Type of aggression.

Aim
In the present study, we aimed to provide an epidemiological and descriptive overview of violence against healthcare workers in an Italian university hospital, presenting and characterizing the risk factors in the department where such events occur and to propose ways to prevent aggressive behaviors.
Methods
We retrospectively analyzed violence against healthcare workers by patients and attendants at an Italian university hospital from 2020 to 2022. Aggressions were documented in anonymous incident reports collected by the hospital’s Clinical Risk Unit. The frequencies and percentages were calculated via a descriptive analysis. Chi-square tests were used to compare the wards with the most aggressions to other wards.
Results
Of the 219 included cases, the aggressors were primarily male patients and the victims female nurses. Most of the aggressions occurred in the psychiatry and emergency department. Among the aggressors, 41.1%, had a psychiatric diagnosis or neurocognitive impairment. Over half the cases involved physical aggression. Compared to other wards, psychiatric wards showed an even distribution of aggressor gender, a higher proportion of male victims, fewer verbal aggressions, and less impact from environmental factors. Notably, female aggressor status (p < 0.001, OR = 8.687) and involvement in physical assaults (p < 0.001, OR = 15.236) were identified as independent risk factors associated with aggression in psychiatric settings.
Conclusion
Our findings align with the literature in that most of the incidents occurred in the psychiatry and emergency medicine departments and involved nurses. However, physical rather than verbal aggression predominated. Notable distribution, risk factor, and qualitative differences were observed between the psychiatric and non-psychiatric services, which warrants further investigation. Our results could be useful in implementing better prevention strategies based on the type of ward.

研究目的：本研究旨在针对意大利某大学附属医院内针对医护人员的暴力行为开展流行病学及描述性分析，明确此类事件发生科室的危险因素特征，并提出攻击性行为的预防策略。

研究方法：本研究回顾性分析了2020—2022年意大利某大学附属医院内患者及陪护人员针对医护人员的暴力事件。暴力事件的相关信息来源于医院临床风险工作组（Clinical Risk Unit）收集的匿名事件报告。通过描述性分析计算事件发生频率与占比，采用卡方检验（Chi-square tests）对比暴力高发病区与其他病区的差异。

研究结果：本研究共纳入219起暴力事件，施暴者以男性患者为主，受害者则以女性护士居多。多数暴力事件发生于精神病区与急诊病区。施暴者中41.1%存在精神疾病诊断或神经认知障碍。超半数事件为肢体暴力攻击。与其他病区相比，精神病区的施暴者性别分布更为均衡，男性受害者占比更高，言语攻击事件更少，且受环境因素影响程度更低。值得注意的是，在精神病区场景中，女性施暴者（p<0.001，比值比（Odds Ratio）=8.687）与肢体攻击行为（p<0.001，比值比（Odds Ratio）=15.236）被确定为与暴力事件相关的独立危险因素。

研究结论：本研究结果与现有文献相符，即多数暴力事件发生于精神病科与急诊医学科，且受害者以护士为主。但本研究中肢体攻击占比高于言语攻击。精神病科与非精神病科服务单元在事件分布、危险因素及质性特征方面均存在显著差异，这一发现有待进一步深入研究。本研究结果可用于针对不同病区类型制定更优化的暴力预防策略。