Workplace violence experienced by occupational therapists who visit people in their own homes

Background

Workplace violence is a common experience for many health professionals. However, little is known about the experience of occupational therapists, specifically those that visit people in their own homes, and experience violence in that context. Home visiting is a fundamental component of practice for many occupational therapists and often takes place with the occupational therapist being alone. This study aimed to explore the experience of this group of occupational therapists, their responses to workplace violence such as reporting, and the impact of their experience on their wellbeing.

Method

A cross-sectional online survey was distributed among occupational therapists via NSW Health services and Occupational Therapy Australia with snowball sampling and links on Twitter, LinkedIn, and Facebook. The survey gathered information on demographics, work organisation, exposure to workplace violence, and strategies used to respond to this. Wellbeing was measured using the Abbreviated Maslach Burnout Inventory and the Kessler Psychological Distress Scale.

Results

A total of 101 surveys were returned: 97% (n = 97) were female, the mean age was 39 years, 52% (n = 52) were located in capital cities, and most worked in disability care (47%, n = 47) or aged care (46%, n = 46) and worked full time (60%, n = 60). Only 5% (n = 5) identified that they never worked alone. Of those who experienced violence at least occasionally, 74% (n = 74) reported verbal aggression, 27% (n = 27) physical aggression from clients or family members, 20% (n = 20) physical aggression using objects, 43% (n = 43) verbal sexual aggression, 46% (n = 46) unwanted sexual attention, and 3.2% (n = 3) sexual assault. Moderate to very high distress was exhibited by 26% (n = 26) of respondents, and 71% (n = 71) exhibited moderate to high emotional exhaustion.

Consumer and Community Involvement

As the target participants were occupational therapists, consumer and community involvement was not sought.

Conclusion

This study has demonstrated the exposure of occupational therapists to risks when visiting clients in their homes and identifies the need for risk management, training, and support for occupational therapists working in this environment.

PLAIN LANGUAGE SUMMARY

Occupational therapists often visit people in their own homes to assess their needs and provide interventions. The home is an important environment as this is where functional activities take place. However, occupational therapists can be at risk of workplace violence from clients and their families, especially if they visit clients alone. Clients may be upset and frustrated by their situations and could strike out. We know very little about workplace violence experienced by occupational therapists, and this study used an online survey to explore how commonly this occurs, the type of incidents experienced, the actions that occupational therapists took following the incident, and how these experiences affected their well-being. We found that workplace violence included verbal attacks and physical and sexual violence. Overall, 76.2% of participants reported any kind of violence. The most frequent type of violence was verbal abuse followed by unwanted sexual attention, verbal sexual abuse, and physical violence with and without objects. Three participants reported a sexual assault. However, fewer participants took actions following the incidents such as reporting it informally or formally. This means that workplace violence is likely to be underreported by occupational therapists. We also found that occupational therapists who were exposed to workplace violence reported higher distress, higher cynicism, and lower professional accomplishment, suggesting a risk of burnout. As employers are required to protect the health and safety of their employees, these findings are very important, and the occupational therapy profession should also address them.