteen times compared to any other professional. Emergency Department (ED) are at a greater risk of such events. The objectives of this study were to describe the frequency, the contributing factors and the reporting of workplace violence against ED workers in University Malaya Medical Center (UMMC), as well as to identify if there is any significant difference in frequency of violence, the feeling of safety and the level of confidence when dealing with workplace violence, based on demographic and occupational characteristics. A cross-sectional study design was conducted from November to December 2018 using quota sampling technique. The questionnaire was adapted from Alshehri (2016) and Kowalenko et al., (2013). Descriptive statistics, Independent t-test, and Analysis of Variance (ANOVA) were used to analyze the data. Two hundred and twenty-six ED workers in UMMC completed the survey. The most common types of violence found to be verbal abuse (100%), followed by physical violence (53%), threats (44%) and sexual harassment (32%). Workplace violence was frequent in the ED of UMMC with each worker experienced at least one episode of verbal abuse in the past 12 months. ‘Waiting time to receive service' and ‘failure to fulfill patients or visitors desire' were the most common contributing factors for violence in ED. Majority of the victim did not report the violent incident with ‘no benefit in writing' and ‘incident was not important' being the common reason. There was a statistically significant difference in the frequency of violence based on education and occupation. Nurses were the most exposed profession to workplace violence compared to other professions. Those with less working experience and Healthcare assistant significantly felt less safe compared to other professions in the ED. Those with more experience, being male, and working as Security guard felt more confident in managing violence at the workplace. Understanding the nature of violence in the workplace is the first step before further developing effective strategies to manage the problem. Enforcement of policies, and establishing a continuous training program could enhance workplace safety for healthcare workers.
format Thesis
qualification_name Master of Philosophy (MPhil)
qualification_level Master's degree
author Satderi, Saidah
author_facet Satderi, Saidah
author_sort Satderi, Saidah
title Workplace violence against emergency department workers in University Malaya Medical Center
title_short Workplace violence against emergency department workers in University Malaya Medical Center
title_full Workplace violence against emergency department workers in University Malaya Medical Center
title_fullStr Workplace violence against emergency department workers in University Malaya Medical Center
title_full_unstemmed Workplace violence against emergency department workers in University Malaya Medical Center
title_sort workplace violence against emergency department workers in university malaya medical center
granting_institution Universiti Utara Malaysia
granting_department Othman Yeop Abdullah Graduate School of Business
publishDate 2019
url https://etd.uum.edu.my/8111/1/822469_1.pdf
https://etd.uum.edu.my/8111/2/822469-2.pdf
_version_ 1747828327946649600
spelling my-uum-etd.81112022-04-13T03:00:06Z Workplace violence against emergency department workers in University Malaya Medical Center 2019 Satderi, Saidah Othman Yeop Abdullah Graduate School of Business Othman Yeop Abdullah Graduate School of Business HD28-70 Management. Industrial Management Healthcare workers are at higher risk to the exposure of workplace violence by sixteen times compared to any other professional. Emergency Department (ED) are at a greater risk of such events. The objectives of this study were to describe the frequency, the contributing factors and the reporting of workplace violence against ED workers in University Malaya Medical Center (UMMC), as well as to identify if there is any significant difference in frequency of violence, the feeling of safety and the level of confidence when dealing with workplace violence, based on demographic and occupational characteristics. A cross-sectional study design was conducted from November to December 2018 using quota sampling technique. The questionnaire was adapted from Alshehri (2016) and Kowalenko et al., (2013). Descriptive statistics, Independent t-test, and Analysis of Variance (ANOVA) were used to analyze the data. Two hundred and twenty-six ED workers in UMMC completed the survey. The most common types of violence found to be verbal abuse (100%), followed by physical violence (53%), threats (44%) and sexual harassment (32%). Workplace violence was frequent in the ED of UMMC with each worker experienced at least one episode of verbal abuse in the past 12 months. ‘Waiting time to receive service' and ‘failure to fulfill patients or visitors desire' were the most common contributing factors for violence in ED. Majority of the victim did not report the violent incident with ‘no benefit in writing' and ‘incident was not important' being the common reason. There was a statistically significant difference in the frequency of violence based on education and occupation. Nurses were the most exposed profession to workplace violence compared to other professions. Those with less working experience and Healthcare assistant significantly felt less safe compared to other professions in the ED. Those with more experience, being male, and working as Security guard felt more confident in managing violence at the workplace. Understanding the nature of violence in the workplace is the first step before further developing effective strategies to manage the problem. Enforcement of policies, and establishing a continuous training program could enhance workplace safety for healthcare workers. 2019 Thesis https://etd.uum.edu.my/8111/ https://etd.uum.edu.my/8111/1/822469_1.pdf text eng public https://etd.uum.edu.my/8111/2/822469-2.pdf text eng public mphil masters Universiti Utara Malaysia Abbas, R. A., & Selim, S. F. (2011). Workplace violence-A survey of diagnostic radiographers in Ismailia governorate hospitals. Egypt. Journal of American Science, 7(6), 1049-1058. doi: 10.1.1.378.8348. Abualrub, R. F., & Al-Asmar, A. H. (2011). Physical violence in the workplace among Jordanian hospital nurses. Journal of Trans cultural Nursing, 22(2), 157-65. doi:10.1177/1043659610395769. Acharya, A. S., Prakash, A., Saxena, P., & Nigam, A. (2013). Sampling: Why and how of it. Indian Journal of Medical Specialties, 4(2), 330-333. doi: 10.7713/ijms.2013.0032. Ahmad, A., Mazlan, N. H., (2013). Identifying types of mental health problems and aggression among security guards: Are they totally safe. Psychology and Behavioral Sciences, 2(3). 130-137. doi: 10.11648/j.pbs.20130203.18. Alameddine, M., Mourad, Y., & Dimassi, H. (2015). A national Study on nurses’ exposure to occupational violence in Lebanon: Prevalence, consequences and associated factors. PloS one 10(9). doi: 10.1371/journal.pone.0137105. Alkorashy, H. A. E., & Al Moalad, F. B. (2016). Workplace violence against nursing staff in a Saudi university hospital. International Nursing Review, 63(2), 226–232. https://doi.org/10.1111/inr.12242. Al-Omari, M. A., Johari, H., & Choo, L. S. (2012). Workplace violence: A case in Malaysian higher education institute. Business Strategy Series, 13(6), 274-283. https://doi.org/10.1108/17515631211286119. Alshehri, F. A. (2017). Workplace violence against nurses working in emergency departments in Saudi Arabia : a cross-sectional study (Doctoral dissertation). Retrieved from https://digital.library.adelaide.edu.au/dspace/bitstream/2440/104816/4/01front.pdf. Alyaemni, A., & Alhudaithi, H. (2016). Workplace violence against nurses in the emergency departments of three hospitals in Riyadh, Saudi Arabia: A cross-sectional survey. NursingPlus Open, 2, 35–41. https://doi.org/10.1016/j.npls.2016.09.001. Aprameya, A. (2016, April). Quota Sampling: When to use it and how to do it correctly [Web log post]. Retrieved from https://blog.socialcops.com/academy/resources/quota-sampling-when-to-use-howto-do-correctly/. Arunah, C., Teo, A. H., Faizah, A., Mahathar A. W., Tajuddin, A. M. N., Khairi, K., … Kasuadi, H. (2010). Emergency and trauma services in Malaysian hospitals. Retrieved from http://www.crc.gov.my/nhsi/wpcontent/ uploads/publications/NHEWS_Hospital2010/Chapter6Hospitals_Report_2010.pdf. Ashton, R. A., Morris, L., & Smith, I. (2018). A qualitative meta-synthesis of emergency department staff experien+es of violence and aggression. International Emergency Nursing, 1–10. https://doi.org/10.1016/J.IENJ.2017.12.004. Atan, S. U., Arabaci, L. B., Sirin, A., Isler, A., Donmez, S., Guler, M. U.,...Tasbasi, F. Y. (2012). Violence experienced by nurses at six university hospitals in Turkey. Journal of Psychiatric and Mental Health Nursing, 20(10), 882-889. doi:10.1111/jpm.12027. Ayranci, U. (2005). Violence toward health care workers in emergency departments in west Turkey. Journal of Emergency Medicine, 28(3), 361-365. doi:10.1016/j.jemermed.2004.11.018. Behnam, M., Tillotson, R. D., Davis, S. M., & Hobbs, G. R. (2011). Violence in the Emergency Department: A national survey of emergency medicine residents and attending physicians. Journal of Emergency Medicine, 40(5), 565–579. doi:10.1016/j.jemermed.2009.11.007. Behnam, M., Tillotson, R. D., Davis, S. M., & Hobbs, G. R. (2011). Violence in the emergency department: A national survey of emergency medicine residents and attending physicians. The Journal of Emergency Medicine, 40(5), 565–579. doi:10.1016/j.jemermed.2009.11.007. Belayachi, J., Berrechid, K., Amlaiky, F., Zekraoui, A., & Abouqal, R. (2010). Violence toward physicians in emergency departments of Morocco: Prevalence, predictive factors, and psychological impact. Journal of Occupational Medicine and Toxicology, 5 (27). doi:10.1186/1745-6673-5-27. Bernama. (2017, April, 29). Physical, verbal abuse new threat for KKM staff. Borneo Post Online. Retrieved from https://www.theborneopost.com/2017/04/29/physicalverbal- abuse-new-threat-for-kkm-staff/. Blando, J. D., O’Hagan, E., Casteel, C., Nocera, M. A., & Peek-Asa, C. (2013). Impact of hospital security programmes and workplace aggression on nurse perceptions of safety. Journal of Nursing Management, 21(3), 491-498. doi: 10.1111/j.1365-2834.2012.01416.x. Boyle, M. J., & Wallis, J. (2016). Working towards a definition for workplace violence actions in the health sector. Safety in Health, 2(1). doi: 10.1186/s40886-016 0015-8. Brislin, R. W. (1970). Back-Translation for Cross-Cultural Research. Journal of Cross- Cultural Psychology, 1(3), 185–216. https://doi.org/10.1177/135910457000100301. Brown, G., Low, N., Franklyn, R., Drever, E., & Mottram, C. (2017, November). GSR quota sampling guidance: What to consider when choosing between quota samples and probability-based designs. Retrieved from https://www.statisticsauthority.gov.uk/wp-content/uploads/2017/12/Quotasampling- guidance.pdf. Burrell, N. A., & Gross, C. (2017). Quantitative research, purpose of. In The sage encyclopedia of communication research method (pp. 1378-1380). Retrieved from doi:10.4135/9781483381411.n476. Camerino, D., Estryn-Behar, M., Conway, P. M., Van Der Heijden, B. I. J. M., & Hasselhorn, H. M. (2008). Work-related factors and violence among nursing staff in the European NEXT study: A longitudinal cohort study. International Journal of Nursing Studies, 45(1), 35–50. doi:10.1016/j.ijnurstu.2007.01.013. Centre for Disease Control and Prevention. (2018, March). Occupational violence. Retrieved from https://www.cdc.gov/niosh/topics/violence/default.html. Chapman, D. P., Liu, Y., Presley-Cantrell, L. R., Edwards, V. J., Wheaton, A. G., Perry, G. S., & Croft, J. B. (2013). Adverse childhood experiences and frequent insufficient sleep in 5 U.S. States, 2009: a retrospective cohort study. BMC Public Health, 13(1), 3. doi:10.1186/1471-2458-13-3. Çikriklar, H., Yürümez, Y., Güngör, B., Askin, R., Yücel, M., & Baydemir, C. (2016). Violence against emergency department employees and the attitude of employees towards violence. Hong Kong Medical Journal, 22(5), 464–471. https://doi.org/10.12809/hkmj154714. Craig, A. (2016). Registered Nurses' attitudes towards, and experiences of, aggression and violence in the acute hospital setting. Retrieved from https://repository.digitalnz.org/system/uploads/record/attachment/784/registered_nurses__attitudes_towards__and_experiences_of__aggression_and_violence_in_the_acute_hospital_setting.pdf. Creswell, J.W. (2013) Research Design: Qualitative, Quantitative, and Mixed Methods Approaches (4th ed). London, Sage Publications, Inc. Dolph, C. L., Sheshukov, A. Y., Chizinski, C. J., Vondracek, B., & Wilson, B. (2010). The Index of Biological Integrity and the bootstrap: Can random sampling error affect stream impairment decisions?. Ecological Indicators, 10(2), 527–537. https://doi.org/10.1016/j.ecolind.2009.10.001. Edwards, A. (2016, May 23). Hospital fights abuse with zero tolerance policy. Malay Mail. Retrieved from https://www.malaymail.com/news/malaysia/2016/05/23/hospital-fights-abuse-withzero-tolerance policy/1125375#lq8VXrHFhBV4UypW.97. Fafliora, E. (2015). Assessment and Analysis of Workplace Violence in a Greek Tertiary Hospital. Archives of Environmental and Occupational Health, 70, 256-264. doi:10.1080/19338244.2013.879564. Farrell, G. A., Shafiei T. (2012). Workplace aggression, including bullying in nursing and midwifery: A descriptive survey (the SWAB study). International journal of nursing studies, 49(11), 1423-1431. doi:10.1016/j.ijnurstu.2012.06.007. Ferri, P., Guerra, E., Marcheselli, L., Cunico, L., & Lorenza, R. Di. (2015). Empathy and burnout: an analytic cross-sectional study among nurses and nursing students. Acta Biomed for Health Professions, 86(S.2), 104–115. Retrieved from https://www.mattioli1885journals.com/index.php/actabiomedica/article/viewFile/4792/3529. Ferri, P., Silvestri, M., Artoni, C., & Lorenzo, R. Di. (2016). Workplace violence in different settings and among various health professionals in an Italian general hospital : a cross-sectional study. Psychology Research and Behaviour Management, 2016:9, 263–275. doi: 10.2147/PRBM.S114870. Fute, M., Mengesha, Z. B., Wakgari, N., & Tessema, G. A. (2015). High prevalence of workplace violence among nurses working at public health facilities in Southern Ethiopia. BioMed Central Nursing, 14(9). doi: 10.1186/s12912-015-0062-1. Gates, D. M., Ross, C. S., & McQueen, L. (2006). Violence against emergency department workers. Journal of Emergency Medicine, 31(3), 331–337. doi:10.1016/j.jemermed.2005.12.028. Gates, D., Gillespie, G., Kowalenko, T., Succop, P., Sanker, M., & Farra, S. (2011). Occupational and demographic factors associated with violence in the emergency department. Advanced Emergency Nursing Journal, 33(4), 303–313. doi: 10.1097/TME.0b013e3182330530. Gelo, O., Braakman, D., & Benetka, G. (2008). Quantitative and qualitative research: beyond the debate. Integrative psychological and behavioral science, 42(3), 262-290. doi: 10.1007/s12124-008-9078-3. Gilbert, N. (2001). Social research update 35: The importance of pilot studies. Retrieved from http://sru.soc.surrey.ac.uk/SRU35.html. Gillespie, G. L., Gates, D. M., Berry, P. (2013). Stressful incidents of physical violence against emergency nurses. The online journal of issues in nursing, 18(1:2). doi:10.3912/OJIN.Vol18No01Man02. Gillespie, G. L., Gates, D. M., Kowalenko, T., Bresler, S., & Succop, P. (2014). Implementation of a comprehensive intervention to reduce physical assaults and threats in the emergency department. Journal of emergency nursing, 40(6), 586-591.doi:10.1016/j.jen.2014.01.003. Gillespie, G. L., Gates, D. M., Miller, M., & Howard, P. K. (2010). Workplace violence in healthcare settings: Risk factors and protective strategies. Rehabilitation nursing, 35(5), 177–184. doi:10.1002/j.2048-7940.2010.tb00045.x. Hahn, S., Zeller, A., Needham, I., Kok, G., Dassen, T., & Halfens, R. J. G. (2008). Patient and visitor violence in general hospitals: A systematic review of the literature. Aggression and Violent Behavior, 13(6), 431–441. doi:10.1016/j.avb.2008.07.001. Hallberg, IR 2008, 'Surveys', in R Watson, H McKenna, S Cowman & J Keady (eds), Nursing research: designs and methods, Elsevier, Edinburgh, pp. 179-187. Han, C. Y., Lin, C. C., Barnard, A., Hsiao, Y. C., Goopy, S., & Chen, L. C. (2017). Workplace violence against emergency nurses in Taiwan: A phenomenographic study. Nursing outlook, 65(4), 428–435. https://doi.org/10.1016/j.outlook.2017.04.003. Harrel, E. (2011). Workplace Violence, 1993-2009: National Crime Victimization survey and the Census of fatal occupational injuries. Retrieved from https://www.bjs.gov/content/pub/pdf/wv09.pdf. Hegney, D., Tuckett, A., Parker, D., & Eley, R. (2010). Workplace violence: differences in perceptions of nursing work between those exposed and those not exposed: across-sector analysis. International Journal of Nursing Practice, 16(2), 188-202. doi:10.1111/j.1440-172X.2010.01829.x. Hogarth, K. M., Beattie, J., & Morphet, J. (2016). Nurses’ attitudes towards the reporting of violence in the emergency department. Australasian Emergency Nursing Journal, 19(2), 75–81. https://doi.org/10.1016/j.aenj.2015.03.006. International Lab our Office, International Council of Nurses, morrnikWorld Health Organization, & Public Services International. (2002). Framework Guidelines for Addressing Workplace Violence in the Health Sector. Retrieved from https://kennisopenbaarbestuur.nl/media/233670/Framework-Guidelines-for-Addressing-Workplace-Violence-in-the-Health-Sector.pdf. Kadam, P., & Bhalerao, S. (2010). Sample size calculation. International Journal of Ayurveda Research, 1(1), 55–57. doi:10.4103/0974-7788.59946. Kamaluddin, M. R., Shariff, N. S. M., Othman, A., Ismail, K. H., & Saat, G. A. M. (2014). Associations between personality traits and aggression among malay adult male inmates in Malaysia. Asean Journal of Psychiatry, 15(2), 176–185. doi:10.1.1.675.9275. Kansagra, S. M., Rao, S. R., Sullivan, A. F., Gordon, J. A.,Magid,D.J., Kaushal, R.,&Blumenthal,D. (2008). A survey of workplace violence across 65 U.S. emergency departments. Academic emergency medicine, 15(12), 1268–1274. doi:10.1111/j.1553- 2712.2008.00282. Kazi, A. and Haslam, C.O. (2013). Stress management standards: a warning indicator for employee health. Occupational medicine, 63(5), pp.335-340. Kelly, S. (2014). Overview and Summary: Societal violence: What is our response. The online journal of issues in nursing, 19(1). doi:10.3912/OJIN.Vol19No01ManOS. Kitaneh, M., & Hamdan, M. (2012). Workplace violence against physicians and nurses in Palestinian public hospitals : a cross - sectional study, 240(July 2011). doi:10.1186/1472-6963-12-469. Kocabiyik, N., Yildrim, S., Turgut, E. O., Turk, M. K., & Ayer, A. (2015). A study on the frequency of violence to healthcare professionals in a mental health hospital and related factors. The Journal of Psychiatry and Neurological Sciences, 28 (3), 112-118. doi: 10.5350/DAJPN2015280203. Kowalenko, T., Gates, D., Gillespie, G. L., Succop, P., & Mentzel, T. K. (2013). Prospective study of violence against ED workers. American Journal of Emergency Medicine, 31(1), 197–205. doi: 10.1016/j.ajem.2012.07.010. Krejcie, R.V., & a, D.W. (1970). Determining Sample Size for Research Activities. Educational and psychological measurement, 30, 607-610. Retrieved from https://home.kku.ac.th/sompong/guest_speaker/KrejcieandMorgan_article.pdf Laerd dissertation (2012). Quota Sampling. Retrieved from http://dissertation.laerd.com/quota-sampling.php. Lau, B. (2016, October 20). Malaysia’s MOH takes a stand against threats and abuse faced by healthcare employees. Mims Today. Retrieved from https://today.mims.com/malaysia-s-moh-takes-a-stand-against-threats-and-abusefaced-by-healthcare-employees. Lenaghan, P. A., Cirrincione, N. M., & Henrich, S. (2018). Preventing emergency department violence through design. Journal of emergency nursing, 44(1), 7–12. https://doi.org/10.1016/j.jen.2017.06.012. Magnavita, N., & Heponiemi, T. (2012). Violence towards health care workers in a Public Health Care Facility in Italy: a repeated cross-sectional study. BMC Health Services Research, 12(1), 108. doi: 10.1186/1472-6963-12-108. Mari´n, G., & Mari´n, B. V. (1991). Research with Hispanic populations. Sage Publications. Mckenna, B. G., Smith, N. A., Poole, S. J., & Coverdale, J. S. (2003). Horizontal violence: experiences of Registered Nurses in their first year of practice. Journal of advance nursing, 42(1), 90-96. Retrieved from https://www.mc.vanderbilt.edu/root/pdfs/nursing/HorizontalViolenceArticle.pdf. Moore, C. G., Carter, R. E., Nietert, P. J., & Stewart, P. W. (2011). Recommendations for planning pilot studies in clinical and translational research. Clinical and translational science, 4(5), 332–337. https://doi.org/10.1111/j.1752-8062.2011.00347.x. Morrison, E. F. (1994). The evolution of a concept: Aggression and violence in psychiatric settings. Archives of psychiatric nursing, 8 (4), 245-253. doi: 10.1016/0883-9417(94)90066-3. Muthiah, W. (2017, April 28). Health Ministry launches new guidelines to protect staff. The Star. Retrieved from https://www.thestar.com.my/news/nation/2017/04/28/health-ministry-launchesnew- guidelines-to-protect-staff/. Ng, C., & Othman, J. (2002). Unwanted and Unwelcome: Sexual Harassment in the Malaysian Workplace. Gender, Technology And Development, 6(3), 389–407. https://doi.org/10.1177/097185240200600304. Nik Azlan, N. M., Ismail, M. S., Azizol, M. (2013). Management of Emergency Department Overcrowding (EDOC) in a Teaching Hospital. Medicine & Health,8(1), 42-46. Retrieved from http://www.medicineandhealthukm.com/article/management-emergencydepartment-overcrowding-edoc-teaching-hospital. Occupational Safety and Health Administration (2015, December). Workplace violence in healthcare: Understanding the challenge. Retrieved from https://www.osha.gov/Publications/OSHA3826.pdf. Park, M., Cho, S.-H., & Hong, H.-J. (2015). Prevalence and perpetrators of workplace violence by nursing unit and the relationship between violence and the perceived work environment. Journal of Nursing Scholarship, 47(1), 87–95. doi: 10.1111/jnu.12112. Partridge, B., & Affleck, J. (2017). Verbal abuse and physical assault in the emergency department : Rates of violence , perceptions of safety , and attitudes towards security. Australasian Emergency Nursing Journal, 20(3), 139–145. doi:10.1016/j.aenj.2017.05.001. Pati, D., Pati, S., & Harvey, T. E. (2016). Security Implications of Physical Design Attributes in the Emergency Department. Health Environments Research & Design Journal, 9(4), 50–63. doi:10.1177/193758671562654. Phillips, J. P. (2016). Workplace Violence against Health Care Workers in the United States. New England Journal of Medicine, 374(17), 1661–1669. doi:10.1056/NEJMra1501998. Pinar, R., & Ucmak, F. (2011). Verbal and physical violence in emergency departments: a survey of nurses in Istanbul, Turkey. Journal of clinical nursing, 20(3-4), 510-517. doi:10.1111/j.1365-2702.2010.03520.x. Ramacciati, N., Andrea, C., Beniamo, A. (2013). Wellbeing at work: going towards a global approach to violence in the ER. Scenario, 30(2), S51-S52. Retrieved from https://www.researchgate.net/publication/257919800_Wellbeing_at_work_going_towards_a_global_approach_to_violence_in_the_ER. Ramacciati, N., Ceccagnoli, A., Addey, B., & Rasero, L. (2018). Violence towards Emergency Nurses. The Italian National Survey 2016: A qualitative study. International Journal of Nursing Studies, 81, 21–29. https://doi.org/10.1016/j.ijnurstu.2018.01.017. Ramacciati, N., Ceccagnoli, A., Addey, B., Lumini, E., & Rasero, L. (2017). Violence towards emergency nurses: A narrative review of theories and frameworks. International Emergency Nursing, 1-11. https://doi.org/10.1016/j.ienj.2017.08.004. Registered Nurses' Association of Ontario (2009). Preventing and managing violence in the workplace. Retrieved from http://rnao.ca/sites/rnaoca/ files/Preventing_and_Managing_Violence_in_the_Workplace.pdf. Resnik, B. D. (2015). What is ethics in research & Why is it Important. Retrieved from https://www.niehs.nih.gov/research/resources/bioethics/whatis/index.cfm. Ruth, P., Samsiah, M., Hamidah, H., & Lp, S. (2009). Workplace Violence Experienced by Nurses in Universiti Kebangsaan Malaysia Medical Centre. Med & Health, 4(2), 115–121. Retrieved from http://journalarticle.ukm.my/1949/. Saidu Badara, M. & Saidin, S. Z. (2014). Internal audit effectiveness: Data screening and preliminary analysis. Asian Social Science, 10(10), 76–85. https://doi.org/10.5539/ass.v10n10p76. Shahian, D. M., Liu, X., Meyer, G. S., & Normand, S. T. (2014). Comparing teaching versus nonteaching hospitals: the association of patient characteristics with teachinf intensity three common medical conditions. Academic Medicine 89(1), 94-106. doi: 10.1097/ACM.0000000000000050. Shamsudin, F. M., & Rahman, R. A. (2006).Workplace violence in Malaysia and the relevance of OSHA 1994. Malaysian Management Review, 41(1), 1-20. Spector, P. E., Zhou, Z. E., & Che, X. X. (2014). Nurse exposure to physical and nonphysical violence , bullying , and sexual harassment : A quantitative review. International Journal of Nursing Studies, 51(1), 72–84. https://doi.org/10.1016/j.ijnurstu.2013.01.010. Squires, A., Aiken, L. H., van den Heede, K., Sermeus, W., Bruyneel, L., Lindqvist, R.,… Matthews, A. (2013). A systematic survey instrument translation process for multi-country, comparative health workforce studies. International Journal of Nursing Studies, 50(2), 264–273. https://doi.org/10.1016/j.ijnurstu.2012.02.015. Suhaila, O., & Kg, R. (2012). Prevalence of Sexual harassment and its associated factors among registered nurses working in government hospitals in Melaka state, Malaysia. Medical Journal Malaysia 67(5), 506–517. Retrived from https://emjm. org/2012/v67n5/sexual-harassment.pdf. Talas, M. S., Kocaöz, S., & Akgüç, S. (2011). A survey of violence against staff working in the emergency department in Ankara, Turkey. Asian Nursing Research, 5(4), 197–203. https://doi.org/10.1016/j.anr.2011.11.00. Taylor, J. L., Rew, l. (2010). A systematic review of the literature: workplace violence in the emergency department. Journal of Clinical Nursing, 20(7-8), 1072-1085. doi: 10.1111/j.1365-2702.2010.03342.x. Terzoni, S., Ferrara, P., Cornelli, R., Ricci, C., Oggioni, C., & Destrebecq, A. (2015). Violence and unsafety in a major Italian hospital: experience and perceptions of health care workers. La Medicina del lavoro, 106(6), 403–411. Retrieved from https://pdfs.semanticscholar.org/06ff/086e9aeb5aa4b0ef40feeb9e9cc3f189c463.pdf Thompson, P. (2015). Mitigating violence in the workplace. Retrieved from https://www.ena.org/docs/default-source/resource-library/practice resources/position-statements/joint statements/mitigatingviolence.pdf?sfvrsn=ae0b949c_6. U.S. Department of Labor, Occupational Safety and Health Administration. (2016). Guidelines for Preventing Workplace Violence for Healthcare and Social Service Workers (OSHA 3148-06R 2016). Retrieved from https://www.osha.gov/Publications/osha3148.pdf. United States Department of Labor (2017, November). Bureau of Labor Statistics: Injuries, Illnesses, and Fatalities. Retrieved from https://www.bls.gov/iif/soii-chartdata- 2016.htm. University Malaya Medical Centre. (n.d). Annual Report 2016. Retrieved from https://www.ummc.edu.my/ummc/annual-report.asp?keyid. Velasco, E. (2010). Inclusion Criteria In: Encyclopedia of Research Design. Sage Research Method. doi:10.4135/9781412961288. Vogel, L. (2016). Abusive patients: Is it time for accountability?. The Canadian Medical Association Journal, 188(11), E241–E242. https://doi.org/10.1503/cmaj.109 5266. Walker, W. (2005). The strengths and weaknesses of research designs involving quantitative measures. Journal of Research in Nursing, 10(5), 571-582. doi:10.1177/136140960501000505. Wei, C.Y., Chiou, S. T., Chien, L.Y., & Huang, N. (2016). Workplace violence against nurses – Prevalence and association with hospital organizational characteristics and health-promotion efforts: Cross-sectional study. International Journal of Nursing Studies, 56, 63–70. doi:10.1016/j.ijnurstu.2015.12.012. Wilson, B. L., Diedrich, A., Phelps, C., Choi, M. (2011). Bullies at work: The impact of horizontal hostility in the hospital setting and intent to leave. Journal of Nursing Administration, 14(11): 453-458. doi: 10.1097/NNA.0b013e3182346e90. Wolf, L. A., Delao, A. M., & Perhats, C. (2014). Nothing changes, nobody cares: Understanding the experience of emergency nurses physically or verbally assaulted while providing care. Journal of Emergency Nursing, 40(4), 305-310. doi:10.1016/j.jen.2013.11.006 Wolf, L. A., Delao, A. M., Perhats, C., Clark, P. R., Moon, M. D., Baker, K. M., … Lenehan, G. (2015). Exploring the management of death: Emergency nurses’ perceptions of challenges and facilitators in the provision of end-of-life care in the emergency department. Journal of Emergency Nursing, 41(5), 1–11. doi:0.1016/j.jen.2015.05.018. Wu, S., Chai, W., & Wang, X. (2012). Workplace Violence and Influencing Factors Among Medical Professionals in China. American Journal of Industrial Medicine,55, 1000–1008. doi:10.1002/ajim.22097. Zainal, N., Rasdi, I., & Saliluddin, S. M. (2018). The Risk Factors of Workplace Violence among Healthcare Workers in Public Hospital. Malaysian Journal of Medicine and Health Sciences, 14. Retrieved from http://www.medic.upm.edu.my/upload/dokumen/2018120409055516_MJMHS_SP _Nov_2018.pdf. Zamboni, J. (2018). What Is the Meaning of Sample Size? : Sciencing. Retrieved from https://sciencing.com/meaning-sample-size-5988804.html. Zhang, L., Wang, A., Xie, X., Zhou, Y., Li, J., Yang, L., & Zhang, J. (2017). Workplace violence against nurses: A cross-sectional study. International Journal of Nursing Studies, 72, 8–14. https://doi.org/10.1016/j.ijnurstu.2017.04.002. Zhulavska, O & Piantkovska, A. (2016). Means of Verbalization of the concept of terrorism in the British newspaper discorse of 2014. GISAP: Philological Sciences, Ukraine, 16-18. doi: http://dx.doi.org/10.18007/gisap:ps.v0i9.1256. Zuraida, A., & Zainal, N. (2015). Exploring Burnout Among Malaysian Junior Doctors Using the Abbreviated Maslach Burnout Inventory. Malaysian Journal of Psychiatry, 24(1), 1–10. Retrieved from http://www.mjpsychiatry.org/index.php/mjp/article/view/348/251.