Affiliations: [a]
Center for the Study of Healthcare Innovation, Implementation and Policy (CSHIIP), VA Greater Los Angeles Healthcare System, Health Services Research and Development (HSR&D), Los Angeles, CA, USA
| [b]
Department of Psychiatry and Biobehavioral Sciences, UCLA David Geffen School of Medicine, Jane & Terry Semel Institute for Neuroscience & Human Behavior, Los Angeles, CA, USA
Correspondence:
[*]
Address for correspondence: Shay Cannedy, Ph.D, Center for the Study of Healthcare Innovation, Implementation and Policy (CSHIIP), VA Greater Los Angeles Healthcare System, Health Services Research and Development (HSR&D), 11301 Wilshire Blvd., Bldg. 206, Los Angeles, CA 90073, USA. E-mail: shay.cannedy@va.gov.
Abstract: BACKGROUND:The impact of patient aggression on primary health care employees is underexplored, yet imperative to address, given high rates of burnout. OBJECTIVE:We qualitatively explore perceptions of patient aggression among staff in women’s health primary care at the Veterans Health Administration (VA). Our objective is to identify coping strategies that staf devised in response to aggressive behavior. METHODS:We conducted semi-structured interviews with 60 VA women’s health primary care employees in 2021 and 2022. Informed by the Job Demands-Resources theoretical model, we used rapid qualitative analysis to identify themes related to patient aggression and employee coping strategies. RESULTS:Disruptive behaviors reported by participants included verbal and physical aggression. Staff cited disruptive patient behavior as emotionally draining and perceived a lack of consequences for low-level aggression. Respondents used coping strategies in response to patient aggression at three time points: before, during, and after a negative interaction. At each point, support from team members emerged as a dominant coping mechanism, as well as rapport-building with patients. CONCLUSION:Patient aggression can negatively impact the work experiences of primary care employees. At VA, women’s health primary care staff have devised multiple strategies to cope with these interactions. However, the ability to effectively prevent and manage patient aggression is limited by the lack of meaningful repercussions for aggression at the organizational level, which has important implications for employee well-being and retention. Retention of women’s health employees in VA is critical given the need for a highly specialized workforce to address the complex health needs of women veterans.
Keywords: Workplace violence, incivility, workforce, veterans, delivery of health care
