<abstract xmlns="http://www.w3.org/1999/xhtml">

<sec id="j_sjph-2021-0014_s_006">
<h3>Introduction</h3>
<p>Healthcare workers (HCWs) are often exposed to mistreatment by patients, which has negative effects on both staff and institutions. To take appropriate action to help HCWs in this context, patient-related social stressors (PSS) should be explored. The purpose of the research was to identify the most pronounced patient behaviour contributing to the social stress (SS) of HCWs, and compare PSS between different HCWs and different types of healthcare institutions.</p></sec>
<sec id="j_sjph-2021-0014_s_007">
<h3>Methods</h3>
<p>750 HCWs from Slovenian public health centres and hospitals participated in the online survey. Although the non-probability sampling was used, the sample was representative according to gender and HCW type (doctors, nurses and other HCWs).</p></sec>
<sec id="j_sjph-2021-0014_s_008">
<h3>Results</h3>
<p>The results show that the most pronounced patient behaviour contributing to the SS of HCWs are attitudes and behaviour of patients that are challenging in terms of what is – from the HCWs’ point of view – considered as acceptable and reasonable (disproportionate patient expectations), and unpleasant, humourless, and hostile patients. HCWs in primary institutions meet less verbally aggressive and unpleasant patients than in tertiary ones. Although among all HCWs less educated ones are more exposed to inappropriate behaviour, doctors are those HCWs who experience more inappropriate behaviour.</p></sec>
<sec id="j_sjph-2021-0014_s_009">
<h3>Conclusion</h3>
<p>Managers should enable HCWs to get comprehensive patient service training, oriented towards improving relationship management and patient-HCW relationships.</p></sec>
</abstract>

Introduction
Healthcare workers (HCWs) are often exposed to mistreatment by patients, which has negative effects on both staff and institutions. To take appropriate action to help HCWs in this context, patient-related social stressors (PSS) should be explored. The purpose of the research was to identify the most pronounced patient behaviour contributing to the social stress (SS) of HCWs, and compare PSS between different HCWs and different types of healthcare institutions.

Methods
750 HCWs from Slovenian public health centres and hospitals participated in the online survey. Although the non-probability sampling was used, the sample was representative according to gender and HCW type (doctors, nurses and other HCWs).

Results
The results show that the most pronounced patient behaviour contributing to the SS of HCWs are attitudes and behaviour of patients that are challenging in terms of what is – from the HCWs’ point of view – considered as acceptable and reasonable (disproportionate patient expectations), and unpleasant, humourless, and hostile patients. HCWs in primary institutions meet less verbally aggressive and unpleasant patients than in tertiary ones. Although among all HCWs less educated ones are more exposed to inappropriate behaviour, doctors are those HCWs who experience more inappropriate behaviour.

Conclusion
Managers should enable HCWs to get comprehensive patient service training, oriented towards improving relationship management and patient-HCW relationships.

Mistreatment by patients: An analysis of the patient-related social stressors among Slovenian healthcare workers

Slovenian Journal of Public Health

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

Neprimerno ravnanje pacientov: Analiza socialnih stresorjev, povezanih z delom s pacienti, med zaposlenimi v Slovenskih zdravstvenih ustanovah

Introduction
Healthcare workers (HCWs) are often exposed to mistreatment by patients, which has negative effects on both staff and institutions. To take...

	Hulbert index of sexual assertiveness
Gender
Male	60 (11.1)
Female	480 (88.9)
Mean age (SD) (n=538)	41.6 (10.5)
Education
High school or less	127 (23.6)
University degree or more	411 (76.4)
No of years in current health institution (n=529)	11.6 (10)
No of working years (n=530)	18.3 (11.1)
HCW
Doctors	118 (22.7)
Nurses	302 (58.2)
Other HCW	99 (19.1)
Institution
Primary	372 (69.7)
Secondary	82 (15.4)
Tertiary	80 (15)

Beta (β)	Ambiguous patient expectations		Disliked patients		Patient verbal aggression		Disproportionate patient expectations
	Std. B	P	Std. B	P	Std. B	P	Std. B	P
Male gender	0	0.956	0.03	0.561	-0.04	0.364	-0.07	0.096
University degree or more	-0.21	<0.001	0.01	0.889	-0.3	<0.001	-0.23	<0.001
Age	0.04	0.405	0.08	0.062	-0.03	0.447	-0.04	0.308
Doctors vs. other HCW	0.15	0.011	0.18	0.003	0.15	0.011	0.15	0.008
Nurses vs. other HCW	0.07	0.201	0.05	0.414	0.1	0.062	0.12	0.04
Primary vs. tertiary	0.04	0.49	-0.13	0.028	-0.15	0.01	0.01	0.83
Secondary vs. tertiary	0.04	0.471	-0.07	0.259	-0.07	0.203	-0.01	0.874

F (P)	3.91 (<0.001)		3.04 (0.004)		8.21 (<0.001)		5.13 (<0.001)

R²	0.05		0.04		0.10		0.07

Mistreatment by patients: An analysis of the patient-related social stressors among Slovenian healthcare workers

Article Category: Original scientific article

Publicado en línea: 18 mar 2021

Páginas: 90 - 96

Recibido: 05 oct 2020

Aceptado: 29 ene 2021

DOI: https://doi.org/10.2478/sjph-2021-0014

Palabras clave
healthcare workers, mistreatment, patients, social stressors

© 2021 National Institute of Public Health, Slovenia

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

Figure 1

Sample description.

Relationships between gender, education, age, HCW type, type of institution, and score on each dimension of the PSS scale (results of the multiple linear regression analysis).

Mistreatment by patients: An analysis of the patient-related social stressors among Slovenian healthcare workers

Article Category: Original scientific article

Publicado en línea: 18 mar 2021

Páginas: 90 - 96

Recibido: 05 oct 2020

Aceptado: 29 ene 2021

DOI: https://doi.org/10.2478/sjph-2021-0014

Palabras clavehealthcare workers, mistreatment, patients, social stressors

© 2021 National Institute of Public Health, Slovenia

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

Figure 1

Sample description.

Relationships between gender, education, age, HCW type, type of institution, and score on each dimension of the PSS scale (results of the multiple linear regression analysis).

Palabras clave
healthcare workers, mistreatment, patients, social stressors