Workplace violence can produce adverse financial outcomes for organizational shareholders, harms employees, and might create long-lasting mental health issues for survivors. Leaders of small businesses might lack the tools available to larger organizations to effectively address the growing incidence of violence in the workplace. The purpose of this multiple case study was to explore strategies some leaders of small businesses used to prevent workplace violence. The targeted population consisted of 3 leaders of small businesses from 3 different organizations in the government consulting industry in northern Virginia who successfully implemented workplace violence prevention programs. The general systems theory was the conceptual framework for this research. Data were collected from applicable company documents and semistructured interviews. The data were analyzed through a 5-phase qualitative analysis cycle. Emergent themes included effective workplace violence prevention policies and procedures and leaders’ role in creating a positive working environment. The implications of this study for positive social change include the potential to reduce work-related stress so that employees are healthy members of society. Leaders of small business who promote a positive work environment and understand the importance of an effective workplace violence prevention policy might be able to increase the performance of their businesses, which could allow them to be more involved in their communities.

Work is a significant part of everyday life for many, so it is not surprising that it would be included in the storylines of many Hollywood films. Movies incorporate elements from everyday life, real or imagined. There is a plethora of research making connections between film and the social world, but not regarding workplace bullying. This study takes a close and in-depth look at workplace bullying as it is depicted in scenes from a sampling of 100 Hollywood films released 1994-2016. It is interpretive in nature and guided by the theoretical underpinnings of film theory, social construction of reality theory, and symbolic interaction theory. Qualitative media analysis (synonymous with ethnographic content analysis) and grounded theory, in concert with Hymes Ethnography of Communication SPEAKING Model methods, blended and facilitated data collection and analysis. The advent of a theoretical frame highlighting the delicate interplay within the depictions of workplace bullying became evident; herein named the paradoxical web of workplace bullying. Within this paradox are tragedy and comedy; from which ambivalence resilience theory emerges. This research contributes to the literature of conflict studies and more specifically the scholarly research and professional practice dedicated toward greater understanding and eradication of this horrific phenomenon, workplace bullying

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The purpose of this study was to investigate how social services workers describe, the risk of being exposed to threats and violence in their profession. Six social services workers were interviewed, four from the Welfare Office in a major city and two from the Child and Family Services in a minor city. Results showed that the majority of social services workers consider themselves exposed in their profession, meaning that they feel there's a risk of a violent or threatening situation occurring in their work situation. All interviewees had experiences from some sort of threat or violence in a work related context and they attested that non-personal assaults, such as threats made through telephone, email and answering machines are more common than verbal assaults made in personal meetings. Being prepared and listening to ones intuition is a way of dealing with exposure when meeting with a client. By working in pairs you can decrease the risk of being exposed in a violent/threatening situation. Several of the interviewees pointed out that they are more tolerant to certain clients in order to cope with their work situation.

Syftet med vår studie var att undersöka hur lärare i grundskolan och gymnasiet förhåller sig till våld i skolan. Vi gjorde en kvalitativ intervjustudie med fem lärare. Lärare såg våld riktat mot lärare i första hand som fysiska handlingar och menade att den egna utsattheten för våld var låg. Samtidigt föreföll psykiskt våld vara vanligt förekommande. Lärarnas strategier för att hantera våld formades av deras konstruktion av den egna yrkesrollen. Särskilt framträdande var lärares motstånd mot att definiera sig som offer. De framställde sig själva som starka och kapabla att hantera våldet och lyfte fram att upprätthålla ordningen i klassrummet som en nyckelfråga för att undvika att bli utsatta för våld. En annan nyckelfråga var goda relationer mellan lärare och elever.De av lärarna föreslagna åtgärderna för att minska våld i skolan innefattade ökade resurser för att förebygga att elever far illa och därigenom undvika att risksituationer uppstår. / The aim of our study was to examine how teachers in the senior level of the 'grundskola' (högstadiet) and upper secondary school (gymnasiet) relate to violence in school. In order to examine this, we have done qualitative interviews with five teachers. The teachers defined violence against them mostly as physical acts and considered their own victimization to be low. The teachers though expressed that exposure to psychological violence was common. Their strategies to cope with violence were formed by the construction of their profession. The teachers were diffident about defining themselves as victims. They held themselves as strong and capable of coping with violence and pointed out maintaining order in class as a key point to avoid victimization. Another key point was good relations between teachers and student. Suggested measures against school violence consisted of increased resources in order to prevent students failure and thereby reduce risk situations.

A research report submitted to the Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, in partial fulfilment of the requirements for the degree of Master of Medicine in Emergency Medicine. Johannesburg, March, 2016 / Objectives: The aim of the current research was to determine the perception and experience of different emergency department occupational groups regarding workplace violence in the past 12 months and to determine the effect that it had on them in two government hospitals in Johannesburg, South Africa. Materials and Methods: The current research was a cross sectional, retrospective qualitative survey. Results: Eighty-six surveys (43%) out of the distributed 200 questionnaires were returned. Five surveys were unfilled leaving 81 surveys (40.5%) that are included in the analysis. Psychological violence was experienced by 73 % (n=51) of the participants while physical violence was experienced by 34.2% (n=27). Patients were the perpetrators of 61% and 67.9% of psychological and physical violence against staff members, respectively. Friends and family members who accompanied patients in the emergency department accounted for 27.4% psychological violence while this same set of people caused 17.3% of physical violence. Ninety-one percent of the participants reported that they did not receive any training courses on how to handle workplace violence incidents. Medical staff (doctors and nurses) were found to be at an increased risk to psychological violence. Conclusions: Workplace violence was commonly experienced by ED staff members. Majority of the incidents were in the form of psychological violence; however, a considerable percentage of the participants experienced physical violent incidents. Most of the violent incidents experienced were perceived to be preventable by majority of participants. This research supports the need for practical training and education of the ED staff members, on how to prevent and deal with issues related to ED WPV. / MT2016

The present thesis was carried out in part fulfilment of the Doctorate in Clinical Psychology at the University of Edinburgh. It is presented in portfolio format, comprising of two individual papers although a total thesis abstract provides an overview of the entire thesis. The first paper is a systematic review of existing empirical research. It explores the predictive validity of risk assessment tools for imminent (short-term) violence and aggression in forensic psychiatric settings. The second paper is an empirical study exploring how frontline nursing staff both predict and emotionally cope with experiencing violence and aggression in a high-security setting. Paper one was prepared for Aggression and Violent Behavior and paper two for The International Journal of Forensic Mental Health; so, follow their respective author guidelines. Mental health, and forensic mental health nurses have been identified as being at particular risk of experiencing patient perpetrated violence and aggression (PPVA). There is relatively little research investigating how nursing staff predict and cope with more immediate, imminent inpatient violence and aggression, specifically within secure (forensic) settings. Negative outcomes of PPVA are widely accepted and demonstrated within empirical literature, including increased anxiety and stress for staff, fractures to the therapeutic relationship between patients and staff, and difficulties with staff retention and absenteeism for the organization. Due to the extensive negative outcomes associated with PPVA, a wealth of research has focused on developing the area of violence risk assessment. Despite this, there remains limited understanding regarding the utility of existing risk assessment tools for predicting and assessing violence risk over brief time frames (i.e. days to weeks). Therefore, a systematic review was conducted to explore the predictive validity of violence risk assessment tools for imminent, short-term risk in inpatient forensic psychiatric settings. Findings demonstrated that multiple tools had decent predictive validity, however quality scores were impacted by small sample sizes. The Dynamic Appraisal of Situational Aggression- Inpatient Version was the most effective tool with the highest mean quality score. The main limitations were the small number of studies assessing some of the included tools and the level of ambiguity between studies regarding the definition of imminent, short-term violence. Developing a shared understanding of what constitutes short-term risk and improving the number and quality of studies on the largely neglected tools, should therefore be research priorities. How nurses actually recognize and predict inpatient violence and aggression in forensic psychiatric settings, and how they emotionally cope with the aftermath, are poorly explored and understood processes. A social constructivist grounded theory approach was used to analyze the transcripts from 12 interviews with frontline nursing staff from an inpatient high-security setting. A model was constructed integrating nurses' beliefs and assumptions about subtypes of violence, their efforts to use observation skills in order to aid risk prediction, and their resultant emotional experiences following PPVA. Nurses emotional coping seemed to be affected by several factors relating to the culture of the organization and the accessibility of support. Seemingly, knowing the patient helped nurses to better identify underlying needs leading to violent behavior. This understanding helped nurses to implement targeted, needs-led interventions to address these unmet needs, and so reduce recurrent and cyclical violence. Recommendations are made to build upon, and utilize nursing skills in risk prediction and management, and to help better support the emotional impact of experiencing PPVA within forensic psychiatric settings.

This dissertation focused on the topic of youth violence in two very different populations, young workers and youth offenders. Youth violence at the home, in school and in the community has been well documented in the literature but very little is known about the prevalence of and risk factors for victimization at the workplace in young workers. In chapter two, a retrospective cohort study was conducted using National Crime Victimization Survey data from 2008–2012. We calculated a rate of workplace violence victimization and compared those rates between occupations and demographic characteristics in young workers 16–24 years. Multilevel, weighted Poisson regression models were used to compare rates of workplace victimization across occupations and demographic characteristics. The rate of workplace violence victimization was 1.11 (95% CI: 0.95–1.27) incidents per 1,000 employed person-months. Young workers in retail sales occupations had a higher rate of workplace victimization than workers in health care occupations (RR = 0.52, 95% CI: 0.26–1.03) but a lower rate of workplace victimization than workers in protective service occupations (RR = 2.25, 95% CI: 1.34–3.77). Rates of workplace violence victimization differed significantly by age, income and workplace location. In contrast, the prevalence of and risk factors for juvenile offender are well-known. However, there still exist major gaps in determining the effectiveness of tertiary interventions, justice-based processes (i.e. formal appearance in court vs. informal agreement or meeting with court officer) and placement (e.g. detention centers, foster care, mental health institutions). In chapters three and four, the effectiveness of justice-based processes and placement on recidivism in young offenders 12–16.5 years were evaluated using data received from the Iowa Criminal and Juvenile Justice Planning Agency (CJJP) from 2010–2013. Multivariable logistic regression was used to impute risk level scores, to calculate propensity scores and to measure associations between demographic or complaint characteristics and main exposures. A sensitivity analysis was conducted by comparing the associations between process type and recidivism in a sample matched on propensity scores to the original unmatched sample. Cox Proportional Hazards models were used to compare time to recidivism by process type or placement in matched and unmatched samples. In chapter three, out of 2,901 youth offenders, 41% recidivated over an 18-month period. Eighteen percent were formally processed while 82% received an informal agreement. Youth who received an informal agreement had a lower risk of reoffending at any time compared to youth who were formally processed in both the unmatched (HR = 0.93, 95% CI: 0.76–1.13) and matched sample (HR= 0.86, 95% CI: 0.65–1.14). These estimates were not statistically significant. We observed an offense-specific association between processing and recidivism. Property (HR = 0.74; 95% CI: 0.57–0.96) offenders who received an informal agreement were significantly less likely to recidivate compared to property offenders who were formally processed. In chapter four, out of 1,469 youth offenders, 36% recidivated over an 18-month period. Nine percent received placement while 91% did not. Youth who received placement had up to an 87% higher risk of reoffending at any time compared to youth who did not receive placement in both unmatched (HR = 1.52, 95% CI: 1.11–2.08) and matched (HR= 1.87, 95% CI: 1.23–2.84) samples. We observed a charge-specific association between receiving placement and recidivism. Youth charged with a simple misdemeanor (HR = 2.74; 95% CI: 1.63–4.60) or other charges (HR = 6.60, 95% CI: 1.56–28.00) and received placement were significantly more likely to recidivate compared to those who did not receive placement. These findings contribute to the youth violence literature in the following ways. Chapter two identified the occupations and target populations in need of policies and evidence-based interventions aimed at improving the working conditions for young workers. Chapter three and four supports the continual evaluation of the juvenile justice system to determine the best practices that may reduce violence and recidivism in young offenders.

Over the past two decades, violence at work has become the object of an increasing level of attention. The objective of the thesis is to analyse how the development of violence at work as a social problem might be understood. The studies in the thesis examine trends in exposure to violence at work among different occupational groups (I), the attention focused on violence at work in trade journals (II), the measures proposed to combat the problem in trade journal articles (III) and in the occupational injury reports made by the victims themselves (IV). The first study shows that, according to victim surveys, levels of exposure to work-related violence have increased since the beginning of the 1980s. The increases are greatest in relation to the female-dominated occupations found in the care provision sectors. Study II presents a quantitative content analysis of trade journals from the period 1978–2004. The results show that there has been an increase in the amount of attention focused on violence at work. The results indicate that definitions of violence have expanded and that attention has become focused on new groups of victims and perpetrators. Study III examines the ways in which trade journals describe measures to combat violence at work. The results indicate that there has been a shift from viewing violence as a problem that should be resolved at the workplace as a health-and-safety issue, to increasingly viewing it as a problem that should be resolved externally with the help of the justice system. Study IV is based on an analysis of occupational injury reports from staff in the care sector who have been exposed to violence at work. Irrespective of the nature of the risk situation that preceded the violent incident, the staff who have been exposed to violence at work would prefer to see the problem resolved internally at the workplace. / Våld i arbetslivet har under de senaste två decennierna fått en större uppmärksamhet. Syftet med avhandlingen är att analysera hur utvecklingen av våld i arbetslivet som samhällsproblem kan förstås. I fyra delstudier behandlas omfattningen och utvecklingen av utsatthet för våld i arbetslivet bland olika yrkesgrupper (I), hur våld i arbetslivet uppmärksammats i facklig press (II) och vilka åtgärder som förespråkas i facklig press (III) samt i arbetsskadeanmälningar (IV). Gemensamt för avhandlingens studier är att de tar upp frågor som rör förändring över tid, hur utvecklingen kan förstås och vilka konsekvenser förändringarna för med sig. I den första studien visas att utsatthet för arbetsrelaterat hot och våld enligt svenska offerunderökningar har ökat sedan 1980-talets början. Ökningarna är störst för de kvinnodominerade jobben inom välfärdssektorerna. I studie II görs en kvantitativ innehållsanalys av facklig press 1978-2004. Resultaten visar att uppmärksamheten för våld har ökat och pekar på vidgade definitioner av våld och att nya grupper uppmärksammas som offer och förövare. I studie III undersöks hur åtgärder mot hot och våld i arbetslivet uppmärksammas i facklig press. Resultaten indikerar att våld i arbetslivet har gått från att ses som ett problem som skall lösas som en intern arbetsmiljöfråga på arbetsplatsen till att allt oftare ses som ett problem som ska lösas externt med hjälp av polis och rättsväsende. Det har skett en förskjutning mot ett förrättsligande när det gäller hur våld i arbetlivet ska åtgärdas. Utvecklingen kan sammanfattas som en rörelse ett arbetsmiljöproblem till ett brottsproblem. Studie IV utgår från en analys av arbetsskadeanmälningar från vård- och omsorgspersonal som utsatts för våld i arbetet. När man ser till de åtgärdsförslag som de utsatta själva föreslår för att undvika att våldet skall inträffa igen så framgår att det finns en diskrepans mellan de åtgärder som uppmärksammas i facklig press och de åtgärder som personalen efterfrågar. De våldsutsatta ser främst att våldsproblemet, oavsett vilken risksituation som föregått våldet, löses internt på arbetsplatsen. Adekvata resurser i form av tid och personal för att utföra arbetet efterfrågas gång på gång. Insatser av externa aktörer såsom polis och rättsväsende efterfrågas däremot inte. / At the time of the doctoral defense, the following paper was unpublished and had a status as follows: Paper 4: Submitted.

Bakgrund: Hot och våld riktat mot vårdpersonal är idag ett växande problem över hela världen. Vårdpersonal tillhör en av de yrkeskategorier där det föreligger en ökad risk att bli utsatt för hot och våld från patienter. Vårdpersonal är de som står för omvårdnaden av patienterna och forskning visar att om personalen blir utsatta för hot och våld kan det uppstå konsekvenser för både vårdpersonal och patienter. Syfte: Syftet med denna litteraturstudie var att belysa upplevelsen av hot och våld hos vårdpersonal inom hälso- och sjukvården. Metod: I litteraturstudien har 8 vetenskapliga, kvalitativa artiklar sammanställts och analyserats med kvalitativ innehållsanalys med induktiv ansats. Artikelsökning har skett i databaserna Cinahl, PsycINFO, PubMed och Scopus. Resultat: Resultatet visar att upplevelsen av att utsättas för hot och våld leder till en mängd starka känslor hos den som blivit utsatt. Känslorna är för det mesta av negativ karaktär och kan handla om känslan av att uppleva sig vara hotad och rädd, att känna både subjektiv ilska samt ilska riktad mot patienterna, känna maktlöshet och att känna hopplöshet och nedstämdhet. Hot och våld leder till konsekvenser för personalen. Det omfattar bland annat att motivationen sänks, personalen “tar med sig jobbet hem” och privatlivet drabbas. Det uttrycktes en stark önskan av stöd, kunskap och utbildning. Slutsats: Litteraturstudiens resultat visar att upplevelsen av att bli utsatt för hot och våld leder till många svåra konsekvenser för de som blir drabbade. För att förbättra hanteringen av konsekvenserna krävs utbildning och stöd till vårdpersonalen samt vidare forskning inom området både för att förebygga och hjälpa personal som blivit utsatt. / Background: Threats and violence against healthcare workers is today a growing problem worldwide. Healthcare personnel are at an increased risk of being subjected to threats and violence by their patients. Health workers are caregivers and advocates for their patients and if they become subject to threats or violence, previous research has shown that the consequences can be many both for caregivers and patients. Aim: The aim of this study was to illuminate the experiences of threat and violence by patients on healthcare personnel. Method: This literature review study included 8 scientific, qualitative articles compiled and analyzed with a description of qualitative content analysis with inductive approach. Article search was performed in the databases Cinahl, PsycINFO, PubMed and Scopus. Results: The results show that the experience of being subjected to threats and violence leads to a lot of strong feelings for the victimized health care worker. Feelings are, for the most part, of negative character and include feeling of threatened and afraid, feeling both anger in general and anger directed toward patients, feeling powerless and feeling hopelessness and depression. Threats and violence also lead to other negative consequences for the staff. These include, among other things, that motivation is lowered, and that workers find themselves “taking their work home with them”, which affects their private lives, often in detrimental ways. Affected workers also expressed a strong desire for support for victims, and knowledge and training for coping skills and tactics for dealing with difficult patients. Conclusion: The results of the literature review study shows that the experience of being subjected to threats and violence leads to many serious consequences for those who are affected. In order to improve the management of the consequences, education and support for healthcare personnel and further research in the area, to be able to prevent further incidents and help the healthcare workers who have been subjected, are required.