• Jianwei Shi, Sheng Wang, Ping Zhou, Leiyu Shi, Yu Zhang, Fei Bai, Di Xue, and Xinkai Zhang.
• Key Lab of Health Technology Assessment, Ministry of Health (Fudan University); Collaborative Innovation Center of Social Risks Governance in Health; School of Public Health, Fudan University, Shanghai, 200032, P.R. China.
• Plos One. 2015 Jan 1; 10 (6): e0128394.

IntroductionIn China, the severity of medical disputes has greatly increased during the past two decades, which has caused various adverse outcomes for health professionals. Previous research on violence in healthcare settings has primarily examined the occurrence of patient-initiated violence and its effects on physicians, but few studies have focused on the impact of the extent of physicians' exposure to violence. This study examined the different frequency levels of specific types of violence and their relationships to physicians' psychological wellbeing, including emotional exhaustion (EE), job satisfaction (JS), and intention to leave (IL).MethodsUsing a stratified random sampling method, the participants were drawn from 123 public hospitals in Shanghai, Hubei Province, and Gansu Province in China, and 1,656 completed questionnaires were collected. Chi-square test, analysis of variance, and mixed linear model were employed in the analysis.ResultsThe results showed that the rate of exposure to verbal abuse (VA) was the highest (92.75%), followed by threats of assault (TA, 88.10%) and physical assaults (PA, 81.04%). Physicians' reported high-frequency exposure to VA, TA, and PA was 35.14%, 27.72%, and 19.32%, respectively. The results indicated that exposure to violence significantly affected EE, JS, and IL, and the intensity of the harm of high-frequency exposure was several times stronger than that of low-frequency exposure. Interestingly, we found that VA produced a greater adverse impact on physicians' EE and satisfaction with work (JS-1) than did TA or PA. This finding may be attributed to the fact that physicians are more likely to be exposed to a high frequency of VA, and the effect of high-frequency exposure is much stronger.ConclusionThe results indicated that decreasing violent incidents and creating a safer work environment for physicians should be a top priority for both government and society.

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