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Title: Prevalence and impact of clinical violence towards nursing students in Hong Kong : a cross-sectional study
Authors: Cheung, K 
Ching, SSY 
Cheng, SHN 
Ho, SSM 
Issue Date: 2019
Source: BMJ open, 2019, v. 9, no. 5, e027385
Abstract: Objectives Studies of violence towards nursing students (NSs) have been scattered mainly in the West and Middle East, but to date there have been no studies in Eastern countries. Differences in nursing education systems and cultures might have contributed to variations in incidences of clinical violence. The purpose of this study was to investigate the prevalence, associated factors and impact of clinical violence to NSs. Methods This was a cross-sectional survey study. Convenience sampling was used to recruit university NSs from March to June 2012 in classroom settings in Hong Kong. A valid and reliable questionnaire was used to collect the data. 1297 questionnaires were distributed and 1017 NSs completed questionnaires, with a response rate of 78.41%. Results Of the 1017 NSs, 37.3% (n=379) reported having experienced clinical violence during their nursing studies. The prevalence of verbal abuse (30.6%) was significantly greater than that of physical violence (16.5%). The perpetrators of verbal abuse were predominantly patients (66.8%), hospital staff (29.7%), university supervisors (13.4%) and patients' relatives (13.2%). Patients (91.0%) were the greatest source of physically violent assaults. Compared with those who had experienced physical violence, the NSs who had experienced verbal abuse were more likely not to take action, and not to stop or report the incident, but were also more likely to tell their friends/families. Although the negative effects on emotions, clinical performance and the extent to which they were disturbed by the violence were significantly greater for verbal abuse than that for physical violence, their intention to leave the nursing profession after experiencing either verbal or physical violence was significantly higher after than before the experience (p<0.001). Conclusions Our results found a moderately high prevalence of clinical violence among NSs. Provision and/or reinforcement of appropriate training about clinical violence in the nursing curricula is necessary.
Keywords: Clinical violence
Nursing students
Physical violence
Verbal abuse
Vertical violence
Publisher: BMJ Publishing Group Ltd
Journal: BMJ open 
EISSN: 2044-6055
DOI: 10.1136/bmjopen-2018-027385
Rights: © Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.
The following publication Cheung K, Ching SSY, Cheng SHN, et al. Prevalence and impact of clinical violence towards nursing students in Hong Kong: a crosssectional study. BMJ Open 2019;9:e027385, is available at
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