Threats and violence in Swedish care and welfare--magnitude of the problem and impact on municipal personnel.

The problem of threats and violence at work has received increasing attention in Sweden in recent years. Exposure is especially high among health-care personnel in social services. A nationwide survey of prevalence, work environment and risk situations was conducted. A questionnaire was sent to a stratified sample of 2800 local government employees in the care and welfare sector, working mainly with the elderly or persons with developmental impairments. Seven occupational groups, including supervisors, specialists and other categories of carers, were included, and represented a population of more than 170 000 employees. The response rate was 85%. The results indicated that as many as 51% of the population had been affected by threats/violence, either verbally or physically, over the previous year. Moreover, the results suggest that over 9% of the employees in the care sector experienced acts of violence or threats on a daily basis, and several times a month by 67%. The most vulnerable groups were assistant nurses and direct carers. Verbal threats appear more common (79%), but 66% appear to have experienced physical assaults. Stratified estimates suggest that feelings of anger (41%) and helplessness (31%), but also minor physical injuries (18%), are frequent reactions. Organizational change in the workplace and high workload entailed increased risk. Threats and violence in health-care settings are a major work-environment issue. Greater knowledge of consequences for organization, work situation and health of personnel is needed.