DOI: 10.1136/bmjopen-2026-117064 ISSN: 2044-6055

Association between healthcare professionals’ perceptions of hospital attitudes towards workplace violence and the prevalence of workplace violence: a nationwide cross-sectional survey in China

Lihong Wu, Jingjing Xia, Bo Yan, Jianhua Chen, Wenhua Zhu, Liying Chen

Objective

To examine the association between healthcare professionals’ (HCPs) perceptions of their hospitals’ attitudes towards workplace violence (HATWPV) and the prevalence of workplace violence (WPV) in China.

Design, settings and participants

This nationwide cross-sectional survey was conducted among HCPs from September 2022 to January 2023. Participants were recruited using a multistage sampling strategy across three provinces (Zhejiang, Henan, Guizhou) representing eastern, central and western China. A total of 2976 valid questionnaires from 92 medical institutions were analysed.

Primary and secondary outcome

The primary outcomes were self-reported physical violence and verbal threats in the past year. Secondary outcomes were HCPs’ perceptions of HATWPV: concern about experiencing WPV (CAE-WPV), satisfaction with hospitals’ procedures and systems for addressing WPV (SHPS-aWPV) and perceived institutional support for reporting WPV incidents (SR-WPVIs).

Results

A total of 2370 (79.6%) HCPs expressed CAE-WPV, 1438 (48.3%) were dissatisfied with SHPS-aWPV and 981 (33.0%) reported working in institutions without SR-WPVIs. After adjusting for sociodemographic, occupational and stress-related factors, negative perceptions across all three HATWPV dimensions were significantly associated with higher risks of both physical violence and verbal threats. The association varied by hospital level and region. For example, dissatisfaction with procedures showed a stronger link with verbal threats in primary care institutions and with physical violence in the eastern region.

Conclusion

HCPs’ perceptions of HATWPV are associated with the prevalence of WPV. Medical institutions should proactively assess these perceptions, establish transparent and supportive reporting mechanisms and integrate violence prevention into organisational culture and evaluation systems to promote a safer workplace.

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