AUTHOR=Díaz Aitor , Utzet Mireia , Mirabent Joan , Diaz Pilar , Ramada Jose Maria , Serra Consol , Benavides Fernando G. 

TITLE=Workplace aggression against healthcare workers in a Spanish healthcare institution between 2019 and 2021: The impact of the COVID-19 pandemic

JOURNAL=Frontiers in Public Health

VOLUME=Volume 11 - 2023

YEAR=2023

URL=https://www.frontiersin.org/journals/public-health/articles/10.3389/fpubh.2023.1070171

DOI=10.3389/fpubh.2023.1070171

ISSN=2296-2565

ABSTRACT=Objectives
Describe the incidence of first aggressions among healthcare workers (HCWs) before and during the COVID-19 pandemic in a Spanish healthcare institution, according to workers’ socio-occupational characteristics and analyze the impact of the pandemic on it.  
Methods 
Retrospective cohort from January 1, 2019 to December 31, 2021 of HCWs working in the institution for at least 1 week each year. Adjusted relative risks (aRR) between periods were estimated with generalized estimating equations negative binomial models. All analyses were sex-stratified. 
Results
The incidence was 6.8% (6.0; 7.8) during the pre-COVID-19 period, 6.0% (5.2; 7.0) during the COVID-19 baseline and 5.1% (4.3; 5.9) during the COVID-19 endline among women, and 4.6% (3.4; 6.1), 5.3% (4.1; 6.8) and 4.4% (3.5; 5.8), respectively, among men. These incidences were significantly higher among male nurses and aides (11.1% (8.0; 15.4), 12.3% (8.9; 16.6), and 9.3% (6.5; 13.3) each period) and psychiatric center workers (women: 14.7% (11.2; 19.0), 15.4 (11.8; 19.8), and 12.4% (9.2; 16.6); men: 12.3% (7.2; 20.0), 17.8% (11.6; 26.2), and 14.3% (8.8; 22.4)).  Women showed a risk of aggression during the COVID-19 endline 23% lower than before the pandemic (aRR=0.77 (0.64; 0.93)), while the risk during the COVID-19 baseline was not different (aRR=0.89 (0.74; 1.06)). 
Conclusions
The COVID-19 pandemic led to an unexpected decrease in first aggressions against HCWs. However, around 5% of HCWs experienced at least one aggression in the last follow-up year. Healthcare managers should continue to increase prevention of aggressions against HCWs, especially among vulnerable groups with a higher incidence.